May 18, 2026
Diannie Chavez/Imagn Images
Middle-aged adults with higher cardiorespiratory fitness, a metric measured by treadmill tests, may avoid Alzheimer's and diabetes longer than their less fit peers. The image above was taken at Canyon Ranch in Tucson, Arizona.
Staying in shape in middle age may reduce the number of illnesses later in life or delay their onset, a new study finds.
Physical fitness has long been associated with longer lifespans. But researchers based in Texas and Boston sought to chart its relationship with healthy aging. Drawing on data from 24,576 participants, they found those with high to moderate cardiorespiratory fitness before the age of 65 not only lived longer, but remained in good health longer and had fewer major diseases than those with low fitness scores.
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The onset of chronic conditions like stroke, diabetes and Alzheimer's disease occurred at least 1 1/2 years later, on average, for the men and women with high cardiorespiratory fitness — a measure of how well your heart and lungs can supply oxygen during exercise.
The fittest participants also extended their "health span," or years of healthy living, by an average of 1.3 years compared to those in the worst shape. Men with high fitness levels had 9% fewer diseases after the age of 65, and women had 12% fewer diseases. In terms of lifespan, men in the highest fitness group generally had a 3% longer life, translating to 2.3 years, than those with low readings. Women averaged a 2% longer lifespan, or an extra 1.4 years.
Since cardiorespiratory fitness is determined by treadmill tests in a medical setting, it is generally considered a more reliable marker of health than self-reported figures. For this study, participants' endurance was measured at the Cooper Clinic in Dallas between 1971 and 2017. Individuals were, on average, 48 years old at the time of the clinic visit and later enrolled in the Medicare Fee-For-Service program. They were all part of the Cooper Center Longitudinal Study, which has been tracking thousands of Americans' health for the past 55 years.
The researchers argued that "addressing aging-related disease broadly, rather than preventing or treating single conditions" will become increasingly vital as baby boomers age. Older Americans are expected to outnumber children for the first time by 2030, according to U.S. Census projections. Given this population shift, delaying disease and extending health spans presents not just individual benefits but national economic ones. Patients with multiple chronic conditions currently account for 71% of all U.S. healthcare spending and 93% of Medicare spending.
As the researchers noted, their sample had limitations. Subjects skewed heavily white (97.6%) and male (75.1%), and all had access to preventative health care, making it hard to generalize the findings for the entire U.S. population. But it adds to the growing body of evidence that consistent cardio exercise is key to healthy aging.
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