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Wei J, Lohman MC, Brown MJ, Hardin JW, Xu H, Yang CH, Merchant AT, Miller MC, Friedman DB. Physical activity initiated from midlife on risk of dementia and cognitive impairment: The Health and Retirement Study. J Am Geriatr Soc 2024. [PMID: 39074909 DOI: 10.1111/jgs.19109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/15/2024] [Accepted: 06/27/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Physical activity is associated with lower risk of dementia and cognitive impairment, but existing randomized controlled trials have shown conflicting results. As cognitive decline occurs decades before the onset of dementia, physical activity interventions initiated in late life may have missed the potential window for prevention. An ideal trial of physical activity initiated from midlife and lasts till incident dementia and cognitive impairment in late life is not feasible. We aimed to estimate the effectiveness of a hypothetical physical activity intervention initiated from midlife on reducing dementia and cognitive impairment by emulating target trials using observational data. METHODS The Health and Retirement Study was used to emulate target trials among noninstitutionalized participants aged 45 to 65 years with normal cognition who were physically inactive in the previous 2 years. Cognitive status was determined based on Langa-Weir classification of cognitive function (including immediate and delayed word recall tests, serial sevens subtraction, counting backward). Individuals were categorized as initiating physical activity or not, based on the self-reported physical activity. Intention-to-treat and per-protocol analysis were conducted with pooled logistic regression models with inverse-probability of treatment and censoring weights to estimate risk ratios (RRs), and 95% confidence intervals (95% CIs) were calculated with 200 sets of bootstrapping. RESULTS Among 1505 participants (average age 57.6 ± 4.8 years, 67% women, 76.5% White), 72 cases of dementia and 409 cases of cognitive impairment occurred. After 12 years of follow-up, physical activity reduced dementia (RR = 0.70, 95% CI: 0.43, 0.99) for intention-to-treat analysis, and reduced dementia (RR = 0.51, 95% CI: 0.19, 0.99) and cognitive impairment (RR = 0.77, 95% CI: 0.61, 0.92) for per-protocol analysis. No significant reduction was found among older adults. CONCLUSIONS Physical activity initiated during midlife may reduce dementia and cognitive impairment in late life, which highlights the importance of preventing cognitive outcomes at an earlier stage of life.
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Affiliation(s)
- Jingkai Wei
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- The Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Matthew C Lohman
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- The Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- The Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - James W Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Hanzhang Xu
- School of Nursing, Duke University, Durham, North Carolina, USA
- Department of Family Medicine and Community Health, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Chih-Hsiang Yang
- The Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- The Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Maggi C Miller
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- The Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Daniela B Friedman
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education, Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Kazibwe R, Schaich CL, Muhammad AI, Epiu I, Namutebi JH, Chevli PA, Kazibwe J, Hughes T, Rikhi RR, Shapiro MD, Yeboah J. Effect of vigorous-intensity physical activity on incident cognitive impairment in high-risk hypertension. Alzheimers Dement 2024; 20:4602-4612. [PMID: 38842100 PMCID: PMC11247677 DOI: 10.1002/alz.13887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/04/2024] [Accepted: 04/22/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION We investigated the effect vigorous physical activity (VPA) on the risk of incident mild cognitive impairment (MCI) and probable dementia among individuals with high-risk hypertension. METHODS Baseline self-reported frequency of VPA was categorized into low VPA (<1 session/week), and high VPA (≥1 session/week). We used multivariate Cox regression analysis to examine the association of VPA categories with incident MCI and probable dementia events. RESULTS Participants in the high VPA category, compared with low VPA, experienced lower events rates (per 1000 person-years) of MCI (13.9 vs 19.7), probable dementia (6.3 vs 9.0), and MCI/probable dementia (18.5 vs 25.8). In the multivariate Cox regression model, high VPA, compared with low VPA, was associated with lower risk of MCI, probable dementia, and MCI/probable dementia (HR [95% CI]: 0.81 [0.68-0.97], 0.80 [0.63-1.03], and 0.82 [0.70-0.96]), respectively. DISCUSSION This study provides evidence that VPA may preserve cognitive function in high-risk patients with hypertension. HIGHLIGHTS Hypertension is associated with an increased risk of cognitive impairment Physical activity (PA) is associated with a lower risk of decline in cognition The effect of ≥1 sessions of vigorous-intensity PA (VPA) per week was assessed This analysis included SPRINT MIND trial participants with high-risk hypertension ≥1 VPA sessions/week was associated with lower risk of future cognitive impairment.
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Affiliation(s)
- Richard Kazibwe
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Christopher L. Schaich
- Hypertension and Vascular Research CenterWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Ahmad Imtiaz Muhammad
- Department of MedicineSection on Hospital MedicineWisconsin College of MedicineMilwaukeeWisconsinUSA
| | - Isabella Epiu
- Prince of Wales Clinical SchoolUniversity of New South Wales SydneySydneyNew South WalesAustralia
| | - Juliana H. Namutebi
- Wake Forest UniversitySchool of Graduate StudiesWinston‐SalemNorth CarolinaUSA
| | - Parag A. Chevli
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Joseph Kazibwe
- Department of CardiologySheffield Teaching HospitalSheffieldUK
| | - Timothy Hughes
- Department of MedicineSection on Cardiovascular Medicine, Wake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Rishi R. Rikhi
- Department of Internal MedicineSection on Gerontology and Geriatrics Medicine & Sticht Center for Healthy Aging and Alzheimer's PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Michael D. Shapiro
- Department of Internal MedicineSection on Gerontology and Geriatrics Medicine & Sticht Center for Healthy Aging and Alzheimer's PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Joseph Yeboah
- Department of Internal MedicineSection on Gerontology and Geriatrics Medicine & Sticht Center for Healthy Aging and Alzheimer's PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
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Sewell KR, Rainey-Smith SR, Pedrini S, Peiffer JJ, Sohrabi HR, Taddei K, Markovic SJ, Martins RN, Brown BM. The impact of exercise on blood-based biomarkers of Alzheimer's disease in cognitively unimpaired older adults. GeroScience 2024:10.1007/s11357-024-01130-2. [PMID: 38488949 DOI: 10.1007/s11357-024-01130-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/08/2024] [Indexed: 03/17/2024] Open
Abstract
Physical activity is a promising preventative strategy for Alzheimer's disease: it is associated with lower dementia risk, better cognition, greater brain volume and lower brain beta-amyloid. Blood-based biomarkers have emerged as a low-cost, non-invasive strategy for detecting preclinical Alzheimer's disease, however, there is limited literature examining the effect of exercise (a structured form of physical activity) on blood-based biomarkers. The current study investigated the influence of a 6-month exercise intervention on levels of plasma beta-amyloid (Aβ42, Aβ40, Aβ42/40), phosphorylated tau (p-tau181), glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) chain in cognitively unimpaired older adults, and as a secondary aim, whether blood-based biomarkers related to cognition. Ninety-nine community-dwelling older adults (69.1 ± 5.2) were allocated to an inactive control, or to moderate or high intensity exercise groups where they cycled twice weekly for six months. At baseline and six months (post-intervention), fasted blood was collected and analysed using single molecule array (SIMOA) assays, and cognition was assessed. Results demonstrated no change in levels of any plasma biomarker from pre- to post-intervention. At baseline, higher NfL was associated with poorer cognition (β = -0.33, SE = 0.13, adjusted p = .042). Exploratory analyses indicated higher cardiorespiratory fitness was associated with higher NfL and GFAP levels in apolipoprotein E (APOE) ε4 non-carriers compared to ε4 carriers (NfL, β = -0.43, SE = 0.19, p = .029; GFAP, β = -0.41, SE = 0.20, p = .044), though this association was mediated by body mass index (BMI). These results highlight the importance of considering BMI in analysis of blood-based biomarkers, especially when investigating differences between APOE ε4 carriers and non-carriers. Our results also indicate that longer follow-up periods may be required to observe exercise-induced change in blood-based biomarkers.
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Affiliation(s)
- Kelsey R Sewell
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia.
| | - Stephanie R Rainey-Smith
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Alzheimer's Research Australia, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Steve Pedrini
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Alzheimer's Research Australia, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
| | - Jeremiah J Peiffer
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
| | - Hamid R Sohrabi
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Alzheimer's Research Australia, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
- Department of Biomedical Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Kevin Taddei
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Alzheimer's Research Australia, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
| | - Shaun J Markovic
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- Alzheimer's Research Australia, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
| | - Ralph N Martins
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Alzheimer's Research Australia, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
- Department of Biomedical Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Belinda M Brown
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Alzheimer's Research Australia, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
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Wang Y, Han Q, Han X, Dong Y, Mao M, Wang C, Wang X, Tang S, Liu C, Li Y, Hou T, Cong L, Du Y, Qiu C. Objectively-measured movement behaviors, systemic low-grade inflammation, and plasma neurofilament light chain in older adults: a population-based study. Immun Ageing 2023; 20:36. [PMID: 37491244 PMCID: PMC10367375 DOI: 10.1186/s12979-023-00363-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 07/13/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Evidence has linked self-reported sedentary behavior (SB) and physical activity (PA) with cognitive impairment; however, the underlying mechanisms are poorly understood. We examined the associations of the accelerometer-measured movement behaviors with plasma neurofilament light chain (NfL) among older adults and the role of systemic low-grade inflammation in the associations. RESULTS This population-based study included 1,029 dementia-free older adults (age ≥ 60 years, range 60-88 years; 59.48% women) who undertook the ActiGraph substudy (March 2018-December 2020) in MIND-China. There were nonlinear relationships of daily SB and PA time with plasma NfL concentration, such that more daily SB time or less time spent in daily light-intensity physical activity (LPA) and moderate-to-vigorous-intensity physical activity (MVPA) was significantly associated with increased plasma NfL only when SB time ≥ 8.00 h/day or LPA time < 5.00 h/day or MVPA time < 2.00 h/day. Furthermore, more daily SB time or less daily LPA and MVPA time was significantly associated with higher serum low-grade inflammation score, a composite measure generated from serum IL-6, IL-8, TNF-α, and ICAM-1 (P < 0.05). Finally, low-grade inflammation score accounted for 14.5% to 17.8% of the associations between movement behaviors and plasma NfL. CONCLUSIONS More daily SB and less PA time are associated with neurodegeneration and systemic low-grade inflammation in older adults. The association of movement behaviors with neurodegeneration is partially mediated by low-grade inflammation.
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Affiliation(s)
- Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, People's Republic of China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Karolinska Institutet, Tomtebodavägen 18A, 171 65, Solna, Stockholm, Sweden
| | - Qi Han
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Xiaolei Han
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Ming Mao
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Chaoqun Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Xiaojie Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Cuicui Liu
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Yuanjing Li
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Karolinska Institutet, Tomtebodavägen 18A, 171 65, Solna, Stockholm, Sweden
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, People's Republic of China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, People's Republic of China.
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China.
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging in Shandong First Medical University, Ministry of Education of the People's Republic of China, Jinan, Shandong, People's Republic of China.
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, People's Republic of China.
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Karolinska Institutet, Tomtebodavägen 18A, 171 65, Solna, Stockholm, Sweden.
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Huang X, Tan CS, Kandiah N, Hilal S. Association of physical activity with dementia and cognitive decline in UK Biobank. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12476. [PMID: 37671035 PMCID: PMC10476274 DOI: 10.1002/dad2.12476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/20/2023] [Accepted: 08/08/2023] [Indexed: 09/07/2023]
Abstract
INTRODUCTION There is a lack of studies on the association between specific physical activity (PA) types and dementia. We examined the association of leisure time physical activity (LTPA), occupational physical activity (OPA), and sedentary lifestyle with dementia risk and cognitive decline using the UK-Biobank study. METHODS Baseline PA was collected using questionnaires. A total of 502,481 dementia-free participants were recruited in 2006-2010 and followed for 10 years until the end of 2020 for the ascertainment of dementia. Associations of PA with incident dementia and cognitive decline were examined. RESULTS Higher levels of LTPA and OPA and lower levels of sedentary hours were associated with lower dementia risk. The fifth quintiles of LTPA (hazard ratio [HR] = 0.53, 95% confidence interval [CI]: 0.43-0.67) and OPA (HR = 0.68, 95% CI:0.51-0.90) had lower dementia risk, whereas the fifth quintile of sedentary lifestyle had higher dementia risk (HR = 1.23, 95% CI:1.08-1.41). DISCUSSION Our findings suggest the promotion of an active lifestyle suggested to be preventive of dementia risk. This research has been conducted using the UK Biobank Resource under Application Number 71022.
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Affiliation(s)
- Xiangyuan Huang
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingaporeSingapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingaporeSingapore
| | - Nagaendran Kandiah
- Dementia Research CentreLee Kong Chian School of MedicineSingaporeSingapore
| | - Saima Hilal
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingaporeSingapore
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
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Solis-Urra P, Molina-Hidalgo C, García-Rivero Y, Costa-Rodriguez C, Mora-Gonzalez J, Fernandez-Gamez B, Olvera-Rojas M, Coca-Pulido A, Toval A, Bellón D, Sclafani A, Martín-Fuentes I, Triviño-Ibañez EM, de Teresa C, Huang H, Grove G, Hillman CH, Kramer AF, Catena A, Ortega FB, Gómez-Río M, Erickson KI, Esteban-Cornejo I. Active Gains in brain Using Exercise During Aging (AGUEDA): protocol for a randomized controlled trial. Front Hum Neurosci 2023; 17:1168549. [PMID: 37284481 PMCID: PMC10239947 DOI: 10.3389/fnhum.2023.1168549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
Alzheimer's disease is currently the leading cause of dementia and one of the most expensive, lethal and severe diseases worldwide. Age-related decline in executive function is widespread and plays a key role in subsequent dementia risk. Physical exercise has been proposed as one of the leading non-pharmaceutical approaches to improve executive function and ameliorate cognitive decline. This single-site, two-arm, single-blinded, randomized controlled trial (RCT) will include 90 cognitively normal older adults, aged 65-80 years old. Participants will be randomized to a 24-week resistance exercise program (3 sessions/week, 60 min/session, n = 45), or a wait-list control group (n = 45) which will be asked to maintain their usual lifestyle. All study outcomes will be assessed at baseline and at 24-weeks after the exercise program, with a subset of selected outcomes assessed at 12-weeks. The primary outcome will be indicated by the change in an executive function composite score assessed with a comprehensive neuropsychological battery and the National Institutes of Health Toolbox Cognition Battery. Secondary outcomes will include changes in brain structure and function and amyloid deposition, other cognitive outcomes, and changes in molecular biomarkers assessed in blood, saliva, and fecal samples, physical function, muscular strength, body composition, mental health, and psychosocial parameters. We expect that the resistance exercise program will have positive effects on executive function and related brain structure and function, and will help to understand the molecular, structural, functional, and psychosocial mechanisms involved.
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Affiliation(s)
- Patricio Solis-Urra
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Faculty of Education and Social Sciences, Universidad Andrés Bello, Viña del Mar, Chile
| | - Cristina Molina-Hidalgo
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
| | - Yolanda García-Rivero
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
- ibs.GRANADA Instituto de Investigación Biosanitaria, Granada, Spain
| | | | - Jose Mora-Gonzalez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Beatriz Fernandez-Gamez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Marcos Olvera-Rojas
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Andrea Coca-Pulido
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Angel Toval
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Darío Bellón
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Alessandro Sclafani
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Isabel Martín-Fuentes
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - Eva María Triviño-Ibañez
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
- ibs.GRANADA Instituto de Investigación Biosanitaria, Granada, Spain
| | - Carlos de Teresa
- Andalusian Centre of Sports Medicine, Consejería de Turismo y Deporte, Granada, Spain
| | - Haiqing Huang
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - George Grove
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Charles H. Hillman
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, United States
- Department of Psychology, Northeastern University, Boston, MA, United States
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, United States
| | - Arthur F. Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, United States
- Beckman Institute, University of Illinois, Urbana, IL, United States
| | - Andrés Catena
- School of Psychology, University of Granada, Granada, Spain
| | - Francisco B. Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Gómez-Río
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
- ibs.GRANADA Instituto de Investigación Biosanitaria, Granada, Spain
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
| | - Irene Esteban-Cornejo
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- ibs.GRANADA Instituto de Investigación Biosanitaria, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
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Li X, Peng A, Li L, Chen L. Association between walking and square dancing-oriented leisure-time physical activity and cognitive function among middle-aged and elderly people in Southwest China. BMC Geriatr 2023; 23:28. [PMID: 36646990 PMCID: PMC9841134 DOI: 10.1186/s12877-023-03737-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/09/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Southwest China is facing a serious aging problem across the country, but the status of cognitive function in middle-aged and elderly people in this region is superior to the national average. This study intends to reveal the leisure-time physical activity (LTPA) pattern in this region and explore whether this pattern is beneficial for cognitive function. METHODS The data came from the 2019-2021 baseline survey on cognitive function of a natural population cohort conducted by West China Hospital of Sichuan University. A structured questionnaire was used to investigate the LTPA status of the participants, and the Mini-Mental State Examination was used to evaluate their cognitive function. Then, we used multiple linear regression to analyze the association between LTPA and cognitive level, and further subgroup analysis was carried out according to sex, age and waist-to-hip ratio. RESULTS A total of 2697 participants were enrolled, with an average age of 66.19 ± 6.68 years. The average cognitive function score was 27.23 ± 2.72, of which 8.60% indicated mild cognitive impairment. Their median LTPA level was 24.50 MET-hours per week, of which 70.37% reached the activity level recommended by WHO, with the main types being walking (1340 cases, 49.68%), square dancing (270 cases, 10.01%), or walking + square dancing (172 cases, 6.38%). Multiple linear regression showed that cognitive function increased with the amount of LTPA from 11.25 MET-hours/week to 36.40 MET-hours/week (β 0.09 for 11.25 ~ 24.50 MET-hours/week, β 0.38 for 24.50 ~ 36.40 MET-hours/week) but stabilized at more (β 0.39 for ≥36.40 MET-hours/week). The positive association persisted even for those who only walked (β 0.37 for 24.50 ~ 36.40 MET-hours/week, P = 0.008). CONCLUSIONS Middle-aged and elderly people in Southwest China hold a relatively high level of LTPA status, and walking and square dancing-oriented LTPA are positively correlated with cognitive function.
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Affiliation(s)
- Xu Li
- Department of Clinical Research and Management, Center of Biostatistics, Design, Measurement and Evaluation (CBDME), West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Anjiao Peng
- Department of Neurology, Joint Research Institute of Altitude Health, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Lin Li
- Department of Clinical Research and Management, Center of Biostatistics, Design, Measurement and Evaluation (CBDME), West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Lei Chen
- Department of Neurology, Joint Research Institute of Altitude Health, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
- Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
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Liu C, Wong PY, Chow SKH, Cheung WH, Wong RMY. Does the regulation of skeletal muscle influence cognitive function? A scoping review of pre-clinical evidence. J Orthop Translat 2023; 38:76-83. [DOI: 10.1016/j.jot.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/25/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
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Ibrahim A, Mat Ludin AF, Singh DKA, Rajab NF, Shahar S. Changes in cardiovascular-health blood biomarkers in response to exercise intervention among older adults with cognitive frailty: A scoping review. Front Physiol 2023; 14:1077078. [PMID: 36875037 PMCID: PMC9975543 DOI: 10.3389/fphys.2023.1077078] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction: Cardiovascular health contributes significantly to the incidence of cognitive impairment. Prior to conducting exercise-related intervention, it is crucial to explore cardiovascular health blood parameters that have been commonly used as guidance for the purpose of monitoring. Information on the effectiveness of exercise on cardiovascular-related biomarkers is lacking, especially among older adults with cognitive frailty. Therefore, we aimed to review existing evidence on cardiovascular-related blood parameters and their changes following exercise intervention among older adults with cognitive frailty. Methods: A systematic search was conducted on PubMed, Cochrane, and Scopus databases. Related studies involving only human and full text in either English or Malay language were selected. Types of impairment were limited to cognitive impairment, frailty, and cognitive frailty. Studies were restricted to randomized controlled trial and clinical trial design studies. For charting purposes, all variables were extracted and tabulated. Trends in types of parameters studied were explored. Results: A total of 607 articles were screened, and the final 16 were included in this review. Four cardiovascular-related blood parameter categories were extracted: inflammatory, glucose homeostasis, lipid profile, and hemostatic biomarkers. The common parameters monitored were IGF-1 and HbA1c, glucose, and insulin sensitivity in some studies. Out of the nine studies on inflammatory biomarkers, exercise interventions showed a reduction in pro-inflammatory markers, namely, IL-6, TNF-α, IL-15, leptin, and C-reactive protein and an increase in anti-inflammatory markers, namely, IFN-γ and IL-10. Similarly, in all eight studies, glucose homeostasis-related biomarkers had improved with exercise intervention. The lipid profile was tested in five studies, with four studies showing improvements with exercise intervention via a decrease in total cholesterol, triglycerides, and low-density lipoprotein and an increase in high-density lipoprotein. A decrease in pro-inflammatory biomarkers and an increase in anti-inflammatory biomarkers were demonstrated with multicomponent exercise, including aerobic exercise in six studies and aerobic exercise on its own in the remaining two studies. Meanwhile, four out of six studies that yielded improvements in glucose homeostasis biomarkers involved only aerobic exercise and the remaining two studies involved multicomponent with aerobic exercise. Conclusion: The most consistent blood parameters studied were glucose homeostasis and inflammatory biomarkers. These parameters have been shown to improve with multicomponent exercise programs, particularly with the inclusion of aerobic exercise.
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Affiliation(s)
- Azianah Ibrahim
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan, Kuala Lumpur, Malaysia
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