This news release from a conference put on by 
the European Society of Cardiology (ESC) describes a moderately-sized cohort study that followed elderly people aged 65 and over for 13 years, focusing on the correlation between the level of physical activity and risk of death. Although the release does a thorough job explaining what the researchers did in this study, it inflates the benefits data by reporting figures in terms of relative risk reduction. In addition, it’s unclear what this study brings to the existing scientific knowledge on aging and physical activity, since we found other published research studying this link that’s not mentioned.
But the biggest deficiency is the release’s failure to point out any of the study’s potential biases or limitations. And that’s the very same problem that has already gotten the ESC nominated to our News Release Wall of Shame in the past. The study looked at a group of elderly people, many of whom are likely to have health problems (perhaps unrecognized health problems) that affect both their risk of death and their ability to exercise. Trying to isolate the effects of physical activity in such a group is a very tricky proposition, but the release never expresses so much as a hint of doubt regarding the findings. While we agree that exercise at any age is likely to be beneficial, we think researchers and communications professionals should provide a balanced view of a study’s strengths and limitations in their news releases. Otherwise, news coverage of the study will also reflect a lopsided view of the findings.
Much media attention is focused on spiraling health care costs, which often are incurred later in life by the elderly, since they consume a disproportionate amount of health care services. But studies suggest that the elderly could reduce their health care bills by exercising regularly. If other research sheds light on how exactly regular exercise translates to increased lifespans and better quality of life, clinicians will be able to make better recommendations for their older patients and curb spiraling health care costs at the same time.
Cost is always a concern. But in this case, the release mentions “brisk walking, cycling, swimming or gymnastics” as physical activities, not some fancy exercise devices. So we’ll rate it Not Applicable, although we’d note that some of these activities might not be accessible without a gym membership or other equipment.
The release started off strong by giving the absolute death rate, but thereafter cited relative risk reductions.
For example, the release states: “…starting or restarting physical activity during retirement reduced the risk of death by two-thirds, but in contrast any reduction, even in low levels of activity, exposed the elderly to a higher risk of death.”
But two-thirds of what? And exactly what figure corresponded to a higher risk of death?
Benefits reported as relative risk reductions may inflate the impression of how effective the intervention really is. This is why we give the release a Not Satisfactory rating here, since we prefer news releases to report benefits data in absolute numbers.
Dr. David Hupin comments, “The level of physical activity in the elderly was negatively associated with mortality rate in a “dose-dependent” way.” He also adds, “Even a little [exercise] is good, and more may be better.”
But exercise is painful for many older adults with arthritis or other physical ailments, and can also lead to falls, which aren’t mentioned. We’re not saying this is a major omission, as the release does emphasize the benefits of low doses that are less likely to cause harm. But it’s still not up to our standard.
The news release gives a good overview of the study design, specifying that 1,000 elderly subjects aged 65 and and over were followed for 13 years. It also details the measures in place to monitor physical activity – these so-called MET-h values. We also applaud the reporting of an important health outcome in this news release — “risk of all cause death.”
However, the release doesn’t point out any limitations in the research, and this is a significant omission. Especially since the study examined older adults who are more likely to have health problems, this study has a high risk of being confounded. People with health problems that might ultimately lead to death are probably less likely than healthy individuals to exercise even a little bit. Maybe it’s the fact that these individuals were sick that led them to avoid physical activity, rather than physical activity being responsible for reducing the overall death rate.
In addition, while the release generally refers only to “correlations” between physical activity and lower death rates, it doesn’t explicitly point out that this was an observational study that’s not capable of proving cause and effect. Such a warning is always welcome.
The release does not engage in disease mongering.
The news release does not mention any funding sources for the study or potential conflicts of interest.
The release mentions various forms of exercise and physical activity, and the comparison of very active to inactive (and various levels within these extremes) is made clear. But there is no attempt to broaden the discussion to related factors that might also impact longevity in old age, including diet, body weight, alcohol consumption, and social engagement. This could have been accomplished in a broad sweep with just a few additional words.
It isn’t a big deal that the news release didn’t discuss the availability of exercise methods, since the elderly can pursue any physical activity for at least 15 minutes a day, five days a week. But we’d note that access to some of the activities mentioned (cycling, swimming, gymnastics) might be limited, and the release could have noted that as well.
There have been numerous studies on the benefits of exercise for the general population. Physicians currently recommend exercising for 30 minutes a day for at least five days a week, which “has been shown to reduce the average risk of death by 30%,” according to an uncited source in the news release.
What’s new, says the news release, is that “a correlation between the level of physical activity and risk of death has not been so clearly determined in the elderly.”
But we found these studies online, some going as far back as 1989, that state the association between regular physical activity and decreased mortality in older adults. In addition, recommendations are already in place for older adults, who are urged to exercise moderately and daily by the CDC.
We’re not sure why the physical activity recommendations for the elderly warrant revision, as stated by the release, or what exactly is new with this research.
The news release uses neutral, unbiased language that edges on jargony. Most lay people would not understand the terms “cohort,” “MET-h values” or “meta- analysis.”
Although these terms could have more simply explained, we feel the absence of sensational language merits a satisfactory rating here.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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