Cardiorespiratory Fitness and Adiposity as Mortality Predictors in Older Adults

I think this study:

JAMA — Abstract: Cardiorespiratory Fitness and Adiposity as Mortality Predictors in Older Adults, December 5, 2007, Sui et al. 298 (21): 2507

deserves its own post, and is significant when thinking of patient-centered health information technology. Why? Because in demonstrating an association with fitness and mortality (death) that is independent of adiposity (fatness – I love medical terminology, don’t you?), a change in focus of our health system is suggested, in my opinion.

Instead of tracking a measure that’s potentially hard to move, and with slow fluctuations, it’s possible that we should be tracking a different measure that’s easy to move, and with significant fluctuations – physical activity. It may be more important that patient-centered health information technology allow patients to track steps per day or some other proxy for active movement, on a regular basis, rather than a periodic weight check. And it may be more important to have a PHR implemented in the first place, because coming to see the doctor for a periodic weight check may not be good enough anymore.

One thing that this study supports in my own practice of medicine is my response to the patient who states that they have stopped exercising due to a symptom or medical condition (physical or emotional). I consider a history of “I’ve stopped exercising because of X” as dangerous as “I have chest pain” and treat it as serious as that.

I think that in the long run, stopping exercise is probably as dangerous as chest pain, if not more dangerous. I think this study backs up that idea.

Ted Eytan, MD