Physical activity and risk of cognitive decline: a meta-analysis of prospective studies

Sofi, Francesco; Valecchi, Debora; Bacci, Duccio; Abbate, Rosanna; Gensini, Gian Franco; Casini, Alessandro; Macchi, Claudio

doi:10.1111/j.1365-2796.2010.02281.x

Cited by 949 publications

(730 citation statements)

References 25 publications

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“…[28][29][30][31] Clinical trials 32 Non-pharmacological measures, such as physical activity, are also important and have been identified to have beneficial effects on cognition as well as protective benefits on brain plasticity in vascular CI and related conditions. 33,34 The main task for physicians is to identify patients with early stages of CI in order to start corrective measures as soon as possible and also manage patients at risk of CI. …”

Section: Importance Of Cognitive Decline For Prognosis and Self-carementioning

confidence: 99%

Cognitive Decline in Heart Failure: More Attention is Needed

Čelutkienė

Vaitkevičius

Jakštienė

et al. 2016

Cardiac Failure Review

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To ensure performance of everyday tasks, adherence to treatment regiments, appointments, and following dietary requirements, cognition is crucial.1 Cognitive impairment (CI) is a broad and inclusive term used to describe dysfunction of processes in various cognitive domains, such as attention, memory, judgment, reasoning, decision-making and problem solving, comprehension and production of language. Prevalence and Pathogenic MechanismsEvidence is mounting that impaired cardiac function may precipitate early-onset CI. Reported prevalence 2-8 of cognitive dysfunction in the heart failure (HF) population parallels the severity of HF, being the highest in the acute decompensation settings (see Table 1).Multiple factors contributing to cognitive decline in HF are presented in Figure 1. Hypertension is found to be independently associated with CI 9,10 through compromise in auto-regulation of cerebral blood flow and cerebral ischaemia (see Figure 2). Neuroimaging has revealed structural brain abnormalities (see Cognitive Domains and Assessment ToolsThe severity of CI may range from mild symptoms to advanced dementia. Mild CI is a commonly used definition for a clinical syndrome in which a patient has subjective complaints as well as objective symptoms of cognitive decline (measured by neuropsychological tests), though daily functioning of the patient is mostly intact.11 It is established that patients with mild cognitive impairment have an increased risk of progression to dementia. 12,13 Dementia is characterised by a progressive impairment in more than one cognitive domain, and compromised daily functioning is evident.Most of the HF patients suffer from mild impairment in cognition, but some of them may have moderate-to-severe CI.13 Heart failure adversely affects various cognitive domains, including attention, learning ability and working memory, executive functions, and information processing speed (see Figure 4). [13][14][15] Cognitive impairment in HF patients usually fulfils the criteria of vascular CI or vascular dementia. 16Being one of the most important cognitive functions, episodic memory of specific personal events and experiences was demonstrated to slowly decline in HF patients. 5,13,14,17 Furthermore, deficits in initial learning as well as delayed information recall were reported in the literature. 17 This suggests that CI in HF patients and CI in patients with vascular dementia could share pathophysiological mechanisms.18 Deficits in executive functioning (problem solving, planning, reasoning and flexibility) have a AbstractCognitive decline is a prevalent condition and independent prognostic marker of unfavourable outcomes in patients with heart failure. The highest prevalence, up to 80 %, is reported in patients hospitalised due to acute decompensation. Numerous factors contribute to cognitive dysfunction in heart failure patients, with hypertension, atrial fibrillation, stroke and impaired haemodynamics being the most relevant. Cerebral hypoperfusion, disruption of blood-brain barrier, oxidative da...

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Section: Importance Of Cognitive Decline For Prognosis and Self-carementioning

confidence: 99%

Cognitive Decline in Heart Failure: More Attention is Needed

Čelutkienė

Vaitkevičius

Jakštienė

et al. 2016

Cardiac Failure Review

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“…The long-term benefits of PA on neurocognitive outcomes among HIV-uninfected older adults are well established [10][11][12]. Epidemiological studies have indicated that midlife PA is associated with a lower risk of neurocognitive decline and dementia later in life [13,14]. Moreover, PA intervention trials have consistently shown improved cognitive function in older HIV-uninfected adults who participate in aerobic activity as compared to control groups [10,[15][16][17][18][19][20].…”

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confidence: 99%

A Longitudinal Analysis of the Impact of Physical Activity on Neurocognitive Functioning Among HIV-Infected Adults

et al. 2016

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Higher levels of physical activity (PA) have been linked to better neurocognitive functioning in many populations. The current study examines the longitudinal association between PA and neurocognitive functioning among HIV-infected and HIV-uninfected persons. Community-dwelling adults (N = 291) self-reported level of PA and completed a comprehensive neuropsychological battery at two to four study visits (Mean follow-up time = 2.6 years). Participants were divided into three PA groups: ''No PA'' (no PA at any visit), ''consistent PA'' (PA at C50% of visits), and ''inconsistent PA'' (PA \ 50% of visits). A mixed effect model, adjusting for significant covariates showed that all PA groups had statistically significant, yet modest, neurocognitive decline over time; and, the consistent PA group began with, and maintained, significantly better neurocognitive function compared to the other two PA groups. This effect was evident among both HIV-uninfected and HIV-infected persons, despite the fact that HIV-infected persons showed lower baseline neurocognitive function. PA is a modifiable lifestyle behavior that may help to protect against neurocognitive impairment regardless of HIV status, however, given the proportion of HIV-infected individuals who evidence neurocognitive difficulties, a focus on increasing PA seems warranted.Resumen La actividad física (AF) ha sido asociada con un mejor funcionamiento neurocognitivo en varios grupos. Este estudio examinó la asociación longitudinal entre la AF y el funcionamiento neurocognitivo en personas con y sin infección del VIH. Adultos viviendo en la comunidad (N = 291) proporcionaron información acerca de sus niveles de AF y completaron una batería neuropsicológica exhaustiva. Los participantes completaron entre dos y cuatro visitas relacionadas con el estudio (tiempo de seguimiento promedio = 2,6 años) y fueron divididos en tres grupos de AF: ''Ninguna AF'' (Ninguna AF durante todas las visitas del estudio), ''AF Consistente'' (AF durante 50% o más de las visitas del estudio), y ''AF Inconsistente'' (AF durante menos del 50% de las visitas del estudio). Un modelo estadístico mixto, ajustando por el efecto de variables externas, indicó que hubo una reducción estadísticamente significativa, pero poco pronunciada, en el funcionamiento neurocognitivo en todos los grupos. Además, el grupo con AF Consistente demostró un mejor funcionamiento neurocognitivo en comparación con los otros dos grupos de AF al comienzo del estudio, el cual se mantuvo durante el seguimiento. A pesar de que las personas con VIH demostraron un funcionamiento neurocognitivo más bajo al comienzo del estudio que las personas sin VIH, el efecto de AF fue demostrado en los dos grupos. Es importante recalcar que la AF es un factor de vida modificable que podría proteger contra los daños neurocognitivos independientemente de si las personas tienen o no VIH. Dada la proporción de personas con VIH que demuestran problemas neurocognitivos relacionados con esta enfermedad, será importante enfocar los esfuerzos ...

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“…Populationbased studies of older adults have reported a slower rate of decline in cognitive function among those engaged in higher levels of physical activity at baseline (Ku et al 2012;Lytle et al 2004;Weuve et al 2004;Yaffe et al 2001). In a meta-analysis of prospective studies involving people aged 65 years and older, physical activity at both high and low-to-moderate levels was found to lower the risk of cognitive decline (Sofi et al 2011). In addition, physical exercise training of older adults has shown some promise in enhancing cognitive vitality (Colcombe and Kramer 2003;Kirk-Sanchez and McGough 2014).…”

Section: Introductionmentioning

confidence: 99%

Changes in physical activity and cognitive decline in older adults living in the community

Lee

Kim

Han

et al. 2015

AGE

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Accumulating evidence suggests that physical activity may be beneficial in preserving cognition in late life. This study examined the association between baseline and changes in physical activity and cognitive decline in community-dwelling older people. Data were from the Korean Longitudinal Study of Aging, with 2605 aged 65 years and older subjects interviewed in 2006 and followed up for 2 years. Cognitive decline was defined by calculating the Reliable Change Index using the Mini-Mental State Examination. Physical activity levels were categorized as sedentary, low, or high. Changes in physical activity were classified as inactive, decreaser, increaser, or active. Logistic regression analysis of baseline and changes in physical activity with cognitive decline was performed. Compared with the sedentary group at baseline, both the low and high activity groups were less likely to experience cognitive decline. The active (odds ratio [OR]=0.40, 95 % confidence interval [CI] 0.23-0.68) and increaser (OR=0.45, 95 % CI 0.27-0.74) group, compared with the inactive counterpart, demonstrated a significantly lower likelihood of cognitive decline. Older adults who remained active or increased activity over time had a reduced risk of cognitive decline. Engagement in physical activity in late life may have cognitive health benefits.

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Physical activity and risk of cognitive decline: a meta-analysis of prospective studies

Cited by 949 publications

References 25 publications

Cognitive Decline in Heart Failure: More Attention is Needed

Cognitive Decline in Heart Failure: More Attention is Needed

A Longitudinal Analysis of the Impact of Physical Activity on Neurocognitive Functioning Among HIV-Infected Adults

Changes in physical activity and cognitive decline in older adults living in the community

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