Protective association of higher frequency physical exercise with all-cause mortality risk in stroke patients: evidence from the health and retirement study.

OBJECTIVE: To examine the association between the different exercise frequency in daily life and all-cause mortality risk of the patients after stroke, and to analyze their dose-response relationship.

METHODS: 1,639 participants with stroke were selected from Health and Retirement Study (HRS) database. Based on physical exercise frequency questionnaires, participants were categorized into five groups: sedentary (n=152), low (n=276), moderate (n=212), high (n=205), and vigorous (n=794). Multivariate Cox proportional hazards regression models and survival analyses were applied to examine the associations between exercise frequency and all-cause mortality risk in stroke patients.

RESULTS: Median follow-up time revealed that both median survival time and interquartile range increased progressively with higher exercise frequency. Multivariate Cox regression analysis demonstrated a significant dose-response relationship: Compared to the sedentary group, moderate, high, and vigorous exercise groups exhibited significantly reduced death risks of 28%, 35%, and 42%, respectively. Exercise score showed a significant negative correlation with mortality rate (r=-0.855). Kaplan-Meier survival analysis revealed significant divergence in survival curves among different exercise frequency groups (log-rank P<0.001), with the vigorous exercise group demonstrating the highest cumulative survival rate. Age-stratified analysis indicated that patients aged ≤65 years had the most favorable survival prognosis, while survival rates significantly decreased with advancing age (log-rank P< 0.001).

CONCLUSION: Higher frequency physical exercise manifested a protective association with reduced all-cause mortality risk in stroke patients, with a clear dose-response relationship. These findings support incorporating regular moderate-to-high-frequency exercise into daily life to reduce the hazards of stroke and improve long-term prognosis.