New research suggests that taking at least 4000 steps on just one or two days each week is linked with a lower risk of early death and cardiovascular disease in older women. Published in the British Journal of Sports Medicine, the study indicates that even infrequent bouts of moderate activity can offer meaningful protection. Rather than requiring daily adherence to step goals, the findings point towards a more flexible approach that still yields health benefits, which may prove especially helpful for older adults who find it challenging to maintain consistent daily routines.
The study addresses a significant gap in current physical activity guidance. While it is well established that lifelong movement supports healthier ageing, there remains considerable uncertainty about how much activity older adults need to achieve measurable benefits. Step counts in particular remain largely absent from guideline recommendations, despite widespread use of step-tracking devices. To shed light on this, the researchers investigated both the total number of steps accumulated per day and the number of days each week on which older women achieved between 4000 and 7000 steps. This dual focus allowed them to examine whether step volume or the pattern of achieving step goals plays a more decisive role in shaping long-term health outcomes.
Their analysis drew upon data from 13,547 women, with an average age of 71, who wore accelerometers for seven days between 2011 and 2015. None had cardiovascular disease or cancer at the start of the study, and all were followed for nearly eleven years. Over this period, 1765 participants died and 781 developed cardiovascular disease. By linking these outcomes to baseline step data, the researchers identified associations between step habits and later health events.
The results were striking. Older women who reached at least 4000 steps on one or two days each week had a 26 per cent lower risk of death from any cause and a 27 per cent lower risk of cardiovascular death compared with those who did not reach this threshold at all. Achieving 4000 steps on three or more days produced an even greater reduction in overall mortality, rising to 40 per cent, though the cardiovascular benefit did not increase further. Higher step totals—between 5000 and 7000 per day on at least three days—were linked with additional reductions in all-cause mortality, though cardiovascular benefits plateaued. Once the data were adjusted for average daily steps, many of these associations weakened, suggesting that overall step volume is the essential factor.
Although the study cannot prove causation and only one week of activity was measured, the authors emphasise a clear message: it is the amount of movement across the week that seems to matter most, not how often step targets are met. Even accumulating steps in an uneven or “bunched” pattern appears to offer a meaningful protective effect. In practical terms, this means older women may benefit from pursuing activity in whatever rhythm suits their lives—slow and steady or concentrated bursts—strengthening the case for including step-based measures in future physical activity guidelines.
More information: Rikuta Hamaya et al, Association between frequency of meeting daily step thresholds and all-cause mortality and cardiovascular disease in older women, British Journal of Sports Medicine. DOI: 10.1136/bjsports-2025-110311
Journal information: British Journal of Sports Medicine Provided by BMJ Group
