These Basic Fitness Tests Could Predict Your Longevity

The study offers a framework that doctors and patients can utilize to track markers of longevity over time. “This gives us very specific information we can use,” says James Powers, MD, a professor of geriatric medicine at Vanderbilt University Medical Center in Nashville, Tennessee, who wasn’t involved in the study.

The study found that cardiorespiratory fitness, muscular strength, and balance and agility all had a connection to longevity. Surprisingly, one area of fitness that people often focus on, flexibility, was not linked to longer lifespan.

Study Looked at 4 Main Areas of Fitness

Published in the journal JAMA Network Open, the study analyzed nationwide health and fitness data from more than 13,000 Taiwanese adults ages 65 and older who completed standardized fitness tests between 2015 and 2016. Over the seven-year study period, about 1,600 subjects died.

• Cardiorespiratory Fitness To measure heart and lung health, participants completed a two-minute step test, where they alternated lifting their knees up and down to a set height. The “score” was how many steps they could take.
• Muscular Strength Two 30-second tests measured this area of fitness. To measure upper body strength, adults performed as many arm curls as possible within the allotted time. For lower-body strength, they crossed their arms over their chest and alternated between sitting and standing.
• Flexibility In the so-called back-scratch test, participants reached one arm up and back and the other down and behind. The “score” was the overlap or gap between the middle fingertips of both hands reaching behind the back. In a second evaluation, a chair sit-and-reach test, participants reached both middle fingertips toward the toes of one extended leg with the heel on the floor, leaving the other leg bent.
• Balance and Agility To test balance, researchers instructed participants to stand on one leg with their eyes open for up to 30 seconds. To assess agility, they had participants rise from a chair, walk eight feet, go around a cone, return, and sit at a fast pace — a test called the “8-foot up-and-go.”

Better Fitness Tied to Lower Risk of Early Death

After analyzing the data, the researchers discovered that people who scored highest on the cardio, strength, and balance-agility tests had a 39 percent lower risk of dying during the study period compared with those who scored lowest. Flexibility scores, however, did not seem tied to lifespan.

The lowered risks varied by test performance:

• Better cardio scores were tied to a 58 percent lower risk.
• Better lower-body strength (measured by the sitting-standing test) was tied to a 55 percent lower risk.
• Better balance scores were tied to a 50 percent lower risk.
• Better agility scores were tied to a 41 percent lower risk of early death.

“Physical fitness reflects how multiple body systems work together,” says study coauthor Li-Lin Liang, PhD, a researcher at the Institute of Public Health in the College of Medicine at the National Yang Ming Chiao Tung University in Taiwan. “It captures the cumulative effects of habitual activity, illness, and biological aging. In other words, a person’s physiological reserve and what they can functionally do, rather than simply which diagnoses they have accumulated.”

These tests also reflect things people may need to do in their daily life, Dr. Powers says. While physical fitness has been linked to longevity for decades, the findings provide a clear way to measure this through simple testing, he points out.

“This provides excellent detail and has some easy tests that can be performed in an office setting,” Power says. People can also do these at home to get a sense of where they stand, he adds.

What Mattered Most and Least for Longevity

Cardio fitness tends to be the biggest predictor of mortality, as the study results suggest, Powers says. “People often die from cardiovascular disease,” he says. “Being flexible doesn’t typically impact that risk.”

While flexibility is a major focus in certain forms of exercise, such as yoga and Pilates, the researchers didn’t find a link between higher flexibility and longer life.

“I’m not too worried about flexibility,” Powers says. “It often improves with other areas of fitness. By itself, it doesn’t relate to fitness the way some of these others do.”

Fitness May Better Predict Lifespan Than Disease Alone, According to Doctors

Doctors will often look at whether someone has these diseases when trying to determine their lifespan and risk of early death, Dr. Liang says. “These measures tell us which conditions a person has accumulated, but they tell us less about what that person can still physically do,” she says. “They may also be less informative for older adults who have not yet developed overt disease or disability.”

These fitness tests “look at things from a different standpoint,” Power says. “If someone has a bad heart, that’s a bad indicator of lifespan,” he continues. “On the other hand, if we know a person’s functional ability, too, we can adapt lifestyle choices to try to improve their health.”

The tests may also help doctors better assess patients’ overall health, regardless of disease, Powers says. “There is a severity of illness, and it can be difficult at times to assess risk and future longevity,” he says. “These types of tests give us specific information.”

The Study Has Strengths and Limitations

The study analyzed very detailed information from a relatively large group of people, Powers points out. But there are a few limitations.

Because the study was observational, it can’t prove that people with lower scores on fitness tests had shorter lifespans; it simply found a link. The participants’ physical fitness was measured at a single point in time, making it hard to know whether it changed over time.

The researchers also didn’t examine how the participants died, making it difficult to know if their fitness may have been a potential factor. Smoking status also wasn’t recorded.

How to Improve Your Fitness With These Measures

Powers doesn’t suggest trying to improve your fitness solely to excel at these tests. But he does recommend focusing on cardiorespiratory fitness for overall health and longevity.

If you haven’t been physically active, it’s usually helpful to start with small amounts of exercise and work your way up, according to Albert Matheny, RD, CSCS, cofounder of SoHo Strength Lab in New York City. “Walking is always a good baseline exercise,” he says. “You can also bike if you need something lower-impact.” From there, he suggests increasing the speed, intensity, and distance of your exercise to increase fitness over time.

Liang stresses that doing what you can to meet physical activity guidelines should help to improve your test performance and, potentially, lifespan. “What our findings do suggest is that physical fitness is a potentially modifiable marker of physiological reserve, rather than simply a fixed consequence of aging,” she says. “Starting with small amounts and building up gradually is reasonable, particularly for people who have been inactive.”