Cognitive and physical activity and dementia

Abstract

ObjectiveTo investigate whether cognitive and physical activities in midlife are associated with reduced risk of dementia and dementia subtypes in women followed for 44 years.MethodsA population-based sample of 800 women aged 38–54 years (mean age 47 years) was followed from 1968 to 2012. Cognitive (artistic, intellectual, manual, religious, and club) and physical activity were assessed at baseline. During follow-up, dementia (n = 194), Alzheimer disease (n = 102), vascular dementia (n = 27), mixed dementia (n = 41), and dementia with cerebrovascular disease (n = 81) were diagnosed according to established criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data. Cox regression models were used with adjustment for age, education, socioeconomic status, hypertension, body mass index, cigarette smoking, diabetes mellitus, angina pectoris, stress, and major depression.ResultsWe found that cognitive activity in midlife was associated with a reduced risk of total dementia (hazard ratio [HR] 0.66; 95% confidence interval [CI] 0.49–0.89) and Alzheimer disease (HR 0.54; 95% CI 0.36–0.82) during follow-up. Physical activity in midlife was associated with a reduced risk of mixed dementia (HR 0.43; 95% CI 0.22–0.86) and dementia with cerebrovascular disease (HR 0.47; 95% CI 0.28–0.78). The results were similar after excluding those who developed dementia before 1990 (n = 21), except that physical activity was then also associated with reduced risk of total dementia (HR 0.67; 95% CI 0.46–0.99).ConclusionOur findings suggests that midlife cognitive and physical activities are independently associated with reduced risk of dementia and dementia subtypes. The results indicate that these midlife activities may have a role in preserving cognitive health in old age.

Midlife Lifestyle Activities Moderate APOE ε4 Effect on in vivo Alzheimer’s Disease Pathologies

“…APOE4, apolipoprotein ε4; CA, cognitive activity; PA, physical activity; HVa, adjusted hippocampal volume; AD-CM, AD-signature region cerebral glucose metabolism; <1 SD, 1 standard deviation below mean value; +1 SD,: 1 SD above mean value. cognitive decline (Ngandu et al, 2015) or AD dementia (Rovio et al, 2005;Najar et al, 2019). Such a discrepancy was also observed in prior studies (Wilson et al, 2013;Gidicsin et al, 2015).…”

“…While APOE4 is a non-modifiable genetic risk factor, modifiable factors such as cognitive activity and physical activity have been associated with a decreased risk of cognitive decline (Ngandu et al, 2015) and AD dementia (Rovio et al, 2005;Kivipelto et al, 2008;Najar et al, 2019). However, studies on the in vivo neuropathological mechanisms underlying the association between cognitive activity or physical activity and AD-related cognitive decline have produced controversial findings (Valenzuela et al, 2008;Erickson et al, 2009;Liang et al, 2010;Bugg and Head, 2011;Head et al, 2012;Landau et al, 2012;Vemuri et al, 2012Vemuri et al, , 2016Vemuri et al, , 2017Brown et al, 2013b;Wirth et al, 2014;Gidicsin et al, 2015;Ko et al, 2018).…”

“…In contrast, midlife cognitive and physical activities are less likely to be affected by AD pathology. Moreover, many previous studies indicated that such midlife activities are related with a decreased risk of late-life cognitive decline (Karp et al, 2009;Inzelberg et al, 2013;Najar et al, 2019) and AD dementia (Rovio et al, 2005;Andel et al, 2008;Kivipelto et al, 2008;Tolppanen et al, 2015).…”

Neighbourhood nursing : connection, place and meaning in the everyday experience of dementia

“…Other factors that affect the development of dementia include age (Blennow, de Leon, & Zetterberg, 2006;Qiu et al, 2001;Sundström et al, 2016;Winblad et al, 2016), a low level of education, physical inactivity and cardiovascular diseases (Kivipelto, Mangialasche, & Ngandu, 2018;Najar et al, 2019;World Health Organization, 2019b). It is important to consider the current biomedical model to understand the development of dementia as a concept (Innes & Manthorpe, 2013;Lyman, 1989).…”

Exercise training improves vascular function in patients with Alzheimer’s disease

“…Indeed, it is well established that exercise training has a direct effect on blood flow (BF), vasoreactivity, vascular growth factors (i.e., vascular endothelial growth factor, VEGF), and angiogenesis at systemic level and all those responses are mediated by the up-regulation of NO-bioavailability and growth factor expression (Mann and Rosenzweig 2012;Izzicupo et al 2017). Although the exercise-induced benefits on vascular and cognitive function in AD are increasingly appreciated (Barnes 2015;Najar et al 2019;Alagiakrishnan et al 2006;Pedrinolla et al 2018;Fonte et al 2019), the mechanisms by which exercise training may induce positive peripheral vascular adaptations in individuals with AD are still matter of debate, and have not been studied in human models.…”