By: Thomas Pickering, MD, DPhil, FRCP, Director of Integrative and Behavioral Cardiology Program
of the Cardiovascular Institute at Mount Sinai School of Medicine, New York.

The benefits of exercise in older people have not been clearly identified. In this study 707 retired men (a sample of the men enrolled in the Honolulu Heart Program) aged between 61 and 81 were evaluated between 1980 and 1982, and followed for 12 years. The assessment included cardiovascular risk factors such as blood pressure and cholesterol and also a record of how much the men walked every day. Only nonsmoking men were included in the study.

During the twelve-year follow-up period, 208 of the men died. After allowing for differences in age, men who walked less than one mile (1.6 km) a day were nearly twice as likely to die as men who walked more than 2 miles (3.2 km). Men who walked between 1 and 2 miles a day had intermediate death rates. These differences in life expectancy could not be explained by differences in blood pressure or cholesterol. Walking appeared to protect not only against cardiovascular disease, but also against cancer, which was actually the most common cause of death: 13.4 percent of the men who walked less than one mile a day died of cancer, as compared to 5.3 percent of those who walked more than two miles.

Doctor's comments

These are dramatic results. Few, if any, medical treatments can claim to halve the death rate in old people, and what could be easier or simpler than walking? The explanation for the large reduction in the overall death rate was that walking not only halved the death rate from cardiovascular disease, but had the same effect on cancer deaths. This of course was unexpected and not easy to explain. All the men were considered to be in good health when they entered the study, and none of them smoked, so it remains a mystery. Whatever the explanation, the lesson is that you are never too old to exercise.

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