Actividad física y envejecimiento saludable: revisión sistemática de evidencia en cohortes prospectivas

Abstract

Introduction: Regular physical activity is a key determinant of overall health in adults, being associated with lower mortality and improved physical and mental functioning. Recent evidence shows benefits even at moderate levels of exercise, reinforcing its role in healthy aging. Objectives: To assess the relationship between physical activity and comprehensive health outcomes including longevity, physical and mental well-being, and successful aging in prospective cohort studies. Methods: A systematic review was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar up to July 2023. Prospective cohorts measuring physical activity (validated questionnaires, functional tests, pedometry) and reporting outcomes such as mortality, frailty, physical function, cognition, well-being, or successful aging were included. Risk of bias was assessed using the Newcastle–Ottawa Scale, and certainty of evidence was graded with GRADE. Results: Eighteen studies were included (≈180,000 participants, follow-up 2–45 years). Physical activity was associated with an 18–30% reduction in all-cause mortality (HR/OR 0.70–0.82; 95% CI) and 30% reduction in cardiovascular mortality (HR ~0.70). A 15–25% lower risk of frailty (OR 0.75–0.85) and a 20–30% increase in well-being and vitality were observed. Three studies reported a 30–60% higher likelihood of aging without disability (RR 1.3–1.6). Certainty was high for mortality and moderate for frailty, function, and well-being. Conclusions: Physical activity significantly reduces mortality and improves multiple domains of aging. Benefits are consistent at moderate levels (≈150 min/week) and show no upper harm thresholds at higher volumes.