Association of Cardiorespiratory Fitness and Morphological Brain Changes in the Elderly: Results of the Austrian Stroke Prevention Study

Sen, Abhijit; Gider, Pierre; Cavalieri, Margherita; Freudenberger, Paul; Farzi, Aitak; Schallert, Michael; Reichmann, Florian; Watzinger, Norbert; Zweiker, Robert; Schmidt, Reinhold; Schmidt, Helena

doi:10.1159/000334760

Cited by 41 publications

(43 citation statements)

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“…As we previously reported, absolute VȮ 2 max was associated with volume of WMLs in our cohort, but not with lacunes or BPF (table e-1). 23 Next, we assessed whether the association between VȮ 2 max and cognition was restricted to subgroups, by stratifying for age, BMI, and APOE e4 carrier status, which revealed a confined effect in younger participants (aged #65 years), participants with lower BMI (#25 kg/m 2 ), and in APOE e4 noncarriers (table 4). We further explored the association between VȮ 2 max and cognition by analyzing the effect of quartiles of the VȮ 2 max distribution (figure) and discovered a linear trend with memory, executive function, as well as global cognition.…”

Section: Resultsmentioning

confidence: 99%

Fitness and cognition in the elderly

et al. 2016

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Objective: To investigate whether greater cardiorespiratory fitness is associated with better global and domain-specific cognitive function. Methods:We investigated 877 participants (aged 65 6 7 years, 55% women) of the Austrian Stroke Prevention Study. For cardiorespiratory fitness, the maximum oxygen consumption (VȮ 2 max) was calculated based on weight and maximum and resting heart rate on a treadmill test (mL$kg 21 $min 21 ). A test battery assessing memory (Bäumler's Lern-und Gedächtnistest), executive function (Wisconsin Card Sorting Test, Trail Making Test-Part B, Digit Span Backward, Alters Konzentrationstest, a computerized complex reaction time task) and motor skills (Purdue Pegboard Test) was administered. Summary measures for cognitive domains and for global cognition were calculated. White matter lesions, lacunes, and brain atrophy were assessed using MRI.Results: Higher VȮ 2 max was associated with better global (B 5 0.024; p 5 0.000) and domainspecific cognitive function (memory B 5 0.026, p 5 0.000; executive function B 5 0.009, p 5 0.003; motor skills B 5 0.012, p 5 0.018) after adjustment for age, sex, education years, and Ca 21 channel antagonists or b-blockers. White matter lesions, lacunes, or brain atrophy did not mediate the effect (p . 0.05 for all mediators). The interactions of VȮ 2 max with age, overweight, and APOE e4 on cognition were not statistically significant (p . 0.05 for all interaction terms) with the exception of a modulating effect of body mass index on VȮ 2 max in the memory domain. Conclusions:Higher VȮ 2 max is associated with better global cognitive function and with better performance in the cognitive domains of memory, executive function, and motor skills in the middle-aged and elderly. The association is not mediated by the presence of white matter lesions, lacunes, and brain atrophy. LGT 5 Lern-und Gedächtnistest; TE 5 echo time; TR 5 repetition time; VȮ 2 max 5 maximum oxygen consumption; WML 5 white matter lesion.Physical activity 1 and cardiorespiratory fitness 2 have been previously associated with cognitive function in the elderly, and the reduction of Alzheimer and Parkinson disease risk.3 Nevertheless, there is a substantial amount of variability in the results linking cognitive performance to physical activity because of heterogeneity in the assessments across the studies. 4 While physical activity and cardiorespiratory fitness are intertwined, their relationships with cognitive performance may be distinct from another. Cardiorespiratory fitness is frequently assessed as the maximum oxygen consumption (VȮ 2 max), which progressively declines with age, 5 but can be increased by prolonged exercise even in the elderly. 6 Cross-sectional observational studies in the elderly found a protective effect of VȮ 2 max on memory 7 and executive function. 8 Similarly, exercise interventional trials improving VȮ 2 max reported improvements in executive function 9 and short-term memory. 10 The mechanism linking higher VȮ 2 max to cognition is, however, not well und...

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Section: Resultsmentioning

confidence: 99%

Fitness and cognition in the elderly

et al. 2016

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“…One possible mechanism is that low CRF leads to morphologic brain changes, including white matter lesions [29][30][31][32] and brain atrophy in certain regions in gray matter, 5 which in turn related to impaired cognitive function in the elderly. [33][34][35][36] However, CRF may alter cognitive function through regulation of cerebral blood flow 37 or a direct molecular pathway beyond vascularization, such as influencing N-acetylaspartate, a metabolite exclusively in cell bodies of neurons, given its identified mediating effect between the association of fitness and Backward Digit Span performance.…”

Section: Discussionmentioning

confidence: 99%

Cardiorespiratory fitness and cognitive function in middle age

et al. 2014

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Objective: To investigate whether greater cardiorespiratory fitness (CRF) is associated with better cognitive function 25 years later. Methods:We studied 2,747 participants in the community-based Coronary Artery Risk Development in Young Adults Study of black and white men and women aged 18 to 30 years at recruitment in [1985][1986] Results: Per minute of baseline CRF, the RAVLT was 0.12 words recalled higher (standard error[SE] 5 0.03, p , 0.0001), the DSST was 0.92 digits higher (SE 5 0.13, p , 0.0001), and the Stroop Test score was 0.52 lower (better performance, SE 5 0.11, p , 0.0001), after accounting for race, sex, age, education, and clinical center. Compared with the lowest quartile of CRF, each cognitive test was 21% to 34% of an SD better in the highest CRF quartile. Further adjustment for lifestyle and clinical measures attenuated coefficients for RAVLT and DSST slightly, while the coefficient predicting the Stroop Test lost more than half its value (p 5 0.07). Analysis in the subset of 1,957 participants who also completed the year-20 treadmill test showed that 20-year change in CRF was positively associated only with DSST (p , 0.001). Cardiorespiratory fitness (CRF), which may be modified by physical activity and weight changes, 1,2 is a potential target for intervention to prevent cognitive function decline with aging. Recent studies showed a positive association between CRF and cognitive function. In participants older than 55 years, higher baseline CRF was associated with smaller decline over 6 years on a modified Mini-Mental State Examination and better performance on cognitive tests 6 years later. Conclusions3 In a meta-analysis of 18 studies, CRF improvement through exercise training was associated with better executive, spatial, and speed function among healthy adults aged 55 and older or those with mild mental disorders and cardiopulmonary obstructive. 4 In addition, lower CRF correlated with progression of dementia severity in Alzheimer disease. 5By age 55 years, pathophysiologic changes underlying both loss of CRF and loss of cognitive function may already have occurred. 2,[6][7][8] No longitudinal studies have investigated the relation between CRF and cognitive function in healthy young and middle-aged adults. Therefore,

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“…[20][21][22][23][24][25][26] In addition, we previously found that higher CRF was related to better cognitive function in participants of the CARDIA Study. 34 Better cognitive function has been observed to relate to white matter integrity in several other large population studies of middle-aged and elderly individuals.…”

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confidence: 86%

Cardiorespiratory fitness and brain volume and white matter integrity

et al. 2015

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Objective: We hypothesized that greater cardiorespiratory fitness is associated with lower odds of having unfavorable brain MRI findings. Methods:We studied 565 healthy, middle-aged, black and white men and women in the CARDIA (Coronary Artery Risk Development in Young Adults) Study. The fitness measure was symptomlimited maximal treadmill test duration (Max dur ); brain MRI was measured 5 years later. Brain MRI measures were analyzed as means and as proportions below the 15th percentile (above the 85th percentile for white matter abnormal tissue volume).Results: Per 1-minute-higher Max dur , the odds ratio for having less whole brain volume was 0.85 (p 5 0.04) and for having low white matter integrity was 0.80 (p 5 0.02), adjusted for age, race, sex, clinic, body mass index, smoking, alcohol, diet, physical activity, education, blood pressure, diabetes, total cholesterol, and lung function (plus intracranial volume for white matter integrity). No significant associations were observed between Max dur and abnormal tissue volume or blood flow in white matter. Findings were similar for associations with continuous brain MRI measures.Conclusions: Greater physical fitness was associated with more brain volume and greater white matter integrity measured 5 years later in middle-aged adults. Cardiorespiratory fitness (CRF), measured by treadmill duration, correlates with reduced cardiovascular diseases and overall mortality rates.

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Association of Cardiorespiratory Fitness and Morphological Brain Changes in the Elderly: Results of the Austrian Stroke Prevention Study

Cited by 41 publications

References 14 publications

Fitness and cognition in the elderly

Fitness and cognition in the elderly

Cardiorespiratory fitness and cognitive function in middle age

Cardiorespiratory fitness and brain volume and white matter integrity

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