A study published in the journal Scientific Reports shows that physical activity can significantly reduce the risks of all-cause mortality and cardiovascular disease mortality in older adults with low socioeconomic status.
Study: Association of physical activity and socio-economic status on mortality in older adults: a retrospective cohort study of KNHANES-mortality linked data. Image Credit: Glowonconcept / Shutterstock
Background
Socioeconomic status, including financial, educational, and occupational status, can significantly influence an individual’s health status by creating health inequalities across social classes.
Existing evidence indicates that socioeconomically deprived older adults exhibit a considerably higher rate of all-cause mortality than their peers with higher educational and economic status.
Studies have also found associations of low socioeconomic status with cardiovascular risk factors and treatment delay, which collectively increase the risk of cardiovascular disease-related mortality.
The risk of all-cause and cardiovascular mortality can be reduced by restricting unhealthy lifestyle factors, including unhealthy diet, lack of physical activity, and smoking and alcohol-drinking habits. Among elderly populations, regular physical activity has been consistently associated with healthy aging and a lower mortality risk.
In South Korea, only 7% of older adults are physically active, and only 16% meet the physical activity guidelines. Moreover, the most significant proportion of premature deaths due to unhealthy lifestyles has been observed among older South Korean adults.
In this study, scientists have investigated whether meeting physical activity guidelines can reduce mortality risks in elderly individuals belonging to different socioeconomic groups in South Korea.Study design
The study evaluated the combined impact of physical activity and socioeconomic status on the risk of all-cause mortality and cardiovascular disease mortality.
The analysis included data from elderly Korean individuals who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) between 2007 and 2013.
Mortality data, including the cause of death, was collected from Statistics Korea (2019), a government organization responsible for providing basic information for establishing national welfare and healthcare policies.
The information on socioeconomic status included household income and educational background. The level of physical activity was calculated using the Korean version of the International Physical Activity Questionnaire.
Appropriate statistical analyses were carried out to investigate the associations of physical activity and socioeconomic status with the risk of mortality. Several confounding factors were adjusted in the analyses, including demographic characteristics, smoking and drinking habits, and chronic comorbidities (hypertension, diabetes, and dyslipidemia).
Important observations
The study population included a total of 6,945 participants aged 71 years on average. During the study follow-up period, 1,509 all-cause mortality and 332 cardiovascular disease mortality were recorded.
Regarding household income, 52.5% of participants belonged to the low-income group, 25% to the lower-middle income group, 12.7% to the upper-middle income group, and 9.6% to the high-income group.
Regarding educational background, 69.4% of participants had elementary school, 11.2% had middle school, 12.7% had high school, and 6.7% had college degrees.
Mortality risk analysis
The study found a significantly lower mortality risk in the high-income group compared to that in the low-income group.
A significantly lower all-cause mortality risk was observed in participants with higher educational status (college degree) than those with lower educational status (elementary school degree).
A significantly lower all-cause and cardiovascular mortality risk was observed in participants with higher physical activity levels compared to those with lower levels of physical activity.
The stratified analysis by socioeconomic status revealed a significant beneficial impact of physical activity on all-cause and cardiovascular mortality risk reduction among low-income participants and participants with lower educational status (elementary school or middle school degree).
Considering the combined impact of physical activity and socioeconomic status, a significantly lower risk of all-cause mortality was observed in all higher-income groups compared to the low-income group for participants with lower physical activity levels. However, no significant association was observed between physical activity and cardiovascular mortality risk in the upper-middle income group and high school education group.
Study significance
The study finds that a sufficient level of physical activity (meeting the international physical activity guidelines) can significantly reduce the risk of all-cause and cardiovascular disease mortality in elderly Korean individuals with varied socioeconomic status, including those with lower financial and educational status.
The study findings indicate that socioeconomic status is significantly associated with the risk of mortality among elderly individuals aged 65 years or above and that the level of physical activity can potentially modify this association.
The study highlights the importance of physical activity in reducing mortality risk and promoting healthy aging among elderly individuals with poor socioeconomic status. The scientists believe that their observations would serve as a reliable basis for developing physical activity-based interventions to improve public health.
Additionally, the study suggests that targeted government interventions could promote physical activity among socioeconomically disadvantaged groups, ultimately helping to mitigate health inequalities.
Journal reference:
- Lee S. 2024. Association of physical activity and socioeconomic status on mortality in older adults: a retrospective cohort study of KNHANES-mortality linked data. Scientific Reports, DOI: 10.1038/s41598-024-62216-7, https://www.nature.com/articles/s41598-024-62216-7