In the JournalsPerspective

Being mentally, physically active in middle age may lower dementia risk

Women with higher levels of cognitive and physical activity in midlife demonstrated a reduced risk for dementia diseases later in life, according to findings published in Neurology.

“Several longitudinal studies report that cognitive and physical activity may reduce the risk of dementia,” Jenna Najar, MD, from the University of Gothenburg in Sweden, and colleagues wrote. “Others have not confirmed these findings. Most studies have a high mean age at baseline and a short observation time. Low levels of cognitive and physical activities may thus be a consequence of preclinical dementia in studies with short follow-up.”

Najar and colleagues conducted a population-based study to determine how cognitive and physical activities in midlife affect the risk of late-life dementia and dementia subtypes among women from Sweden.

The researchers enrolled 800 women aged between 38 and 54 years (mean age, 47 years) and followed them for 44 years, from 1968 to 2012. At baseline, they assessed participants’ cognitive and physical activity.

Women with higher levels of cognitive and physical activity in midlife demonstrated a reduced risk for dementia diseases later in life.
Source: Adobe Stock

Cognitive activities included intellectual activities, such as reading and writing; artistic activities, such as singing in a choir; manual activities, such as gardening; club activities; and religious activity, according to the researchers. Participants were given a comprehensive cognitive activity score based on how often they participated in mental activities, receiving 0 to 2 points in each of the five areas (0 for no or low activity, 1 for moderate activity and 2 for high activity) for a potential total of 10. Based on their cognitive activity score, participants were categorized into either the low group (scores between 0 and 2; 44%) or the high group (scores between 3 and 10; 56%).

Participants were also categorized into two groups based on their physical activity: active (82%) or inactive (17%). Those in the active group participated in light physical activity such as walking, gardening, bowling or biking for at least 4 hours per week or regular intense exercise such as running or swimming several times a week or competitive sports, according to the researchers.

Over the course of the study, the researchers identified 194 women with dementia, 102 with Alzheimer’s disease, 27 with vascular dementia, 41 with mixed dementia and 81 with dementia with cerebrovascular disease.

The analysis was adjusted for age, education, socioeconomic status, hypertension, BMI, cigarette smoking, diabetes mellitus, angina pectoris, stress and major depression.

High levels of cognitive activity in midlife were associated with a 46% lower risk for Alzheimer’s disease and a 34% lower risk for dementia overall, compared with low levels of cognitive activity.

Additionally, participants in the physically active group had a 52% lower risk for dementia with cerebrovascular disease and a 56% lower risk for mixed dementia, compared with those in the inactive group.

After excluding participants who developed dementia before 1990 (n = 21), the results remained similar, with the exception that physical activity was then associated with a 34% lower risk for total dementia.

“These results indicate that these activities in middle age may play a role in preventing dementia in old age and preserving cognitive health,” Najar said in a press release. “It’s exciting as these are activities that people can incorporate into their lives pretty easily and without a lot of expense.” – by Alaina Tedesco

 

Disclosures: The authors report no relevant financial disclosures.

Women with higher levels of cognitive and physical activity in midlife demonstrated a reduced risk for dementia diseases later in life, according to findings published in Neurology.

“Several longitudinal studies report that cognitive and physical activity may reduce the risk of dementia,” Jenna Najar, MD, from the University of Gothenburg in Sweden, and colleagues wrote. “Others have not confirmed these findings. Most studies have a high mean age at baseline and a short observation time. Low levels of cognitive and physical activities may thus be a consequence of preclinical dementia in studies with short follow-up.”

Najar and colleagues conducted a population-based study to determine how cognitive and physical activities in midlife affect the risk of late-life dementia and dementia subtypes among women from Sweden.

The researchers enrolled 800 women aged between 38 and 54 years (mean age, 47 years) and followed them for 44 years, from 1968 to 2012. At baseline, they assessed participants’ cognitive and physical activity.

Women with higher levels of cognitive and physical activity in midlife demonstrated a reduced risk for dementia diseases later in life.
Source: Adobe Stock

Cognitive activities included intellectual activities, such as reading and writing; artistic activities, such as singing in a choir; manual activities, such as gardening; club activities; and religious activity, according to the researchers. Participants were given a comprehensive cognitive activity score based on how often they participated in mental activities, receiving 0 to 2 points in each of the five areas (0 for no or low activity, 1 for moderate activity and 2 for high activity) for a potential total of 10. Based on their cognitive activity score, participants were categorized into either the low group (scores between 0 and 2; 44%) or the high group (scores between 3 and 10; 56%).

Participants were also categorized into two groups based on their physical activity: active (82%) or inactive (17%). Those in the active group participated in light physical activity such as walking, gardening, bowling or biking for at least 4 hours per week or regular intense exercise such as running or swimming several times a week or competitive sports, according to the researchers.

Over the course of the study, the researchers identified 194 women with dementia, 102 with Alzheimer’s disease, 27 with vascular dementia, 41 with mixed dementia and 81 with dementia with cerebrovascular disease.

The analysis was adjusted for age, education, socioeconomic status, hypertension, BMI, cigarette smoking, diabetes mellitus, angina pectoris, stress and major depression.

High levels of cognitive activity in midlife were associated with a 46% lower risk for Alzheimer’s disease and a 34% lower risk for dementia overall, compared with low levels of cognitive activity.

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Additionally, participants in the physically active group had a 52% lower risk for dementia with cerebrovascular disease and a 56% lower risk for mixed dementia, compared with those in the inactive group.

After excluding participants who developed dementia before 1990 (n = 21), the results remained similar, with the exception that physical activity was then associated with a 34% lower risk for total dementia.

“These results indicate that these activities in middle age may play a role in preventing dementia in old age and preserving cognitive health,” Najar said in a press release. “It’s exciting as these are activities that people can incorporate into their lives pretty easily and without a lot of expense.” – by Alaina Tedesco

 

Disclosures: The authors report no relevant financial disclosures.

    Perspective

    This study provides further evidence supporting staying physically active and socially engaged throughout the lifespan to reduce the risk of dementia. In addition to other health benefits, this may be the spark that some people need to get off the couch and turn off the TV. Often, the approach to dementia has been very nihilistic, this study changes that paradigm.

    Physicians should get in the habit of counseling their patients to get or stay physically active and to get more engaged in cerebral activities. This should be standard, much like our advice to quit smoking, moderate alcohol use and follow a healthy diet.

    Consolidated sleep for 7 to 8 hours a night has also been shown to benefit memory and this should be advocated for as well with our patients.

    Further studies to replicate these findings would be helpful. A study in men to make certain the findings are not unique to women would also be helpful.

    • Donn Dexter, MD
    • Assistant Professor of Neurology
      Mayo Clinic College of Medicine and Science
      Fellow of the American Academy of Neurology

    Disclosures: Dexter reports no relevant financial disclosures.