Association of Physical Activity Level With Risk of Dementia in a Nationwide Cohort in Korea

Yoon, Minjae; Yang, Pil-Sung; Jin, Moo-Nyun; Yu, Hee Tae; Kim, Tae Hoon; Jang, Eunsun; Uhm, Jae Sun; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung

doi:10.1001/jamanetworkopen.2021.38526

Cited by 33 publications

(21 citation statements)

References 44 publications

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“…Actually, achieving > 150 min/week of moderate-intensity aerobic exercise was associated with at least a 30% lower risk of morbidity, mortality, disability, frailty, and dementia compared with being inactive 23 . Our previous study also showed that increasing levels of physical activity were associated with a gradual decrease in the risk of dementia, and even a low amount of light-intensity physical activity was associated with reduced dementia risk 24 . Our results are consistent with previous studies and highlight the importance of the role of CVH, in particular physical activity, in promoting brain health at older ages.…”

Section: Discussionmentioning

confidence: 62%

Association of cardiovascular health with the risk of dementia in older adults

Cho

Yang

Kim

et al. 2022

Sci Rep

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It has been becoming important to identify modifiable risk factors to prevent dementia. We investigated the association of individual and combined cardiovascular health (CVH) on dementia risk in older adults. From the National Health Insurance Service of Korea-Senior database, 191,013 participants aged ≥ 65 years without prior dementia or cerebrovascular diseases who had check-ups between 2004 and 2012 were assessed. Participants were stratified into three groups according to the number of optimal levels of CVH (low, 0–2; moderate, 3–4; and high CVH status, 5–6) and grouped by levels of individual CVH metrics, the number of optimal CVH metrics, and the CVH score. Over a median follow-up of 6.2 years, 34,872 participants were diagnosed with dementia. Compared with low CVH status, moderate and high CVH status were associated with a decreased risk of dementia (hazard ratio [95% confidence interval], 0.91 [0.89–0.92] for moderate; 0.78 [0.75–0.80] for high CVH status) including Alzheimer’s and vascular dementia. The risk of dementia decreased with an increase in the number of optimal CVH metrics (0.94 [0.93–0.94] per additional optimal metric) and with an increase in the CVH score (0.93 [0.93–0.94] per 1-point increase). After censoring for stroke, the association of CVH metrics with dementia risk was consistently observed. Among individual metrics, physical activity had the strongest association with the risk of dementia. In an older Asian population without prior dementia or cerebrovascular disease, a consistent relationship was observed between the improvement of a composite metric of CVH and the reduced risk of dementia.

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Section: Discussionmentioning

confidence: 62%

Association of cardiovascular health with the risk of dementia in older adults

Cho

Yang

Kim

et al. 2022

Sci Rep

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“…Eight studies ( Lee A. T. C. et al, 2015 , 2018 ; Kishimoto et al, 2016 ; Zhou et al, 2017 ; Dupré et al, 2021 ; Fajersztajn et al, 2021 ; Sato et al, 2021 ; Yoon et al, 2021 ) investigated the effect of leisure activities on dementia in older adults. The I 2 was 97.1%.…”

Section: Resultsmentioning

confidence: 99%

Effect of leisure activities on cognitive aging in older adults: A systematic review and meta-analysis

Yang

Guo

et al. 2022

Front. Psychol.

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Abnormal cognitive aging in older adults is a growing public health problem. Previous studies showed inconsistent results pertaining to the effects of leisure activities on cognitive function in older adults. We conducted a systematic review and meta-analysis of published observational longitudinal studies to examine and synthesize the effects of leisure activities on cognitive function in older adults. MEDLINE, PubMed, EMBASE, PsycINFO (Ovid), CINAHL (EBSCO), and Web of Science databases were searched from January 2012 to January 2022. Relative risks (RRs) with 95% confidence intervals (CIs) were pooled using random-effects meta-analysis. Most studies found that leisure activities had a positive effect on cognitive function in older adults. The pooled RR for the effect of leisure activity on cognitive function was 0.77 (95% CI: 0.72–0.81, p < 0.01). The effects of leisure activities on cognitive function varied by different cognitive statuses in older adults, with RRs ranging from 0.55 (95% CI: 0.37–0.83) to 1.07 (95% CI: 0.95–1.22). Meta-regression analysis showed that compared with studies with percentage of female ≥50%, studies with female participant percentage <50% had significantly increased RR (p = 0.01). Moreover, studies conducted in European and American countries had significantly lower RR (p = 0.019), compared with those conducted in Asian countries. Our study revealed different effects of various types of leisure activities on different cognitive statuses in older adults. To make innovative recommendations for promoting cognitive function in older adults, more detailed observational longitudinal studies investigating the effects of different types of leisure activities on different cognitive statuses in older adults are needed.

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“…The environmental component of ARCD and ARD is well-established in large cohort studies in multiple countries but has yet to form the basis of ARD prevention or treatment policies [ 10 , 37 , 38 , 39 , 40 ]. This includes significantly increased risk of ARCD and ARD as well as worse cognitive function associated with sedentary behavior and reduced physical activity [ 37 , 41 , 42 , 43 ], chronic sleep deprivation or sleep disruption [ 37 , 44 , 45 ], insulin resistance and dysglycemia [ 46 , 47 ], poor-quality nutrition and associated changes in nutrient status [ 10 , 48 ], body composition [ 49 , 50 , 51 , 52 ], sex hormone status during and after the menopausal transition [ 53 ], and the effect of social isolation and poor social support [ 54 ]. Early evidence is mounting to suggest that lifestyle and environmental modification has the potential to prevent or even reverse ARD, especially when initiated early in the ARCD process [ 10 , 55 , 56 , 57 ].…”

Section: Population-level Observations and Evolutionary Theory Derive...mentioning

confidence: 99%

Demand Coupling Drives Neurodegeneration: A Model of Age-Related Cognitive Decline and Dementia

Turknett¹,

Wood

2022

Cells

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The societal burden of Alzheimer’s Disease (AD) and other major forms of dementia continues to grow, and multiple pharmacological agents directed towards modifying the pathological “hallmarks” of AD have yielded disappointing results. Though efforts continue towards broadening and deepening our knowledge and understanding of the mechanistic and neuropathological underpinnings of AD, our previous failures motivate a re-examination of how we conceptualize AD pathology and progression. In addition to not yielding effective treatments, the phenotypically heterogeneous biological processes that have been the primary area of focus to date have not been adequately shown to be necessary or sufficient to explain the risk and progression of AD. On the other hand, a growing body of evidence indicates that lifestyle and environment represent the ultimate level of causation for AD and age-related cognitive decline. Specifically, the decline in cognitive demands over the lifespan plays a central role in driving the structural and functional deteriorations of the brain. In the absence of adequate cognitive stimulus, physiological demand–function coupling leads to downregulation of growth, repair, and homeostatic processes, resulting in deteriorating brain tissue health, function, and capacity. In this setting, the heterogeneity of associated neuropathological tissue hallmarks then occurs as a consequence of an individual’s genetic and environmental background and are best considered downstream markers of the disease process rather than specific targets for direct intervention. In this manuscript we outline the evidence for a demand-driven model of age-related cognitive decline and dementia and why it mandates a holistic approach to dementia treatment and prevention that incorporates the primary upstream role of cognitive demand.

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Association of Physical Activity Level With Risk of Dementia in a Nationwide Cohort in Korea

Cited by 33 publications

References 44 publications

Association of cardiovascular health with the risk of dementia in older adults

Association of cardiovascular health with the risk of dementia in older adults

Effect of leisure activities on cognitive aging in older adults: A systematic review and meta-analysis

Demand Coupling Drives Neurodegeneration: A Model of Age-Related Cognitive Decline and Dementia

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