Minimum physical activities protective against Alzheimer's disease in late life: a systematic review.

An insider's view on physical activity in later life

BackgroundPhysically active lifestyle prevents and contributes to managing non-communicable diseases. Childhood physical activities have shown to associate with physically active lifestyle in adulthood. More research on which childhood physical activity modes associate with physical activity in later life is still needed. Within the present study, we examined how physically active commuting to school in childhood contributed to overall physical activity in adulhood.MethodsThe participants (N = 3596) were from the population-based, longitudinal Cardiovascular Risks in Young Finns Study. Questionnaires were used in assessing subjects' childhood (1980) and adulthood (2001-2018) physical activity. ActiGraph accelerometers were also applied in the adulthood measurements (2018-2020). The results were analyzed using logistic and linear regression models. Participants' age, sex, parents' educational background, parents' income level, childhood living area, participants' educational background, adulthood income level, and adulthood living area were adjusted for in the models.ResultsBased on the preliminary examinations, childhood commuting was not associated with self-reported commuting to work (2001-2018) or accelerometer-measured overall physical activity (2018-2020) in adulthood (p>.05). Active commuting in childhood associated with increased self-reported leisure-time physical activity in the year 2001 (b=.38, p>.001), 2007 (b=.35, p>.001), and 2018 (b=.28, p=.012), but the association between childhood commuting and self-reported physical activity in the years 2001 and 2018 attenuated after adjusting for all covariates (p>.05).ConclusionsPhysically active commuting in childhood (1980) was associated with higher levels of self-reported leisure-time physical activity in adulthood (2001-2018). The associations attenuated after adjusting for covariates excluding the one between active commuting and leisure-time physical activity assessed in 2007. Physically active commuting can be regarded as recommendable with respect to the development of physically active lifestyle, if supportive evidence for the causality between childhood commuting and leisure-time physical activity in adult age can be found. Future research should also focus on assessing whether active commuting in childhood contributes to adulthood activities parallel to active commuting in childhood.

Studies suggest that individuals who are at increased risk for Alzheimer disease (AD) in late life differ on measures of cognition, linguistic performance, and brain metabolism in earlier adult life compared with those with lower risk of this illness. The present study was undertaken to determine whether smaller head circumference (HC), a predictor of AD in late life, could influence educational attainment earlier in life, specifically among individuals at increased risk for AD. Data from the Nun Study, a longitudinal clinicopathologic study of dementia, were analyzed using logistic regression to assess the association between HC and attainment of less than a bachelor's degree. Modification of this association was studied by comparing those with and without evidence of increased AD risk, including possession of apolipoprotein E (APOE)-epsilon 4 alleles, occurrence of dementia before death, and satisfaction of AD neuropathologic criteria at autopsy. Small HC was associated with lower educational attainment in those carrying an APOE-epsilon 4 allele [odds ratio (OR)=6.27, 1.21 to 32.48], those who became demented (OR=3.23, 1.27 to 8.21), and those who fulfilled AD neuropathologic criteria (OR=5.03, 1.29 to 19.66), but not in those without these characteristics. These findings suggest that small HC limits educational attainment only among individuals who have greater risk of AD owing to their APOE genotype or who are destined to develop this illness later in life.

Growing evidence supports a strong and likely causal association between cardiovascular disease (CVD), and its risk factors, with incidence of cognitive decline and Alzheimer's disease. Individuals with subclinical CVD are at higher risk for dementia and Alzheimer's. Several cardiovascular risk factors are also risk factors for dementia, including hypertension, high LDL cholesterol, low HDL cholesterol and especially diabetes. Moderate alcohol appears to be protective for both CVD and dementia. In contrast, inflammatory markers predict cardiovascular risk, but not dementia, despite biological plausibility for such a link. The substantial overlap in risk factors points to new avenues for research and prevention.

Physical Activity in Childhood and Adolescence as Predictor of Physical Activity in Young Adulthood

BackgroundMore people are living longer lives leading to a growth in the population of older adults, many of whom have comorbidities and low levels of physical function. Physical activity in later life can prevent or delay age-related disability. Identifying a cost-effective means of increasing physical activity in older adults therefore remains an important public health priority.Physical Activity Facilitation (PAF) is an intervention shown to increase physical activity in adults with depression. The PAF model was modified for a population of older adults at risk of disability. This study aimed to assess the feasibility of undertaking a definitive RCT of the PAF intervention in the target population.MethodsA pilot randomised controlled trial (RCT) was delivered through primary care. Patients at risk of disability and who were not meeting recommended levels of physical activity were recruited through postal invitation and direct approach in the practice waiting room. Those meeting eligibility criteria were enrolled and randomised at a 2:1 ratio to the PAF intervention and control. Behaviour change techniques were used by facilitators with participants over the telephone and face-to-face for 6 months. Outcome measures including physical function, physical activity, depression, social support, and quality of life were collected at baseline and at 6 months.ResultsA high proportion of patients responded to the initial invitation (68%), yet many were ineligible due to high levels of self-reported physical activity and baseline physical function. Fifty-one participants were recruited to the trial, with an average age of 74 years (range 65–89), and there were high rates of adherence and retention to the study (94% follow-up at 6 months). The majority of outcome data collected from participants was complete; however, the validated scale used to measure self-reported physical activity was associated with high levels of missing data.ConclusionsThe findings of this pilot RCT suggest that it is feasible to deliver a definitive RCT of the PAF intervention in this population. Further work is required to improve the efficiency of recruitment and to minimise missing data from self-reported physical activity measures.Trial registrationCurrent controlled trials ISRCTN80470273. Registered 25 October 2013.

Adolescent participation in sports and adult physical activity

Maintaining physical activity in later life is important for maintaining health and function. Activity outdoors, such as walking, jogging and cycling, may provide an accessible, sociable and practical solution, but maintaining outdoor mobility may be a challenge in later life. Providing green environments which are supportive of physical activity may facilitate this, yet research into how greenspace could be best used is inconclusive. This study evaluates the role of greenspace in protecting against decline in physical activity over time in older adults.Data from the European Prospective Investigation of Cancer Norfolk, UK, cohort 1993–2009 (N=15,672) was used. Linear regression modelling was used to examine the association between exposure to greenspace in the home neighbourhood and change in overall, recreational and outdoor physical activity measured in terms of metabolic equivalent cost (MET) in hours/week. Mediation analysis was conducted to assess if dog walking explained the relationship between greenspace and physical activity change. Models were adjusted for known and hypothesised confounders.People living in greener neighbourhoods experienced less of a decline in physical activity than those living in less green areas. Comparing change for those living in the greenest versus least green quartiles, participants showed a difference in overall physical activity of 4.21 MET hours/week (trend P=0.001), adjusted for baseline physical activity, age, sex, BMI, social class and marital status. This difference was 4.03 MET hours/week for recreational physical activity (trend P<0.001) and 1.28 MET hours/week for outdoor physical activity (trend P=0.007). Dog walking partially mediated the association between greenspace and physical activity change, by 22.6% for overall, 28.1% for recreational and 50.0% for outdoor physical activity (all P<0.001).Greenspace in the home neighbourhood may be protective against decline in physical activity among older people as they age. Dog walking is a potential mechanism in this relationship, and warrants further investigation as a way of maintaining physical activity in later life.

BackgroundThe level of physical activity (PA) among patients with coronary heart disease (CHD) living in Chinese communities who do not participate in cardiac rehabilitation programs and the factors contributing to patient maintenance of PA are unclear.ObjectiveThis cross-sectional study, guided by the Transtheoretical Model, evaluated (1) the maintenance of PA in Chinese patients with CHD 12 months after hospital discharge and (2) the demographic, clinical, and psychological characteristics associated with maintenance of PA.MethodsA total of 1162 patients completed 6 questionnaires at 12 months posthospitalization to assess their maintenance of PA, stage of change, symptoms of depression and anxiety, and health-related quality of life and sleep.ResultsOnly 40% of patients with CHD maintained regular PA 12 months after hospital discharge. Walking was their primary PA. Thirty-seven percent of patients reported no intention of having regular PA. Male sex (odds ratio [OR], 1.69), awareness of PA's cardiac benefit (OR, 4.12), a history of regular PA before the cardiac event (OR, 6.08), history of chronic disease (OR, 1.43), mild depressive symptoms (OR, 1.40), moderate and severe depressive symptoms (OR, 0.41), smoking (OR, 0.54), and years of CHD (OR, 0.96) were related to maintenance of regular PA. Patients with CHD who maintained regular PA had better quality of life and sleep (P < .001) and fewer unplanned clinic visits (P = .001) and cardiac cause readmissions (P = .012) and reported fewer declines in PA capacity (P < .001).ConclusionsWalking is the most common form of PA 12 months posthospitalization among patients with CHD in China. Patient education and counseling about the cardiac benefits of PA, taking into account stage of change, are important considerations to improve maintenance of PA.

BackgroundExposure to higher magnitude vertical impacts is thought to benefit bone health. The correlates of this high-impact physical activity (PA) in later life are unknown.MethodsParticipants were from the Cohort for Skeletal Health in Bristol and Avon, Hertfordshire Cohort Study and MRC National Survey of Health and Development. Associations of demographic, behavioural, physiological and psychological factors with vertical acceleration peaks ≥1.5 g (i.e. high-impact PA) from 7-day hip-worn accelerometer recordings were examined using linear regression.ResultsA total of 1187 participants (mean age = 72.7 years, 66.6% females) were included. Age, sex, education, active transport, self-reported higher impact PA, walking speed and self-rated health were independently associated with high-impact PA whereas BMI and sleep quality showed borderline independent associations. For example, differences in log-high-impact counts were 0.50 (P < 0.001) for men versus women and −0.56 (P < 0.001) for worst versus best self-rated health. Our final model explained 23% of between-participant variance in high impacts. Other correlates were not associated with high-impact activity after adjustment.ConclusionsBesides age and sex, several factors were associated with higher impact PA in later life. Our findings help identify characteristics of older people that might benefit from interventions designed to promote osteogenic PA.

The authors of this prospective cohort study sought to examine associations between mid- and late-life physical activities and incident clinical depression and anxiety among community-dwelling older adults. The sample included 2,630 adults to examine the outcome of clinical depression (median follow-up length=5.4 years) and 2,444 to examine clinical anxiety (median follow-up length=5.6 years). Participants were ages ≥70 years, were enrolled in the Mayo Clinic Study of Aging, and did not have dementia or the respective neuropsychiatric symptoms at baseline. Mid- and late-life physical activities were assessed as predictors with a validated questionnaire, and physical activity composite scores were calculated. Outcomes of interest were new onset of clinical depression and anxiety, measured with the Beck Depression Inventory (score >13) and Beck Anxiety Inventory (score >7), respectively. The authors used Cox proportional hazard models, adjusted for age (timescale), sex, education, apolipoprotein E ε4 genotype status, and comorbid medical conditions. Higher overall physical activity in late life was associated with a decreased risk for incident clinical depression (hazard ratio [HR]=0.85, 95% CI=0.74-0.98, p=0.025). Higher late-life overall physical activity (HR=0.79, 95% CI=0.71-0.89, p<0.001) and moderate-to-vigorous physical activity (MVPA; HR=0.86, 95% CI=0.77-0.95, p=0.003) were associated with a decreased risk for incident clinical anxiety. Higher midlife overall physical activity (HR=1.16, 95% CI=1.05-1.28, p=0.003) and MVPA (HR=1.12, 95% CI=1.02-1.23, p=0.019) were associated with an increased risk for new-onset clinical anxiety but not depression. Engagement in late-life physical activity was associated with reduced risk for new-onset depression and anxiety among community-dwelling older adults without dementia.

Earlier-life individual and spatial socioeconomic conditions and later-life physical activity.

Introduction: Physical activity (PA) has been identified as a protective factor for dementia, but the mechanisms linking PA to brain health are unclear. To elucidate potential pathways linking PA to brain health, we tested the hypothesis that higher levels of late-life PA are associated with a lower burden of Alzheimer’s disease (AD) pathology, cerebrovascular disease, and neurodegeneration measured through brain imaging and plasma biomarkers. Methods: ARIC-NCS participants without dementia in 2011-13 and with measures of PA, 3T brain magnetic resonance imaging (MRI), and stored plasma samples were examined (n=1,771; mean age: 76.5 years; 40.5% male; 27.6% Black). Participants were classified as meeting or not meeting 2018 aerobic PA guidelines based on a standardized interviewer-administered questionnaire. MRI biomarkers included white matter hyperintensity (WMH) volume (cm 3 ), total brain volume (TBV) (cm 3 ), and cortical thickness (CT) (mm). Plasma biomarkers of the ratio of amyloid beta 42 to 40 (Aβ42/Aβ40), phosphorylated Tau-181 (p-Tau181), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) were measured using Quanterix Simoa immunoassays. All biomarkers were standardized to measures in 2011-13 to facilitate comparisons. Covariate-adjusted linear regression models estimated cross-sectional associations of PA with MRI or plasma biomarkers. Covariate-adjusted linear mixed effects models quantified associations of PA with the 5-year rate of change in a subset of participants with MRI (n=669) or plasma (n=651) biomarkers at both baseline and follow-up from 2011-19 (median follow-up: 5.4 years). Results: Meeting versus not meeting aerobic PA guidelines was cross-sectionally associated with lower volumes of WMH (β = -0.16, 95% CI: -0.25, -0.07), higher TBV (β = 0.09; 95% CI: 0.05, 0.13), and lower plasma NfL (β = -0.102, 95% CI: -0.184, -0.021) ( Figure ). Late-life PA was not associated with 5-year rates of change in MRI or plasma biomarkers. Conclusions: Late-life PA was cross-sectionally associated with less neurodegeneration and cerebrovascular disease. Associations with 5-year changes in imaging and plasma biomarkers of AD pathology, cerebrovascular disease, or neurodegeneration were not statistically supported. Longitudinal biomarker studies with wearable devices that quantify other daily intensity-based movement metrics (e.g., light PA) and larger sample sizes are needed to further examine mechanisms linking PA to brain health.

Demographic and psychosocial correlates of physical activity in late life

Dog ownership and physical activity in later life: A cross-sectional observational study