Physical activity, morbidity and mortality in twins: a 24-year prospective follow-up

Abstract

The aim of this study was to find out whether persistent leisure-time physical activity, adjusted for genetic liability and childhood experiences, protect against occurrence of specific chronic diseases and all-cause mortality. Study design was a 24-year prospective follow-up after 6-year physical activity discordance in twin pairs. From 5663 healthy adult twin pairs, 146 pairs (including 29 mozygotic) discordant for both intensity and volume of leisure physical activity at baseline in both 1975 and 1981 were systematically identified.Mortality and occurrence of chronic diseases (diabetes, hypertension, coronary heart disease defined according to reimbursable medication status) were followed for the period 1.1.1983 -31.12.2006 for mortality and 1.1.1983 -31.12.2004 for diseases. By end of follow-up, 19 inactive and 10 active co-twins had died. In the whole sample, HR of death adjusted for social class was 2.08 (95 % CI 1.06 -4.09) for inactive vs. active co-twins, the HR being 2.67 (95 % CI 1.15 -6.20) among DZ pairs with no mortality difference among the smaller number of discordant MZ pairs. The reimbursable medication analyses showed a tendency of higher risk for inactive vs. active co-twins. Among DZ pairs, HR of diabetes medication adjusted for social class was 2.73 (95 % CI 0.62 -12.00) and HR of hypertension medication was 2.14 (95 % CI 0.94 -4.89). This study supports the earlier findings that physical activity is associated with reduced mortality. However the difference was seen only in DZ pairs and therefore some residual genetic confounding effects on mortality cannot be excluded.

Cardiovascular Disease and All-Cause Mortality in Male Twins With Discordant Cardiorespiratory Fitness: A Nationwide Cohort Study

“…However, the association between self-reported PA and mortality has previously been evaluated in twin studies with somewhat inconclusive results. In studies based on the Finnish Twin Cohort, lower risk of mortality was observed in twins with higher levels of self-reported PA ( 34 , 35 ). However, the associations were significant only in the subcohort of dizygotic twins, which might indicate residual genetic confounding or lack of statistical power.…”

Impact of body size and physical activity during adolescence and adult life on overall and cause-specific mortality in a large cohort study from Iran

“…Physical activity during childhood and adolescence seems to play a modest role in adult disease, and this effect seems to be short lasting and disappear after some time [40]. In the Finnish Twin Cohort Study [15], co-twins with less physical activity had increased adult mortality, but the effect was only seen in dizygotic (and not monozygotic) twins, and so the authors could not exclude residual genetic confounding. Longitudinal studies such as the Oslo Youth Study [14], and The Amsterdam Growth and Health Longitudinal Study [41] have found no evidence for a beneficial effect of physical activity during adolescence beyond the age of 40.…”

“…The effect of physical activity on mortality has also been shown in several studies, yet there is not enough information about the effects of life-course activity on adult morbidity and mortality [14], especially in low- and middle-income countries. While some investigators have shown long-term effects of physical activity during early life on mortality and health outcomes [15], others believe that this effect fades after the age of 40 [14]. …”

Physical Activity at Age of 20-64 Years and Mobility and Muscle Strength in Old Age: A Community-Based Study

“…Grip strength is a signifi cant determinant of functional performance ( 2 ), but good balance reduces the risk of fall-related injuries in older people ( 3 ). Conversely, an inactive lifestyle is linked to an increased risk of death and disability ( 4 ).…”