Abstract
BackgroundThere is epidemiological evidence of an association between the metabolic syndrome (MetS), a cluster of cardiovascular risk factors related to central adiposity and insulin resistance, and cognitive impairment and dementia. On the other hand, there is evidence for a beneficial effect of physical activity on cognitive outcomes in older adult populations. In a cross-sectional study, we evaluated the relationship between aerobic physical activity and cognition in a cohort of overweight/obese older adults with MetS at risk for dementia. Cognitive function was assessed in a subsample of 82 subjects (men 55–75 y; women 60–75 y), with MetS and a BMI ≥27 to < 40 kg/m2 enrolled in the PREDIMED-PLUS study, a trial of diet and exercise in individuals with MetS with outcomes of cardiovascular prevention. Domain Z scores were calculated for the different cognitive domains. Aerobic physical activity was determined with the Rapid Assessment of Physical Activity questionnaire.ResultsAdjusted covariance analyses revealed that, compared to sedentary participants, those physically active obtained higher scores in mean global cognitive scores, with mean adjusted difference 0.254 (95% CI 0.032 to 0.477, p = 0.026) and frontal composites, with mean adjusted difference 0.375 (95% CI 0.110 to 0.639, p = 0.006).ConclusionsOur findings indicate that aerobic physical activity is associated with better global cognition and frontal function in overweight/obese older individuals with MetS, suggesting that physical activity could be a therapeutic strategy to reduce the risk of developing cognitive impairment or dementia in this population.
Highlights
There is epidemiological evidence of an association between the metabolic syndrome (MetS), a cluster of cardiovascular risk factors related to central adiposity and insulin resistance, and cognitive impairment and dementia
A recent systematic review and meta-analysis of 13 longitudinal population-based studies found a weak association of MetS with cognitive decline, but this relationship was not observed in the older age group (> 70 years) when an age-stratified analysis was performed [14], concurring with other reports suggesting that the association between MetS and poor cognitive function does not hold in older populations [9, 15, 16]
In line with these findings, some studies indicate that the risk of developing dementia is stronger when exposure to risk factors such as obesity, diabetes or hypertension occurs in mid-life rather than in late life [17,18,19]
Summary
There is epidemiological evidence of an association between the metabolic syndrome (MetS), a cluster of cardiovascular risk factors related to central adiposity and insulin resistance, and cognitive impairment and dementia. A recent systematic review and meta-analysis of 13 longitudinal population-based studies found a weak association of MetS with cognitive decline, but this relationship was not observed in the older age group (> 70 years) when an age-stratified analysis was performed [14], concurring with other reports suggesting that the association between MetS and poor cognitive function does not hold in older populations [9, 15, 16] In line with these findings, some studies indicate that the risk of developing dementia is stronger when exposure to risk factors such as obesity, diabetes or hypertension occurs in mid-life rather than in late life [17,18,19]. While three meta-analyses of prospective studies found a positive effect of physical activity on cognition [20,21,22], another systematic review reported no cognitive benefit [23], and a recent large prospective cohort study with a 28-year follow-up suggested that physical activity in midlife is not associated with a reduced risk of dementia and that previous findings of a lower risk of dementia in physically active individuals might be attributable to reverse causation [24]
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