Abstract
Depression both affects physical activity (PA) and cognition in older persons, yet its impact on the association between PA and cognitive decline is to be determined. We aimed to investigate the association between baseline PA and cognitive functioning over time, stratified for depression. We used data of the Netherlands Study of Depression in Older persons (NESDO), a multi-site cohort study with 6-years follow-up. Patients with complete data on PA and cognitive functioning at baseline were included, yielding 394 participants for the analyses of whom 297 were depressed and 97 non-depressed. PA (continuous) was measured with the International Physical Activity Questionnaire. Linear mixed models were used to determine differential effects of baseline PA on the rate of decline of 5 standardized outcomes of cognitive functioning over 6-year follow-up. For this purpose, we examined the significance of the interaction-term (PA*time) in both basic and adjusted models. We also assessed the association between time and cognitive functioning. All analyses were stratified for depression. In both groups, no robust significant interactions of PA with time were found. Furthermore, only decline in working memory was significantly worse in the depressed compared to the non-depressed. At older age, the impact of a more inactive lifestyle on cognitive decline was shown to be limited, irrespective of depression that appeared to worsen age-related decline of working memory only. As a higher PA-level at older age has a positive effect on a multitude of other health outcomes, PA should still be encouraged in this population.
Highlights
As the population ages, new challenges arise, such as how to gain an extended period of good health with increasing longevity.[1]
Data were available from participants of the Netherlands Study of Depression in Older persons (NESDO), a longitudinal, multisite, naturalistic cohort study that included 378 older adults with a depressive disorder and 132 nondepressed older adults with no diagnosis of depression during their lifetime
In the total sample we firstly investigated the significance of the 3-way interaction term “physical activity (PA)**time* depression” for all cognitive outcomes in a basic model using linear mixed models (LMM)
Summary
New challenges arise, such as how to gain an extended period of good health with increasing longevity.[1] Healthy aging is closely linked to the preservation of cognitive capabilities.[2] Physical activity (PA) may be employed as a potential protective strategy for healthy aging in general, and for cognitive decline in particular.[3] PA may slow cognitive decline directly through increased blood flow resulting in preservation of the cardiovascular integrity of the brain,[4] or indirectly by reducing other risk factors (namely, cardiovascular disease, obesity, and diabetes).[5] Two metaanalyses examining prospective cohort studies including persons over 406 and 65 years[7] demonstrated clear evidence for an association between higher levels of (PA) and a reduced risk of cognitive decline and (Alzheimer’s) dementia.[6,7].
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