Background: Patients with schizophrenia have about 20 years shorter lifetime expectancy compared to healthy population. Among these patients, cognitive performance is a predictor of early death while illness severity, as expressed in both symptom activity and remission status, has no relation with length of life. Vital signs, such as blood pressure and heart rate, weight including BMI, and spontaneously reported symptoms did neither indicate an increased risk for early death. This work focus on whether self-rated physical condition and activities, in contrast to vital signs and perceived symptoms, could be related to cognitive performance and length of life.Methods: From the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS) study, 310 participants were categorized into 4 groups from their cognitive performance at baseline: good cognitive function (GCF), n = 114, impaired cognitive function (ICF), n = 90, and severely impaired cognitive function (SICF), n = 45. The fourth group was patients who had passed away during the study time, n = 61. Patients’ perceived physical condition was assessed at baseline using the SF-36, which included 10 questions about everyday physical activities. The 4 groups were compared using ANOVAs and post hoc analyzes.Results: Patients who had deceased reported, on average 9.5 years before their death, a significantly (P < .001) more impaired physical condition compared to the GCF group and the ICF group (P = .028) but did not show any difference compared with the SICF group (P = .424). An item analysis showed that especially physical activities, such as walking a distance or climbing the stairs, were impaired. When only alive patients’ physical status vs cognitive performance were analyzed, the GCP were more physical fit than the ICF (P = .018) and SICF (P = .011), but there were no difference between ICF and SICF.Conclusion: In contrast to vital signs and perceived symptoms of illness, patient reported differences in physical fitness corresponded to differences in their cognitive ability. It has earlier been argued that physical performance is an underappreciated variable for improving ADLs. This study indicates that patents’ physical performance may, several years in advance, offer important information about increased risk of an early death.