LAUSR

Objectives To examine associations between long-term (11–22 years) adherence to physical activity recommendations and mortality from all causes and from cardiovascular disease. Design Prospective population-based study with repeated assessments of self-reported physical activity (1984–86, 1995–97 and 2006–08) and follow-up until the end of 2013. Setting County of Nord-Trøndelag, Norway. Participants Men and women aged ≥20 years; 32 811 who participated in 1984–86 and 1995–97; 22 058 in 1984–86 and 2006–08; 31 948 in 1995–97 and 2006–09 and 19 349 in all three examinations (1984–1986, 1995–95 and 2006–08). Main outcome measures All-cause mortality and cardiovascular disease mortality from the national Cause of Death Registry. Results Compared with the reference category comprising individuals who adhered to the physical activity recommendations (≥150 min of moderate intensity or ≥60 min of vigorous intensity physical activity per week) over time, individuals who remained inactive (reporting no or very little physical activity) from 1984–86 to 1995–97 had HRs (95% CI) of 1.56 (1.40 to 1.73) for all-cause mortality and 1.94 (1.62 to 2.32) for cardiovascular disease mortality. Individuals who were inactive in 1984–86 and then adhered to recommendations in 2006–08 had HRs of 1.07 (0.85 to 1.35) for all-cause mortality and 1.31 (0.87 to 1.98) for cardiovascular disease mortality. In a subsample of individuals who participated at all three time points, those who were inactive or physically active below the recommended level across three decades (1984–86, 1995–97 and 2006–2008) had an HR of 1.57 (1.22 to 2.03) for all-cause mortality and 1.72 (1.08 to 2.73) for cardiovascular disease mortality. Conclusion Individuals who remained, or became, physically inactive had substantially greater risk of all-cause and cardiovascular disease mortality compared with those who met the physical activity recommendations throughout the lifespan.