Midlife Fitness Associated With Lower Risk for Depression and CVD Death

These results demonstrate the importance of midlife fitness to prevent depression and subsequent CVD mortality in older age.

Fitness during midlife is strongly associated with lower risk for later-life depression, mortality from cardiovascular disease (CVD), and CVD mortality following incident depression in later life, according to a study published in JAMA Psychiatry.

This single-center, retrospective cohort study included 17,989 individuals, 80.2% of whom were men. There were 2701 cases of depression, 610 cases of CVD death, and 231 CVD deaths following observed depression. Compared with low fitness, a healthy level of fitness during midlife showed strong associations with reduced risk for depression (hazard ratio [HR] 0.84; 95% CI 0.74-0.95), reduced risk for CVD mortality with no prior depression (HR 0.39; 95% CI, 0.31-0.48), and reduced risk for CVD mortality following a depression diagnosis (HR 0.44; 95% CI, 0.31-0.64).

The mean age of participants in this study was 50.0 (SD 8.7) years, and they received Medicare follow-up for an equivalent of 117,218 person-years. Individuals were largely healthy, and those included in the study reported no previous myocardial infarction, depression, or stroke. All underwent preventative medical evaluations during midlife. The participants’ fitness levels were estimated using exercise testing on treadmills. The study was part of the Cooper Center Longitudinal Study, which collected data between 1971 and 2009. 

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The study researchers concluded that “[midlife] fitness is associated with a lower risk for later-life depression, CVD mortality, and CVD mortality after incident later-life depression. These findings suggest the importance of midlife fitness in primary prevention of depression and subsequent CVD mortality in older age and should encourage physicians to consider fitness and physical activity in promoting healthy aging.”


Willis BL, Leonard D, Barlow CE, Martin SB, DeFina LF, Trivedi MH. Association of midlife cardiorespiratory fitness with incident depression and cardiovascular death after depression in later life [published online June 27, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2018.1467