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August 24, 1994

Physical Activity and Risk of Severe Gastrointestinal Hemorrhage in Older Persons

Author Affiliations

From the Department of Gerontology, Catholic University, Rome, Italy (Dr Pahor); the Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, Md (Drs Guralnik, Salive, and Brown); and the Department of Preventive Medicine and Environmental Health, the University of Iowa, Iowa City (Drs Chrischilles and Wallace). This work was completed while Dr Pahor was a visiting scientist at the National Institute on Aging.

JAMA. 1994;272(8):595-599. doi:10.1001/jama.1994.03520080037040

Objective.  —To assess whether regular physical activity is associated with a decreased risk of severe gastrointestinal hemorrhage (GIH) in older persons.

Design.  —Cohort study with 3 years of follow-up.

Setting.  —Three communities of the Established Populations for Epidemiologic Studies of the Elderly.

Participants.  —A total of 8205 persons aged 68 years or older, yielding 22 277 person-years of follow-up.

Measurements.  —The occurrence of severe GIH was defined as either a hospital discharge diagnosis of gastrointestinal bleeding associated with blood transfusion or death during the hospital stay or a nonhospital death with mention of GIH on the death certificate. Physical activity was measured by self-reported frequency of walking, gardening, or doing vigorous physical activity. Those participants doing the activity three times per week or more were compared with the remaining participants. Adjusted relative risks (RRs) of GIH were controlled for age, gender, body mass index, blood pressure, chronic conditions, number of hospital admissions in the past year, and number and types of drugs taken.

Results.  —Severe GIH occurred in 241 participants (rate, 10.8 per 1000 person-years). After adjusting for potential confounding variables, the RRs and 95% confidence intervals (CIs) for severe GIH associated with walking, gardening, and vigorous physical activity were 0.6 (0.4 to 0.8), 0.8 (0.5 to 1.1), and 0.7 (0.4 to 1.2), respectively. The RR associated with a summary variable for the three activities was 0.7 (95% CI, 0.5 to 0.9). These results were consistent after stratifying on health status and disability or by excluding those who were not mobile, ie, not able to walk half a mile or climb a flight of stairs.

Conclusions.  —Regular physical activity is associated with a decreased risk for severe GIH in older persons.(JAMA. 1994;272:595-599)