BACKGROUND: Given increasing incidence of cognitive impairment and dementia, further understanding of modifiable factors contributing to increased healthspan is crucial. Extensive literature provides evidence that physical activity (PA) delays the onset of cognitive impairment; however, it is unclear whether engaging in PA in older adulthood is sufficient to influence progression through cognitive status categories.
METHODS: Applying a coordinated analysis approach, this project independently analyzed fourteen longitudinal studies (NTotal = 52,039; mean baseline age across studies= 69.9-81.73) from North America and Europe using multi-state survival models to estimate the impact of engaging in PA on cognitive status transitions (non-impaired, mildly impaired, severely impaired) and death. Multinomial regression models were fit to estimate life expectancy (LE) based on American PA recommendations. Meta-analyses provided the pooled effect sizes for the role of PA on each transition and estimated LEs.
RESULTS: Controlling for baseline age, sex, education and chronic conditions, analyses revealed that more PA is significantly associated with decreased risk of transitioning from non-impaired to mildly impaired cognitive functioning and death, as well as substantially longer LE. Results also provided evidence for a protective effect of PA after onset of cognitive impairment (e.g., decreased risk of transitioning from mild to severe cognitive impairment; increased likelihood of transitioning backward from severe to mild cognitive impairment), though between-study heterogeneity suggests a less robust association.
CONCLUSIONS: These results yield evidence for the importance of engaging in PA in older adulthood for cognitive health, and a rationale for motivating older adults to engage consistently in PA.
|Journal||The journals of gerontology. Series A, Biological sciences and medical sciences|
|Publication status||E-pub ahead of print - 25 Oct 2020|