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Low cardiorespiratory fitness in young adulthood and future risk of disability pension: a follow-up study until 59 years of age in Swedish men
  1. Rynaz Rabiee1,
  2. Emilie Agardh1,
  3. Katarina Kjellberg2,3,
  4. Daniel Falkstedt1
  1. 1Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  2. 2Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
  3. 3Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Daniel Falkstedt, Department of Public Health Sciences, Karolinska Institutet, Stockholm 17177, Sweden; daniel.falkstedt{at}


Background There is a strong belief in the potential of increased physical activity to improve the health of populations. The objective of the present study was to estimate the association between low cardiorespiratory fitness in young adulthood and subsequent health impairment until middle age, measured by disability pension.

Methods The study utilised data on cardiorespiratory fitness and a number of covariates (social background, health behaviours and psychological characteristics) from the Swedish Conscription Cohort of 1969/1970 including 49 321 men born in 1949–1951, and data on disability pension from 1971 to 2008 (20–59 years of age) through record linkage with two national insurance databases. Cox proportional-hazards regressions yielded hazard ratios (HR) with 95% confidence intervals (CI).

Results Having low-level or mid-level cardiorespiratory fitness in late adolescence was associated with an increased HR of disability pension across the follow-up (HR for low fitness: 1.85, CI 1.71 to 2.00; HR for mid-level fitness: 1.40, CI 1.31 to 1.50). The association was stronger with earlier disability pensions than with later disability pensions, which was also seen after multiple confounding adjustments. At the same time, these adjustments revealed considerable confounding of the association by individual differences in psychological characteristics in particular.

Conclusions Lower levels of cardiorespiratory fitness in young adulthood were found to be associated with an increased HR of disability pension throughout the follow-up until 59 years of age, even after adjustment for important confounding factors measured in late adolescence. Increased physical fitness may thus have a lowering effect on the risk of disability pension.

  • Cohort studies

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