Abstract
ObjectiveTo investigate whether cognitive and physical activities in midlife are associated with reduced risk of dementia and dementia subtypes in women followed for 44 years.MethodsA population-based sample of 800 women aged 38–54 years (mean age 47 years) was followed from 1968 to 2012. Cognitive (artistic, intellectual, manual, religious, and club) and physical activity were assessed at baseline. During follow-up, dementia (n = 194), Alzheimer disease (n = 102), vascular dementia (n = 27), mixed dementia (n = 41), and dementia with cerebrovascular disease (n = 81) were diagnosed according to established criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data. Cox regression models were used with adjustment for age, education, socioeconomic status, hypertension, body mass index, cigarette smoking, diabetes mellitus, angina pectoris, stress, and major depression.ResultsWe found that cognitive activity in midlife was associated with a reduced risk of total dementia (hazard ratio [HR] 0.66; 95% confidence interval [CI] 0.49–0.89) and Alzheimer disease (HR 0.54; 95% CI 0.36–0.82) during follow-up. Physical activity in midlife was associated with a reduced risk of mixed dementia (HR 0.43; 95% CI 0.22–0.86) and dementia with cerebrovascular disease (HR 0.47; 95% CI 0.28–0.78). The results were similar after excluding those who developed dementia before 1990 (n = 21), except that physical activity was then also associated with reduced risk of total dementia (HR 0.67; 95% CI 0.46–0.99).ConclusionOur findings suggests that midlife cognitive and physical activities are independently associated with reduced risk of dementia and dementia subtypes. The results indicate that these midlife activities may have a role in preserving cognitive health in old age.
Highlights
We found that cognitive activity in midlife was associated with a reduced risk of total dementia and Alzheimer disease (HR 0.54; 95% CI 0.36–0.82) during follow-up
Physical activity in midlife was associated with a reduced risk of mixed dementia (HR 0.43; 95% CI 0.22–0.86) and dementia with cerebrovascular disease (HR 0.47; 95% CI 0.28–0.78)
The results were similar after excluding those who developed dementia before 1990 (n = 21), except that physical activity was associated with reduced risk of total dementia (HR 0.67; 95% CI 0.46–0.99)
Summary
A population-based sample of 800 women aged 38–54 years (mean age 47 years) was followed from 1968 to 2012. As part of the Gothenburg H70 Birth Cohort Studies, we examined incidence of dementia in the Prospective Population Study of Women in Gothenburg, Sweden. In 1968–1969, a systematically selected sample of 899 women (participation rate 89%) aged 38, 46, 50, and 54 years (mean age 47 years) were invited to a health examination that included both physical and psychiatric investigations.[16] The women were selected from the Swedish Population Registry based on specific birth dates to yield a representative sample.[16] There were no differences in age, socioeconomic status (SES), work outside the home, or history of contact with mental health services among those who participated at baseline in 1968 (n = 800) compared to nonparticipants (n = 99).[17]. Dementia diagnoses were collected from the Swedish Hospital Discharge Registry for all individuals discharged from hospitals on a nationwide basis from 1978 to 2012
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