Abstract
Background: Physical activity and cardiorespiratory fitness relate to better cognitive performance. Little is known about the effects of fitness on structural brain abnormalities in the elderly. Objective: Assess the association between maximal oxygen consumption (VO<sub>2</sub>max), white matter lesion (WML) volume and brain parenchymal fraction (BPF) in a large cohort of community-dwelling elderly individuals. Methods: The study population consisted of 715 participants of the Austrian Stroke Prevention Study who underwent brain MRI with semi-automated measurement of WML volume (cm<sup>3</sup>) and automated assessment of BPF (%) by the use of SIENAX. A maximal exercise stress test was done on a bicycle ergometer. VO<sub>2</sub>max was calculated based on maximum and resting heart rate. Results: After adjustment for possible confounders, VO<sub>2</sub>max was independently associated with WML volume (β = –0.10; p = 0.02); no significant relationship existed with silent cerebral infarcts and BPF. Associations between VO<sub>2</sub>max and WML load were only significant in men, but not in women. Conclusion: Our findings may have important preventive implications because WMLs are known to be a major determinant of cognitive decline and disability in old age.
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