Higher Cardiovascular Fitness Research Articles

The relationship between white matter microstructure, cardiovascular fitness, gross motor skills, and neurocognitive functioning in children.

Recent evidence indicates that both cardiovascular fitness and gross motor skill performance are related to enhanced neurocognitive functioning in children by influencing brain structure and functioning. This study investigates the role of white matter microstructure in the relationship of both cardiovascular fitness and gross motor skills with neurocognitive functioning in healthy children. In total 92 children (mean age 9.1 years, range 8.0–10.7) were included in this study. Cardiovascular fitness and gross motor skill performance were assessed using performance‐based tests. Neurocognitive functioning was assessed using computerized tests (working memory, inhibition, interference control, information processing, and attention). Diffusion tensor imaging was used in combination with tract‐based spatial statistics to assess white matter microstructure as defined by fractional anisotropy (FA), axial and radial diffusivity (AD, RD). The results revealed positive associations of both cardiovascular fitness and gross motor skills with neurocognitive functioning. Information processing and motor response inhibition were associated with FA in a cluster located in the corpus callosum. Within this cluster, higher cardiovascular fitness and better gross motor skills were both associated with greater FA, greater AD, and lower RD. No mediating role was found for FA in the relationship of both cardiovascular fitness and gross motor skills with neurocognitive functioning. The results indicate that cardiovascular fitness and gross motor skills are related to neurocognitive functioning as well as white matter microstructure in children. However, this study provides no evidence for a mediating role of white matter microstructure in these relationships.

Mountain evidence on the relationship between iron status and pulmonary vasoconstriction.

Mountain evidence on the relationship between iron status and pulmonary vasoconstriction.

Immediate effects of a single session of physical exercise on cognition and cerebral blood flow: A randomized controlled study of older adults

BackgroundRegular physical activity is beneficial for cognitive performance in older age. A single bout of aerobic physical exercise can transiently improve cognitive performance. Researchers have advanced improvements in cerebral circulation as a mediator of long-term effects of aerobic physical exercise on cognition, but the immediate effects of exercise on cognition and cerebral perfusion are not well characterized and the effects in older adults are largely unknown. MethodsForty-nine older adults were randomized to a 30-min aerobic exercise at moderate intensity or relaxation. Groups were matched on age and cardiovascular fitness (VO2 max). Average Grey Matter Blood Flow (GMBF), measured by a pulsed arterial-spin labeling (pASL) magnetic resonance imaging (MRI) acquisition, and working memory performance, measured by figurative n-back tasks with increasing loads were assessed before and 7 min after exercising/resting. ResultsAccuracy on the n-back task increased from before to after exercising/resting regardless of the type of activity. GMBF decreased after exercise, relative to the control (resting) group. In the exercise group, higher n-back performance after exercise was associated with lower GMBF in the right hippocampus, left medial frontal cortex and right orbitofrontal cortex, and higher cardiovascular fitness was associated with lower GMBF. ConclusionThe decrease of GMBF reported in younger adults shortly after exercise also occurs in older adults and relates to cardiovascular fitness, potentially supporting the link between cardiovascular fitness and cerebrovascular reactivity in older age.

Regular participation in leisure time activities and high cardiovascular fitness improve motor sequence learning in older adults

IntroductionOlder adults show higher interindividual performance variability during the learning of new motor sequences than younger adults. It is largely unknown what factors contribute to this variability. This study aimed to, first, characterize age differences in motor sequence learning and, second, examine influencing factors for interindividual performance differences.Method30 young adults (age M = 21.89, SD = 2.08, 20 female) and 29 older adults (age M = 69.55, SD = 3.03, 18 female) participated in the study. Motor sequence learning was assessed with a discrete sequence production (DSP) task, requiring key presses to a sequence of visual stimuli. Three DSP practice phases (á 8 blocks × 16 sequences, two six-element sequences) and two transfer blocks (new untrained sequences) were performed. Older participants conducted the Mini-Mental Status Examination and a visuospatial working-memory task. All participants finished a questionnaire on everyday leisure activities and a cardiovascular fitness test.ResultsPerformance speed increased with practice in both groups, but young improved more than older adults (significant Group × Time effect for response time, F(1,5) = 4.353, p = 0.004, eta_{p}^{2} = 0.071). Accuracy did not change in any age group (non-significant Group × Time effect for error rates, F(1,5) = 2.130, p = 0.091, eta_{p}^{2} = 0.036). Older adults revealed lower transfer costs for performance speed (significant Time × Group effect, e.g., simple sequence, F(1,2) = 10.511, p = 0.002, eta_{p}^{2} = 0.156). High participation in leisure time activities (β = − 0.58, p = 0.010, R2 = 0.45) and high cardiovascular fitness (β = − 0.49, p = 0.011, R2 = 0.45) predicted successful motor sequence learning in older adults.DiscussionResults confirmed impaired motor learning in older adults. Younger adults seem to show a better implicit knowledge of the practiced sequences compared to older adults. Regular participation in leisure time activities and cardiovascular fitness seem to prevent age-related decline and to facilitate motor sequence performance and motor sequence learning in older adults.

Higher Fitness Levels Influence Association Between Cognition And Mobility In Older Adults With Hypertension And Dementia Risk

Higher levels of fitness are associated with preserved cognitive function in older adults. Preserved cognition is linked to better mobility and reduced risk of falls. However, it remains to be explored whether cardiovascular fitness (CF) influences the link between cognition and mobility in individuals with cardiovascular disease burden and risk of dementia. PURPOSE: We explored whether CF influences the relationship between cognition and mobility in older adults with hypertension and subjective cognitive decline. These individuals are at higher risk of dementia due to cardiovascular disease burden and early sings of cognitive impairment. METHODS: Older adults (n = 118, age 70.1 (SD = 6.7) years, 62% males) underwent CF assessment (Bruce protocol treadmill stress test) and were grouped based on Bruce protocol stage completion into low (stage 1 [n=31]), average (stage 2 [n=57]), and high (stage ≥3 [n=30]) CF groups. Cognition was measured via the Cambridge Brain Sciences cognitive battery; mobility (usual and dual-task gait [naming animals]) was measured using the GAITRite walkway system. We conduced hierarchical regression models adjusting for sex, age and years of education to determine whether CF modulated association between cognition and mobility. RESULTS: For usual gait, cognition was positively associated with gait velocity in high CF (Change statistics: F(1,25)=14.3, p=.001, R2=.35,), as well as step length in high CF (F(1,25)=10.8, p=.003, R2 =.27) and average CF (F(1,50)=4.4, p=.04, R2 =.08,), and gait variability in average CF (F(1,48)=9.8, p=.003, R2=.17). For dual-task gait, cognition was positively associated with gait velocity in both high CF (F(1,25)=9.15, p=.006, R2=.26) and average CF (F(1,49)=5.8, p=.02, R2 =.10), as well as step length in both high CF group (F(1,25)=7.2, p=.01, R2=.21) and average CF group (F(1,49)=7.2, p=.01, R2 =.13). CONCLUSIONS: Cognition was positively associated with mobility outcomes in individuals with average and high CF, while no associations were seen in those with low CF. These findings suggest that the protective effects of cognition on mobility (e.g., reduced falls risk and prolonged independence) may be hindered by low CF in older adults with hypertension.

Influences of Cardiovascular Fitness and Body Fatness on the Risk of Metabolic Syndrome: A Systematic Review and Meta-Analysis.

The purpose of this meta-analysis was to investigate the associations between combined cardiovascular fitness, obesity, and the risk of metabolic syndrome. The MEDLINE and EMBASE databases were used to select relevant studies that included the relative risk (RRs) of metabolic syndrome based on the combined effects of cardiovascular fitness and obesity from January 1990 to July 2019. The inclusion criteria were providing the RRs for the associations between combined cardiovascular fitness and obesity and the risk of metabolic syndrome. The exclusion criteria were review studies, duplicated studies, and no RRs reported for those associations. All selected studies categorized levels of cardiovascular fitness (high cardiovascular fitness vs low cardiovascular fitness) and obesity (normal vs obesity) and directly extracted the RRs for the risk of metabolic syndrome from these data. All selected studies were cross-sectional studies. All RRs and 95% CIs from the selected studies were computed to find the associations between combined cardiovascular fitness and obesity and the risk of metabolic syndrome. A total of 8 studies were selected for this meta-analysis. Low cardiovascular fitness was associated with 3. Fifty-nine times increased metabolic syndrome risk regardless of obesity (3.59, 95% CI: 3.07-4.20; P = .00). And obesity was associated with 1.62 times increased metabolic syndrome risk regardless of cardiovascular fitness level (1.62, 95% CI: 1.32-1.98; P = .00). Lastly, the risk of metabolic syndrome decreased by 77% with high cardiovascular fitness regardless of obesity (0.23, 95% CI: 0.12-0.43; P = .00). The combined effects of cardiovascular fitness and obesity are important factors when determining metabolic syndrome risk. The minimum level of cardiovascular fitness is 8.39 metabolic equivalent (METs) for adults to lower the risk of metabolic syndrome. Enhanced cardiovascular fitness and maintaining normal weight should be recommended for individuals to reduce the risk of metabolic syndrome.

Effect of Acute Moderate-Intensity Exercise on the Mirror Neuron System: Role of Cardiovascular Fitness Level.

ObjectivesThe aims of this study were to use functional near-infrared spectroscopy (fNIRS) to determine whether cardiovascular fitness levels modulate the activation of the mirror neuron system (MNS) under table-setting tasks in non-exercise situation, to replicate the study that positive effect of acute moderate-intensity exercise on the MNS and investigate whether cardiovascular fitness levels modulates the effect of exercise on the activation of the MNS.MethodsThirty-six healthy college-aged participants completed a maximal graded exercise test (GXT) and were categorized as high, moderate, or low cardiovascular fitness. Participants then performed table-setting tasks including an action execution task (EXEC) and action observation task (OBS) prior to (PRE) and after (POST) either a rest condition (CTRL) or a cycling exercise condition (EXP). The EXP condition consisted of a 5-min warm-up, 15-min moderate-intensity exercise (65% VO2max), and 5-min cool-down.ResultsNo significant differences were observed for Oxy-Hb and Deoxy-Hb between different cardiovascular fitness levels in the EXEC or OBS tasks in the non-exercise session. But there were significant improvements of oxygenated hemoglobin (Oxy-Hb) in the inferior frontal gyrus (IFG) and pre-motor area (PMC) regions under the OBS task following the acute moderate exercise. Particularly, the improvements (Post-Pre) of Δ Oxy-Hb were mainly observed in high and low fitness individuals. There was also a significant improvement of deoxygenated hemoglobin (Deoxy-Hb) in the IPL region under the OBS task. The following analysis indicated that exercise improved Δ Deoxy-Hb in high fitness individuals.ConclusionThis study indicated that the activation of MNS was not modulated by the cardiovascular fitness levels in the non-exercise situation. We replicated the previous study that moderate exercise improved activation of MNS; we also provided the first empirical evidence that moderate-intensity exercise positively affects the MNS activation in college students of high and low cardiovascular fitness levels.

Explaining Individual Differences in Fine Motor Performance and Learning in Older Adults: The Contribution of Muscle Strength and Cardiovascular Fitness.

It remains controversial whether aging influences motor learning and whether physiological factors, such as local strength or fitness, are associated with fine motor performance and learning in older adults (OA). OA (n = 51) and young adults (YA, n = 31) performed a short-term motor learning session using a precision grip force modulation task. The rate of improvement of OA compared with YA was steeper with respect to performance variability and temporal precision. Both age groups showed positive transfer during an unpracticed variant of the force modulation task. Local muscle strength (pinch and grip strength) and high cardiovascular fitness positively predicted fine motor performance, whereas initial performance, muscle strength, and motor fitness (heterogeneous motor test battery) negatively predicted rate of improvement. Analyses indicated potentials, but also limits of plasticity for OA.

Cardiovascular fitness and risk of migraine: a large, prospective population-based study of Swedish young adult men

ObjectivesTo examine the longitudinal relationship between cardiovascular fitness in young adult men and future risk of migraine and to estimate eventual differential effects among categories of body mass index (BMI)...

Reader response: Midlife cardiovascular fitness and dementia: A 44-year longitudinal population study in women.

Horder et al.1 advanced the hypothesis that midlife cardiovascular fitness protects against old-age dementia. However, the limitations of the data were not fully discussed. The estimated benefit of greater fitness in terms of dementia prevention is overoptimistic. Using data from tables 3 and 4 in the article,1 we calculated a population attributable fraction (PAF) of 78.3%, suggesting that 8 of 10 dementia cases would be avoided if all women had high cardiovascular fitness (table). This is more than 2 times greater than the collective PAF for all known modifiable risk factors in the most recent synopsis,2 which is itself an upper-bound estimate.3

Socioeconomic multi-domain health inequalities in Dutch primary school children.

This study assesses socio-economic health inequalities (SEHI) over primary school-age (4- to 12-years old) across 13 outcomes (i.e. body-mass index [BMI], handgrip strength, cardiovascular fitness, current physical conditions, moderate to vigorous physical activity, sleep duration, daily fruit and vegetable consumption, daily breakfast, exposure to smoking, mental strengths and difficulties, self-efficacy, school absenteeism and learning disabilities), covering four health domains (i.e. physical health, health behaviour, mental health and academic health). Multilevel mixed effect (linear and logistic) regression analyses were applied to cross-sectional data of a Dutch quasi-experimental study that included 1403 pupils from nine primary schools. Socioeconomic background (high-middle-low) was indicated by maternal education (n = 976) and parental material deprivation (n = 784). Pupils with higher educated mothers had lower BMIs, higher handgrip strength and higher cardiovascular fitness; their parents reported more daily fruit and vegetable consumption, daily breakfast and less exposure to smoking. Furthermore these pupils showed less mental difficulties and less school absenteeism compared with pupils whose mothers had a lower education level. When using parental material deprivation as socio-economic indicator, similar results were found for BMI, cardiovascular fitness, sleep duration, exposure to smoking and mental strengths and difficulties. Socio-economic differences in handgrip strength, cardiovascular fitness and sleep duration were larger in older than in younger pupils. Childhood SEHI are clearly found across multiple domains, and some are larger in older than in younger pupils. Interventions aiming to tackle SEHI may therefore need a comprehensive and perhaps more fundamental approach.

High Cardiovascular Fitness in Midlife Tied to Lower Dementia Risk Later

Women with a high level of cardiovascular fitness at midlife may have a reduced risk for dementia years later, a Neurology study suggests.Nearly 200

Midlife cardiovascular fitness and dementia: A 44-year longitudinal population study in women.

ObjectiveTo investigate whether greater cardiovascular fitness in midlife is associated with decreased dementia risk in women followed up for 44 years.MethodsA population-based sample of 1,462 women 38 to 60 years of age was examined in 1968. Of these, a systematic subsample comprising 191 women completed a stepwise-increased maximal ergometer cycling test to evaluate cardiovascular fitness. Subsequent examinations of dementia incidence were done in 1974, 1980, 1992, 2000, 2005, and 2009. Dementia was diagnosed according to DSM-III-R criteria on the basis of information from neuropsychiatric examinations, informant interviews, hospital records, and registry data up to 2012. Cox regressions were performed with adjustment for socioeconomic, lifestyle, and medical confounders.ResultsCompared with medium fitness, the adjusted hazard ratio for all-cause dementia during the 44-year follow-up was 0.12 (95% confidence interval [CI] 0.03–0.54) among those with high fitness and 1.41 (95% CI 0.72–2.79) among those with low fitness. High fitness delayed age at dementia onset by 9.5 years and time to dementia onset by 5 years compared to medium fitness.ConclusionsAmong Swedish women, a high cardiovascular fitness in midlife was associated with a decreased risk of subsequent dementia. Promotion of a high cardiovascular fitness may be included in strategies to mitigate or prevent dementia. Findings are not causal, and future research needs to focus on whether improved fitness could have positive effects on dementia risk and when during the life course a high cardiovascular fitness is most important.

ASSESSMENT OF CARDIO-VASCULAR FITNESS AND SELF-CONCEPT OF BADMINTON PLAYERS OF HIGH AND LOW PERFORMANCE ABILITY

The purpose of this study was to assess the cardio-vascular fitness and self-concept of badminton players of low and high performance ability. Thirty male badminton players (fifteen districts level and fifteen state level) were randomly selected for this study. All the players were residing in Lucknow city and their age ranged from 19-25 years. Data on cardio-vascular fitness of the subjects were collected with the help of Harvard Step Test. For measuring the self-concept, a questionnaire prepared by Dr. G. P. Sherry was used. To compare the cardio-vascular fitness and self-concept of badminton players “t-ratio” was employed and the level of significance was set at 0.05. On the basis of the results of the study, high performance level badminton players had significantly high cardio-vascular fitness than those of low performance level badminton players, where as in the dimension of self-concept significant difference was not found between them. Article visualizations:

Association of High Cardiovascular Fitness and the Rate of Adaptation to Heat Stress.

This study aimed to compare changes in genes expression associated with inflammation and apoptosis in response to heat stress caused by sauna between people with varying cardiorespiratory fitness levels. We hypothesis that high cardiorespiratory level caused higher positive changes after four weeks of sauna bathing. Blood samples were taken at rest before and after the first and last sauna sessions and 48 hours after the last sauna session and used to assay HSP70 (HSPA1A), HSP27 (HSPB1), interleukin 6 (IL6), and interleukin 10 (IL10) genes expression in blood with quantitative real-time qRT-PCR. Overall, small decreases in rest values of HSPA1A and IL6 mRNA, increase in HSPB1 mRNA, and a significant increase in IL10 mRNA were observed after four weeks of exposure to heat stress. Our findings suggest that an adaptive response to heat stress (an anti-inflammatory response) occurs faster in people with higher cardiorespiratory fitness.

Sport participation and vigilance in children: Influence of different sport expertise

PurposeThe present study aimed to investigate the relationship between different types of sport expertise (externally-paced vs. self-paced sports) and vigilance performance in children by evaluating the cardiovascular fitness level of the participants. MethodsThree groups of children (11.0 ± 0.2 years) differentiated in terms of their regular sport participation (football players, n = 20; track and field athletes, n = 20; non-athletic controls, n = 20) took part in the study. In one session, participants performed the Leger Multi-stage fitness test to estimate their aerobic fitness level. In another session, participants completed the Psychomotor Vigilance Task (PVT) to evaluate their vigilance performance under 2 conditions of velocity demands (normal vs. speed). ResultsThe results revealed that both groups of sport practitioners had higher cardiovascular fitness than non-athlete controls. In contrast, no significant differences in the performance PVT were found between track and field athletes and controls. Crucially, football players showed better performance in the PVT than track and field athletes and controls. These between-group differences were not modulated by the speed demands of the task. ConclusionThe major novel finding of this research points to a positive relationship between sport participation and vigilance performance during childhood. We discuss our results in terms of the different hypotheses put forward in the literature to explain the relationship between regular exercise and cognitive functioning: the “cardiovascular fitness” and the “cognitive component skills” hypotheses.

The Relationship between Cardiorespiratory Fitness and Allostatic Load

Background: There is evidence that chronic stress/burnout have a negative impact on physical and mental health. Annually global burden of stress related disorders amounts to 300 billion dollars. Conversely, physical fitness seems to have a significant influence on the development of a large number of mental and physical disorders and on reduction of physical stress. The aim of this study was to examine stress related cumulative physiological burden in relation to cardiorespiratory fitness level. Methods: A sample of 86 healthy males aged between 28-60 years from an international company took part in the study. In addition to questionnaires, an indicator of cumulative physiological burden (allostatic load) was calculated including systolic and diastolic blood pressure, waist to hip ratio and 24–hour overnight urinary epinephrine and norepinephrine, cortisol and HRV variables (SDNN, rMSSD and LF/HF). All individuals underwent additionally a maximal incremental exercise test on an electronically braked cycle ergometer. Results: All participants showed high working stress, measured by effort/reward ration. High allostatic load was significantly associated with low cardiorespiratory fitness. Individuals with higher cardiovascular fitness showed significantly lower WHR, HR, DBP and significantly higher SDNN and rMSSD compared to participants with lower cardiorespiratory fitness. Conclusion: Signs of work-stress related physiological burden were significantly related to cardiorespiratory fitness. Significant reduction of physiological burden could be observed if people achieved more than 120% of age related cardiovascular fitness but not if participants felt below this threshold.

Cardiovascular fitness in young males and risk of unprovoked venous thromboembolism in adulthood

Background: Whether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown. The present study aims to determine whether high cardiovascular fitness reduces the risk of VTE.Methods: A Swedish cohort of male conscripts (n = 773,925) born in 1954–1970 with no history of previous VTE were followed from enlistment (1972–1990) until 2010. Data on cardiovascular fitness using a cycle ergonometric test (maximal aerobic workload in Watt [Wmax]) at conscription were linked with national hospital register data and the Multi-Generation Register. We identified all full-siblings and first-cousin pairs discordant for maximal aerobic workload. This co-relative design allows for adjustment for familial resemblance.Results: In total, 3005 (0.39%) males were affected by VTE. Cardiovascular fitness estimated with Wmax was not associated with VTE risk when adjusted for body mass index (BMI). However, cardiovascular fitness estimated with Wmax/kg and adjusted for BMI was associated with reduced risk for VTE (Hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.78–0.85 per standard deviation compared with mean Wmax/kg). The association was weaker over time and also when examining discordant first cousins and full-sibling pairs.Conclusions: These results suggest that there is a relationship between cardiovascular fitness and weight that is important for future VTE risk.Key messagesWhether high cardiovascular fitness is associated with reduced risk of venous thromboembolism (VTE) is unknown.A Swedish cohort of male conscripts (n = 773,925) tested with a cycle ergometric test with no history of previous VTE were followed from enlistment (1972–1990) until 2010.Cardiovascular fitness estimated with Wmax/kg and adjusted for BMI was associated with reduced risk for VTE (HR 0.81, 95% CI 0.78–0.85).These results suggest that there is a relationship between cardiovascular fitness and weight that is important for future VTE risk.

Obesity, Cardiovascular Fitness, and Inhibition Function: An Electrophysiological Study.

The purpose of the present study was to examine how obesity and cardiovascular fitness are associated with the inhibition aspect of executive function from behavioral and electrophysiological perspectives. One hundred college students, aged 18–25 years, were categorized into four groups of equal size on the basis of body mass index and cardiovascular fitness: a normal-weight and high-fitness (NH) group, an obese-weight and high-fitness (OH) group, a normal-weight and low-fitness (NL) group, and an obese-weight and low-fitness (OL) group. Behavioral measures of response time and number of errors, as well as event-related potential measures of P3 and N1, were assessed during the Stroop Task. The results revealed that, in general, the NH group exhibited shorter response times and larger P3 amplitudes relative to the NL and OL groups, wherein the OL group exhibited the longest response time in the incongruent condition. No group differences in N1 indices were also revealed. These findings suggest that the status of being both normal weight and having high cardiovascular fitness is associated with better behavioral and later stages of electrophysiological indices of cognitive function.

Abstract P116: Physical Fitness in Early Adulthood: A Modifiable Risk Factor for Neurological and Psychiatric Diseases

Low cardiovascular fitness in mid- and late life represents a risk factor for several neurological diseases. However, the respective effect of aerobic cardiovascular and muscle fitness in early adulthood is largely unknown. Therefore, we analyzed these in young men with regard to long-term risk serious depression, bipolar disorders, stroke and dementia. We performed population-based longitudinal cohort studies of Swedish male conscripts registered in 1968-2005 for mandatory military service (approx. 1,800,000 subjects), representing about 95 % of all Swedish males at age 18 during this time period. Data on cardiovascular fitness (determined by the cycle ergometric test), muscle strength (isometric contraction) and cognitive performance (IQ tests) were subdivided into low, medium, high fitness groups. Over a 40-year follow-up, risk of serious depression, bipolar disorder, stroke and dementia were calculated with Cox proportional hazards models controlling for potential confounders. To identify cases, we used the International Classification of Diseases (ICD) 8-10 in the Hospital Discharge Register and the Cause of Death Register. Depression. Adjusted hazard ratios (HRs) with confidence interval (CI) show significant relationships between fitness and severe depression for low compared to high fitness: HR (CI) 1.80 (1.64-1.99) for cardiovascular fitness and 1.43 (1.32-1.55) for muscle strength. Bipolar disorders exhibited a lower, yet significant association with cardiovascular fitness and muscle strength (adjusted hazard ratios (HRs) with confidence interval (CI): 1.35 (1.12-1.63) and 1.22 (1.05-1.42), respectively. Stroke. Adjusted HRs show inverse relationships between fitness and stroke for low compared to high fitness HR (CI) 1.70 (1.50-1.93) for cardiovascular fitness and 1.39 (1.27-1.53) for muscle strength. All three stroke types (subarachnoidal hemorrhage, intracerebral hemorrhage and ischemic stroke displayed similar associations. There were stronger associations for fatal stroke. Dementia. Low compared to high cardiovascular fitness was significantly associated with an increased risk for diagnosis of dementia before age 60: HR (CI) 2.49 (1.87-3.32). Mild cognitive impairment (MCI) showed an even greater association: HR (CI) 3.57 (2.23-5.74). The combination of low cardiovascular fitness and poor cognitive performance in early adulthood was associated with a >8-fold increase in the risk of early-onset MCI and a >7-fold increased risk of early-onset dementia. In summary, this study sheds light on physical fitness as an early-life risk factor for psychiatric and neurological conditions, and underlines the potential for lifestyle modification to reduce the risk of late-life CNS impairments.