Relationship Between Step Counts and Cerebral Small Vessel Disease in Japanese Men

Abstract

Background and Purpose: Cerebral small vessel disease (CSVD) is a common subclinical feature of the aging brain. Steps per day may contribute to its prevention. We herein investigated the association between step counts and CSVD in a healthy Japanese male population. Methods: We analyzed data from 680 men who were free of stroke and participated in this observational study. Seven-day step counts were assessed at baseline (2006–2008) using a pedometer. CSVD was assessed at follow-ups (2012–2015) based on deep and subcortical white matter hyperintensities (WMHs), periventricular hyperintensities, lacunar infarcts, and cerebral microbleeds on magnetic resonance imaging. Using a logistic regression analysis, we computed the adjusted odds ratios, with 95% CIs, of prevalent CSVD according to quartiles of step counts (reference: Q1). We also investigated the association between step counts and WMH volumes using a quantile regression. Results: Steps per day were significantly associated with lower odds ratios, with the lowest at Q3 (8175–10 614 steps/day), of higher (versus low or no burden) deep and subcortical WMHs (odds ratio, 0.52 [95% CI, 0.30–0.89]), periventricular hyperintensities (0.50 [95% CI, 0.29–0.86]), and lacunar infarcts (0.52 [95% CI, 0.30–0.91]) compared with Q1 (≤6060 steps/day) but not cerebral microbleeds. An inverse linear association was observed between step counts and WMH volumes. These associations were independent of age and smoking and drinking status and remained consistent when adjusted for vascular risk factors. Conclusions: We found a J-shaped relationship between step counts and prevalent CSVD in healthy Japanese men, with the lowest risk being observed among participants with ≈8000 to 10 000 steps/day. Higher steps were also associated with lower WMH volumes.

The relationships between step count and all-cause mortality and cardiovascular events: A dose–response meta-analysis

“…Five studies 15 , 32 , 41 , 42 , 43 included a total of 14,670 participants with 1082 cases. The pooled RR of CVD for a 500-step increment in step count was 0.94 (95%CI: 0.91–0.97), with high heterogeneity ( I 2 = 79.6%, p = 0.001, Supplementary Fig.…”

“…Four studies 15 , 32 , 41 , 42 were included in the dose–response analysis of daily steps and risk of CVD. These 4 studies had 13,080 participants with 848 cases.…”

“…Several recent prospective research studies have used device-based methods, such as accelerometers, to evaluate associations between steps per day and mortality or cardiovascular disease (CVD) and reduce the bias associated with self-reporting. 12 , 13 , 14 , 15 However, the majority of these studies are statistically inadequate due to their relatively short follow-up time and the low number of participants. 16 …”

ESO Guideline on covert cerebral small vessel disease

“… 118 Another prospective observational study, The Shiga Epidemiological Study of Subclinical Atherosclerosis, in healthy Japanese men has reported a relationship between higher average step count at baseline and lower burden of WMH and lacunar infarcts, but not microbleeds on MRI scans approximately 6 years later. 119 …”

“…118 Another prospective observational study, The Shiga Epidemiological Study of Subclinical Atherosclerosis, in healthy Japanese men has reported a relationship between higher average step count at baseline and lower burden of WMH and lacunar infarcts, but not microbleeds on MRI scans approximately 6 years later. 119 Existing guidelines 101 promote lifestyle factors such as physical activity (moderate to vigorous intensity aerobic physical activity at least 40 min/day 3 to 4 days/ week is recommended), diet rich in fruit and vegetables, Mediterranean diet supplemented with nuts, overweight reduction and quitting smoking (assisted by counselling in combination with drug therapy) to reduce the risk of stroke in adults with no history of stroke or TIA. 101 The beneficial effects of physical exercise are clear in the general population and current evidence does not suggest any harm of such activity in ccSVD.…”