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BMI and cardiorespiratory fitness predicted mortality in older adults

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Dr X Sui

Correspondence to: Dr X Sui, University of South Carolina, Columbia, SC, USA;


In older adults, do measures of adiposity and cardiorespiratory fitness predict mortality?



prospective cohort study with mean follow-up of 12 years.


healthcare clinic in Dallas, Texas, USA.


2603 people ⩾60 years of age (mean 64 y, 80% men) who completed a maximal treadmill exercise test with ⩾85% of age-predicted maximal heart rate and had body mass index (BMI) ⩾18.5 kg/m2.

Risk factors:

fitness (total treadmill time) and measures of adiposity (BMI, percentage of body fat, fat-free mass, and waist circumference).


all-cause mortality identified through the National Death Index and death certificates.


Risk of death decreased with increasing levels of fitness (table). BMI had a J-shaped association with mortality (table). People with abdominal obesity (waist circumference ⩾88 cm in women and ⩾102 cm in men) had increased mortality, but this did not differ from those with normal waist circumference when adjusted for fitness (table). Percentage of body fat and fat-free mass were not associated with mortality.


In older adults, body mass index and cardiorespiratory fitness were predictors of mortality.


Sui X, LaMonte MJ, Laditka JN, et al. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. JAMA 2007;298:2507–16.

View this table:
Association between cardiorespiratory fitness and measures of adiposity and all-cause mortality in older adults at mean 12 years

Abstract and commentary also published in "ACP Journal Club: Best Evidence for Patient Care" in Annals of Internal Medicine.

Clinical impact ratings: GP/FP/Primary care 6/7; Geriatrics 6/7; Special interest obesity—physician 6/7; IM/Ambulatory care 5/7

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  • Source of funding: National Institutes of Health.