Abstract
BackgroundWhile it is well established that physical activity is associated with reduced risk of vascular and nonvascular outcomes as well as mortality, evidence on the association between physical activity and dementia is inconsistent. We aimed to assess the associations of physical activity with the risk of dementia and Alzheimer's disease (AD).Material and methodsWe analysed data on 2394 apparently healthy men with good baseline cognitive function from the prospective population‐based Kuopio Ischaemic Heart Disease study. We assessed habits of physical activity at baseline using a 12‐month leisure time physical activity (LTPA) questionnaire. Using Cox regression, we calculated hazard ratios adjusted for body mass index, systolic blood pressure, smoking status, history of type‐2 diabetes, total cholesterol, high‐density lipoprotein cholesterol, alcohol consumption, history of coronary heart disease and high‐sensitivity C‐reactive protein.ResultsDuring a median follow‐up of 24.9 years (interquartile range: 18.3‐26.9), 208 men developed dementia and 128 developed AD. Multivariable adjusted hazard ratios for dementia comparing top vs bottom tertiles of physical activity were 0.97 (95% confidence intervals: 0.69‐1.38) for total physical activity volume, 0.96 (0.69‐1.34) for conditioning LTPA volume and 1.13 (0.80‐1.61) for total LTPA volume. Corresponding hazard ratios for AD were 1.19 (0.76‐1.85), 0.98 (0.64‐1.49) and 1.22 (0.77‐1.93). Associations were consistent in analyses restricted to participants with ≥10 years of follow‐up.ConclusionsIn middle‐aged Caucasian men, various physical activity exposures were not associated with all‐cause dementia or AD. Future studies should address biases due to reverse causation and regression dilution and should involve objective measures of physical activity.
Highlights
The role of physical activity in disease prevention has been studied widely and is well established
To help clarify these associations, we set out to assess the relationships of physical activity with the long-term risk of all-cause dementia and Alzheimer's disease (AD) in the Finnish Kuopio Ischaemic Heart Disease (KIHD) population-based prospective cohort study
The 10-year threshold was chosen for consistency with a previous report[12] and because it has been reported that physical activity tends to decline approximately a decade before dementia diagnosis.[15]
Summary
The role of physical activity in disease prevention has been studied widely and is well established. Several prospective cohorts have investigated the associations of physical activity with the risk of dementia or AD, but they yielded inconsistent results.[12,13,14,15] Whereas some studies reported inverse relationships (i.e. a decreased dementia risk with higher physical activity),[13,14] others found no evidence of association.[12,15] To help clarify these associations, we set out to assess the relationships of physical activity with the long-term risk of all-cause dementia and AD in the Finnish Kuopio Ischaemic Heart Disease (KIHD) population-based prospective cohort study. Several different physical activity exposures are available within the KIHD study database, enabling us to evaluate the nature and magnitude of the associations in greater detail than in previous studies
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