Physical Activity Steadily Declines From Young Adulthood to Middle Age
MONDAY, July 28, 2025 -- Moderate-to-vigorous physical activity (MVPA) decreases from young adulthood into middle age, with accelerated declines seen within two years prior to a cardiovascular disease (CVD) event, according to a study published online July 23 in JAMA Cardiology.
Yariv Gerber, Ph.D., from Tel Aviv University in Israel, and colleagues examined MVPA trajectories across adulthood, pre-CVD and post-CVD changes, and demographic variations using data from the Coronary Artery Risk Development in Young Adults study initiated in 1985 to 1986 with up to 10 MVPA assessments through 2020 to 2022. Long-term MVPA trajectories were examined across adulthood in a cohort analysis (3,068 participants), while pre-CVD and post-CVD MVPA trajectories were assessed in a nested case-control analysis (236 incident CVD cases matched 1:1 to control participants).
The researchers observed a steady decrease in MVPA from young adulthood into middle age, stabilizing in later years. A more sustained decline was seen in Black men, while the lowest MVPA was consistently reported by Black women. In the nested analysis, MVPA began declining about 12 years before CVD, with accelerated declines seen within two years of the event. The case-control gap persisted post-CVD. Steeper pre-CVD declines were seen in heart failure, and consistently low post-CVD levels were seen across all types of CVD. Cases were more likely than controls to exhibit low MVPA post-CVD, after adjusting for pre-CVD MVPA (odds ratio, 1.78), with the highest risk seen in Black women (odds ratio, 4.52).
"These findings reinforce the importance of preventing age-related declines and promoting post-CVD recovery -- especially among women," the authors write.
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