Exercise, Disabilities in Activities of Daily Living and Physical Performance During the Last 6 Years of Life in China: A Cohort Study

Background: Physical performance impairment and disability are common in the elderly. As human longevity increases, maintaining their independent living ability and healthy physical function are meaningful and necessary. This study aimed to investigate the extent of the effect of exercise duration and its cessation on disability and physical performance of older Chinese adults during their last 6-yr before death. Methods: Deceased older populations from the Chinese Longitudinal Healthy Longevity Study interviewed during 1998-2014and died during 2005-2014 were included to be divided into long-term non-exercising group (NN), non-exercising to exercise group (NY), exercise to non-exercising group (YN), or long-term exercise group (YY). Disability and physical performance were measured by using the activities of daily living (ADL) scale and three objective performance-based tests every three years. And the differences of four groups were compared using logistic regression analyses. Findings 7384 participants were included(NN: 3708; NY: 1017; YN: 1622; and YY: 1037). Compared with NN group, YY group had lower risk of having moderate (odds ratio [OR]=0·48, 95% confidence interval [CI] 0·30–0·77; p =0·02) and severe (OR=0·13, 95% CI 0·09–1·89; p <0·0001) disability after adjustment for the various confounding factors; YN group had higher risk to have moderate disability (OR=1·68, 95% CI 1·28–2·25; p <0·0001), but no significant difference in objective physical performance. Interpretation: Exercise may be beneficial in decreasing disability risk and physical performance impairment in older adults before death. However, these benefits may be lost upon the cessation of exercise. Funding Statement: None. Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: The CLHLS was approved by the Research Ethics Committees of Peking University and Duke University (IR1052-13074). The survey got informed consent prior to the investigation from all the participants. All data sources (except those protected by data agreement) are publicly available online.