Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies

Xu, Wei; Wang, Hui Fu; Wan, Yu; Tan, Cheng; Yu, Jin‐Tai; Tan, Lan

doi:10.1136/bmjopen-2016-014706

Cited by 136 publications

(99 citation statements)

References 46 publications

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“…Physical activity (PA) is considered an important lifestyle factor for promoting healthy aging [3]. A large body of research suggests that PA may reduce the risk of cognitive decline and dementia [4,5], and a recent meta-analysis demonstrated a dose-response relationship with a 10% reduction in risk of all-cause dementia per each 10 additional metabolic equivalent task-hours per week [6]. Results from observational studies suggest that the intensity of PA may be an important factor in the prevention of cognitive decline [7], dementia [8], and dementia-related mortality [9].…”

Section: Introductionmentioning

confidence: 99%

Midlife Physical Activity, Psychological Distress, and Dementia Risk: The HUNT Study

Zotcheva

Bergh

Selbæk

et al. 2018

JAD

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Background: Physical activity (PA) is associated with a decreased dementia risk, whereas psychological distress (distress) is linked to an increased dementia risk.Objective: We investigated independent and joint associations of midlife moderate-to-vigorous PA (MVPA) and distress with incident dementia.Methods: Our study comprised 28,916 participants aged 30-60 years from the Nord-Trøndelag Health Study (HUNT1, 1984(HUNT1, -1986. Data on MVPA and distress from HUNT1 was linked to the Health and Memory Study in Nord-Trøndelag for dementia case identification. Participants were followed from 1995 until 2011. We used adjusted Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI).Results: In fully adjusted analyses, MVPA was associated with a reduced dementia risk (HR 0.81, 95% CI 0.62-1.06), compared to no MVPA. Distress was associated with an increased dementia risk (HR 1.30, 95% CI 0.99-1.70). Compared to distressed participants not taking part in MVPA, non-distressed no-MVPA participants had a reduced dementia risk (HR 0.72, 95% CI 0.54-0.96). The same applied to distressed MVPA participants (HR 0.50, 95% CI 0.22-1.14), and non-distressed MVPA participants (HR 0.63, 95% CI 0.44-0.90). Our results indicated an additive interaction between MVPA and distress on dementia risk.Conclusion: Our results suggest that midlife MVPA reduces risk of incident dementia among both distressed and non-distressed individuals.

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Section: Introductionmentioning

confidence: 99%

Midlife Physical Activity, Psychological Distress, and Dementia Risk: The HUNT Study

Zotcheva

Bergh

Selbæk

et al. 2018

JAD

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“…4 Several longitudinal studies 5,6 and metaanalyses 7,8 have suggested that physical activity could reduce the risk of incident dementia and that there is a dose-response relationship between them, 9,10 whereas other studies have not reported this protective effect. 4 Several longitudinal studies 5,6 and metaanalyses 7,8 have suggested that physical activity could reduce the risk of incident dementia and that there is a dose-response relationship between them, 9,10 whereas other studies have not reported this protective effect.…”

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confidence: 99%

“…4 Several longitudinal studies 5,6 and metaanalyses 7,8 have suggested that physical activity could reduce the risk of incident dementia and that there is a dose-response relationship between them, 9,10 whereas other studies have not reported this protective effect. 10 Therefore, to better understand the relationship between physical activity and incident dementia in older Japanese adults, 18 053 males and 33 424 females were examined at baseline and followed up for 7 years in Okayama City, Japan. 10 Therefore, to better understand the relationship between physical activity and incident dementia in older Japanese adults, 18 053 males and 33 424 females were examined at baseline and followed up for 7 years in Okayama City, Japan.…”

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confidence: 99%

“…Physical activity is considered a modifiable factor associated with incident dementia. 4 Several longitudinal studies 5,6 and metaanalyses 7,8 have suggested that physical activity could reduce the risk of incident dementia and that there is a dose-response relationship between them, 9,10 whereas other studies have not reported this protective effect. 11,12 Apart from inconsistent findings, there are other obvious limitations to the existing studies, such as a small sample size, short follow-up periods, and lack of quality investigations in Asia.…”

mentioning

confidence: 99%

“…11,12 Apart from inconsistent findings, there are other obvious limitations to the existing studies, such as a small sample size, short follow-up periods, and lack of quality investigations in Asia. 10 Therefore, to better understand the relationship between physical activity and incident dementia in older Japanese adults, 18 053 males and 33 424 females were examined at baseline and followed up for 7 years in Okayama City, Japan. We hypothesized that older adults who performed regular physical activity would have a lower risk of incident dementia.…”

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confidence: 99%

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Physical activity and incident dementia in older Japanese adults: The Okayama study

Liu

Mitsuhashi

Yamakawa

et al. 2019

Int J Geriat Psychiatry

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Objective To evaluate the association between regular physical activity and the risk of incident dementia in older Japanese adults. Methods This was a retrospective cohort study performed in Okayama City, Japan. Overall, 51 477 older Japanese adults were followed from 2008 to 2014. A health checkup questionnaire was used to assess regular physical activity. The Dementia Scale of long‐term care insurance was used as a measure of incident dementia. Cox proportional hazard models were used to calculate adjusted hazard ratios, with their 95% confidence intervals, for the incidence of dementia across the categories of physical activity. Results During a 7‐year follow‐up, 13 816 subjects were considered as having incident dementia. Compared with participants who performed physical activity less than or equal to one time per week, the multivariate adjusted hazard ratio values (95% confidence intervals) for participants who performed physical activity greater than or equal to two times per week but not every day and those who performed physical activity every day were 0.79 (0.75‐0.84) and 0.94 (0.89‐0.98), respectively. The interaction of physical activity and sex was statistically significant (P < .01). In subgroup analysis, the multivariate‐adjusted hazard ratio values (95% confidence intervals) remained low, at 0.76 (0.70‐0.84) in males and 0.81 (0.76‐0.87) in females who performed physical activity greater than or equal to two times per week but not every day; they were 0.82 (0.76‐0.89) in males and 1.01 (0.95‐1.07) in females who performed physical activity every day. Conclusions Regular physical activity could reduce the risk of incident dementia in older Japanese adults, except females who performed physical activity every day.

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Physical Activity and Cognitive Decline Among Older Adults

Iso-Markku,

Aaltonen,

Kujala

et al. 2024

JAMA Netw Open

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ImportancePhysical activity is associated with the risk for cognitive decline, but much of the evidence in this domain comes from studies with short follow-ups, which is prone to reverse causation bias.ObjectiveTo examine how length of follow-up, baseline age, physical activity amount, and study quality modify the longitudinal associations of physical activity with cognition.Data SourcesObservational studies of adults with a prospective follow-up of at least 1 year, a valid baseline cognitive measure or midlife cohort, and an estimate of the association of baseline physical activity and follow-up cognition were sought from PsycInfo, Scopus, CINAHL, Web of Science, SPORTDiscus, and PubMed, with the final search conducted on November 2, 2022.Study SelectionTwo independent researchers screened titles with abstracts and full-text reports.Data Extraction and SynthesisTwo reviewers independently assessed study quality and extracted data. Pooled estimates of association were calculated with random-effects meta-analyses. An extensive set of moderators, funnel plots, and scatter plots of physical activity amount were examined. This study is reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.Main Outcomes and MeasuresPooled estimates of the associations between physical activity and global cognition, as well as specific cognitive domains, were examined.ResultsA total of 104 studies with 341 471 participants were assessed. Analysis of binary outcomes included 45 studies with 102 452 individuals, analysis of follow-up global cognition included 14 studies with 41 045 individuals, and analysis of change in global cognition included 25 studies with 67 463 individuals. Physical activity was associated with a decreased incidence of cognitive impairment or decline after correction for funnel plot asymmetry (pooled risk ratio, 0.97; 95% CI, 0.97-0.99), but there was no significant association in follow-ups longer than 10 years. Physical activity was associated with follow-up global cognition (standardized regression coefficient, 0.03; 95% CI, 0.02-0.03) and change in global cognition (standardized regression coefficient, 0.01; 95% CI, 0.01 to 0.02) from trim-and-fill analyses, with no clear dose-response or moderation by follow-up length, baseline age, study quality or adjustment for baseline cognition. The specific cognitive domains associated with physical activity were episodic memory (standardized regression coefficient, 0.03; 95% CI, 0.02-0.04) and verbal fluency (standardized regression coefficient, 0.05; 95% CI, 0.03-0.08).Conclusions and RelevanceIn this meta-analysis of the association of physical activity with cognitive decline, physical activity was associated with better late-life cognition, but the association was weak. However, even a weak association is important from a population health perspective.

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Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies

Cited by 136 publications

References 46 publications

Midlife Physical Activity, Psychological Distress, and Dementia Risk: The HUNT Study

Midlife Physical Activity, Psychological Distress, and Dementia Risk: The HUNT Study

Physical activity and incident dementia in older Japanese adults: The Okayama study

Physical Activity and Cognitive Decline Among Older Adults

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