Even fewer than 10,000 steps a day protect seniors from…

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Amherst, Massachusetts – Seniors who walk 6,000 to 9,000 steps a day are less likely to develop cardiovascular disease. This came up in a meta-analysis Circulation (2022; DOI: 10.1161/­MOVEMENT­TIONAH.122.061288) out.

Most people today have a smartphone or a fitness bracelet that measures their daily step count. According to a widespread urban legend, a positive effect only occurs from 10,000 steps a day, which older people in particular can no longer manage.

The US Steps for Health Collaborative evaluated the results of eight prospective observational studies in which 20,152 participants determined their daily step count. The younger participants, under the age of 60, walked an average of 6,911 steps per day. For seniors aged 60 plus, the average was 4,323 steps.

In the following years, the 12,741 seniors had 1,210 serious cardiovascular events such as a fatal or non-fatal heart attack, stroke or heart failure.

Amanda Paluch of the University of Massachusetts at Amherst and collaborators divided the seniors into 4 quartiles based on the number of steps taken. The top quartile walked an average of 9,259 steps per day. Here, 187 cardiovascular events occurred compared to 457 events in the bottom quartile with an average of just 1,811 steps per day.

Paluch and co-workers find an adjusted hazard ratio of 0.51, which is highly significant with a 95% confidence interval of 0.41 to 0.63. In other words: the older people who walked vigorously fell ill only half as often as the older people who were sedentary.

However, a protective association was also evident in quartiles 2 and 3, who walked an average of 3,823 and 5,520 steps per day, respectively. Paluch et al. determine an adjusted hazard ratio of 0.80 (0.69-0.93) for the 2nd quartile and an adjusted hazard ratio of 0.62 (0.52-0.74) for the 3rd quartile. Thus, seniors in these groups had reduced cardiovascular disease rates by 20% and 38%, respectively.

The benefits start at fewer than 10,000 steps per day, writes Paluch. The majority of seniors, for whom 10,000 steps is an unattainable goal, could do something for their health with fewer steps.

However, the usual caveats apply. Observational studies can never unequivocally prove a benefit. It is possible that some participants were no longer motivated or unable to engage in physical activity due to pre-existing conditions, and that these pre-existing conditions are responsible for the cardiovascular events.

The researchers tried to rule out this bias in the results by comparing other properties.

Information was available to them on age and gender, ethnicity, education and income, body mass index, pedometer wear time, some lifestyle factors (e.g. smoking, alcohol consumption) and chronic diseases such as diabetes, high blood pressure, high cholesterol levels as well for the subjective assessment of health and bodily functions. This information was included in the hazard ratio calculations.

The causality is also underlined by a dose-response relationship: the more steps the seniors took per day, the lower their cardiovascular risk. The effect of the first 6,000 steps seems to be greatest. Again, this could encourage seniors to exercise daily.

Incidentally, the meta-analysis found no clear protective association for younger people (under 60 years of age). However, this could be due to the fact that cardiovascular diseases are significantly less common at this age. © rme/aerzteblatt.de

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