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  • Publish Date：2026-08-19
NYCU-Led Study Links Better Fitness to 61% Lower Mortality Risk in Older Adults
NYCU-Led Study Links Better Fitness to 61% Lower Mortality Risk in Older Adults
Maintaining strength, balance and mobility may help older adults preserve independence and age more healthily, an NYCU-led study suggests.
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Edited by Chance Lai
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A seven-year study of 13,423 adults aged 65 and older in Taiwan found that those in the top 20% of overall fitness had a 61% lower risk of death from any cause than those in the bottom 20%.

Researchers at National Yang Ming Chiao Tung University (NYCU) conducted the study in collaboration with colleagues from Chung Yuan Christian University, National Taiwan University of Sport and several other academic institutions. The study, titled  “Physical Fitness and All-Cause Mortality in Older Adults,” was published on August 10 in JAMA Network.

The association remained significant after the researchers accounted for age, sex, socioeconomic status, physical activity, body mass index and chronic health conditions. The findings suggest that healthy aging depends not only on preventing disease but also on maintaining strength, balance and mobility.
 
Li-Lin Liang, an associate professor at NYCU’s Institute of Public Health, led the cross-university research team behind the seven-year study.
Li-Lin Liang, an associate professor at NYCU’s Institute of Public Health, led the cross-university research team behind the seven-year study.

Simple Tests Offer a Broader Picture of Health

The researchers analyzed data from adults aged 65 and older who completed standardized fitness assessments in Taiwan between 2015 and 2016. Their health records were tracked through the end of 2022, with a median follow-up of seven years. During that period, 1,631 participants, or 12.2% of the study population, died.

Participants completed seven functional fitness tests covering four areas: cardiorespiratory endurance, muscular strength, flexibility, and balance and agility. The tests included stepping in place for two minutes, performing repeated arm curls and chair stands, reaching forward from a seated position, reaching behind the back, standing on one leg with the eyes open, and rising from a chair to walk around a marker before sitting down again.

Rather than measuring athletic performance, these exercises reflect abilities that older adults rely on in daily life, such as standing up without assistance, walking safely and maintaining balance.

Balance, Mobility and Leg Strength Stand Out

Balance and agility showed the strongest associations with survival, followed by lower-body strength and cardiorespiratory fitness. Compared with participants in the lowest-performing 20%, those in the highest-performing group on the 8-foot up-and-go test had a 59% lower risk of death. The test requires participants to rise from a chair, walk 8 feet, turn around, return and sit back down.

Top performers on the one-leg stance test had a 50% lower risk of death, while those who performed best on the chair-stand test had a 45% lower risk. Participants with the best results on the two-minute step test had a 42% lower risk.

The findings highlight the importance of maintaining the ability to stand, walk and respond to changes in balance. These abilities are central to independent living and may also help reduce the risk of falls, fractures and related complications.

 

Older Adults Do Not Need to Become Athletes

The relationship between fitness and mortality was not always linear. For several measures, mortality risk declined most sharply as participants moved beyond the lowest fitness levels, with the reduction leveling off at higher levels.

This suggests that older adults may not need to achieve exceptional fitness to see a meaningful difference. Moving from a low to a moderate level of fitness may offer the greatest potential benefit. “The findings are especially meaningful for older adults who may feel that it is too late to improve their health,” said Li-Lin Liang, an associate professor at NYCU’s Institute of Public Health and a co-corresponding author of the study.

“Even if someone starts with limited physical capacity, becoming more active and gradually improving strength, balance and mobility may bring meaningful health benefits.

Looking Beyond a List of Diseases

Liang said the findings support a more comprehensive view of healthy aging. Health assessments should consider not only which diseases an older person has but also how much “physiological reserve” that person retains. Physiological reserve refers to the body’s capacity to maintain function, respond to stress and recover from illness or injury. An older adult may have one or more chronic conditions yet remain physically capable and independent.

“An older adult may have a chronic disease but still be able to walk a considerable distance and maintain good balance and muscle strength,” Liang said. “That person has a very different level of physiological reserve from someone whose mobility has already declined substantially,” Liang added that physical fitness is a valuable indicator of overall health because it reflects the status of more than one organ or disease. Instead, it captures the combined effects of daily functioning, disease burden and physiological aging.

Rethinking What It Means to Age Well

Because the study was observational, it identified an association but could not prove that better fitness directly extends life. Fitness was also measured only once, and information on certain factors, including participants’ smoking history, was unavailable.

Despite these limitations, the consistency of the findings across multiple fitness measures underscores the value of looking beyond disease diagnoses when assessing the health of older adults. Liang said the results support continued efforts to promote fitness among older adults and incorporate simple functional assessments into routine care. Such tests could help health professionals detect declining mobility earlier and develop strategies to preserve strength, balance and independence.

The study offers a practical message: Healthy aging does not require becoming an athlete. For older adults, retaining the ability to rise from a chair, stand steadily and walk with confidence may be a more meaningful goal—and those starting at the lowest fitness levels may have the most to gain from taking the first step.

Better performance in balance, mobility, lower-body strength and cardiorespiratory fitness was associated with a substantially lower mortality risk among older adults.Better performance in balance, mobility, lower-body strength and cardiorespiratory fitness was associated with a substantially lower mortality risk among older adults.
文/公關組 照片/研究團隊
資訊圖/國際宣傳辦公室

想要健康長壽，除了少生病，還要有足夠的體適能。臺灣一項針對逾萬名65歲以上長者進行的大型追蹤研究發現，體適能與死亡風險有關。其中，整體體適能表現最佳的前20%長者，相較於表現最差者，死亡風險大幅降低61%。

這項由臺灣多所學術與醫療機構合作的研究，花費近七年追蹤超過一萬名65歲以上長者。其研究結果明確指出，心肺耐力、肌力、柔軟度、平衡與敏捷等多項體適能表現，皆與後續死亡風險密切相關，既使在校正了年齡、性別、社經地位、慢性病等因素後，兩者的關聯依然明顯。

研究透過多項功能性體適能測試，評估長者的身體能力，包括抬腿踏步、椅子坐立、坐姿前彎、開眼單腳站立、起身行走等，分別反映心肺耐力、肌力、柔軟度、平衡及敏捷能力。

結果顯示，平衡及敏捷與下肢肌力尤其重要。包含從座椅上起身行走，以及開眼單腳站立等項目中，表現較佳長者的死亡風險可以降低超過五成。這也反映出長者能否自行起身行走，不僅與日常生活息息相關，也有助於降低跌倒骨折的風險。

值得注意的是，研究發現體適能與死亡風險並非單純線性關係。換句話說，長者並不需要把體能練到頂尖才能看到健康成效。數據顯示，當體適能從較差程度改善至中等程度時，所帶來的健康效益最為明顯。
 



研究主持人、公共衛生研究所副教授梁立霖表示，這項結果對高齡長者具有重要意義。即使原本體能不好，只要開始增加活動、逐步改善肌力、平衡及行動能力，就有實質健康益處。

梁立霖也說，這項研究支持一個更全面的健康老化觀念。評估高齡健康不應只聚焦於罹患了哪些疾病，更應關注長者還保有多少「生理儲備」(physiological reserve)，以及實際還能做到哪些日常動作。雖然只是相關性研究，但結果支持政府持續推廣體適能。

「一名長者即使罹患慢性疾病，但如果還能走得遠，並維持良好平衡與肌力，與另一名活動能力已明顯下降長者的生理儲備截然不同。」梁立霖表示，體適能之所以值得重視，在於它不只是反映單一器官或特映疾病，而是一種綜合性的健康指標，可以呈現出一個人的日常活動能力、疾病負擔與生理老化程度。

這項研究本月發表於《JAMA Network》國際期刊，發表後也受到國際媒體關注。研究結果再次提醒，對長者而言，健康的目標不必是成為運動高手，而是盡可能維持起得來、站得穩、走得動的行動能力。從每天多走一點、多活動一點，就是邁向健康長壽的重要一步。

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