The association among cardiorespiratory fitness (“fitness”), adiposity, and mortality in older adults was examined in data from 2603 adults aged ≥60 years who completed a baseline health examination during 1979–2001. 450 deaths occurred during a mean 12-year follow-up and 31,236 person-years of exposure. Adjusted death rates per 1000 person-years were 13.9, 13.3, 18.3, and 31.8 across BMI groups of 18.5–24.9, 25.0–29.9, 30.0–34.9, and ≥35.0, respectively (p=0.01 for trend); 13.3 and 18.2 for normal and high waist circumference (≥88 cm in women; ≥102 cm in men) (p=0.004); 13.7 and 14.6 for normal and high percent body fat (≥30% in women; ≥25% in men) (p=0.51); and 32.6, 16.6, 12.8, 12.3, and 8.1 across incremental fifths of fitness (p<0.001 for trend). The association between waist circumference and mortality persisted after adjusting for smoking, baseline health status, and BMI (p=0.02) but not after additional adjustment for fitness (p=0.86). Fitness predicted mortality risk after further adjustment for smoking, baseline health, and either BMI, waist circumference, or percent body fat (p<0.001 for trend).
