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Physical Activity as Protective Factor against Dementia: A Prospective Population-Based Study (NEDICES)

  • Sara Llamas-Velasco (a1) (a2), Israel Contador (a3), Alberto Villarejo-Galende (a1), David Lora-Pablos (a4) and Félix Bermejo-Pareja (a2) (a5) (a6)...

Abstract

The aim of this study was to analyze whether physical activity (PA) is a protective factor for the incidence of dementia after 3 years of follow-up. The Neurological Disorders in Central Spain (NEDICES) is a prospective population-based survey of older adults (age 65 years and older) that comprised 5278 census-based participants at baseline (1994–1995). A broad questionnaire was used to assess participants’ sociodemographic characteristics, health status, and lifestyle. Subsequently, a modified version of Rosow-Breslau questionnaire was applied to classify individuals’ baseline PA into groups (i.e., sedentary, light, moderate, and high). Cox regression models adjusted for several covariates (age, sex, education, previous stroke, alcohol consumption, hypertension, health related variables) were carried out to estimate the association between the PA groups and risk of dementia at the 3-year follow-up (1997–1998). A total of 134 incident dementia cases were identified among 3105 individuals (56.6% female; mean age=73.15±6.26) after 3 years. Hazard ratios (HRs) of the light, moderate, and high PA groups (vs. sedentary group) were 0.40 (95% confidence interval {CI} [0.26, 0.62]; p<.001), 0.32 (95% CI [0.20, 0.54]; p<.001) and 0.23 (95% CI [0.13, 0.40]; p<.001), respectively. Even after controlling for covariates and the exclusion of doubtful dementia cases, HRs remained significant. However, a supplementary analysis showed that the dose-effect hypothesis did not reach statistical significance. PA is a protective factor of incident dementia in this population-based cohort. (JINS, 2015, 21, 861–867)

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Corresponding author

Correspondence and reprint requests to: Sara Llamas Velasco, Department of Neurology, University Hospital “12 de Octubre”, Madrid, Spain; Av. Córdoba s/n, 28041, Madrid, Spain. E-mail: laisset@hotmail.com.

References

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Army Individual Test Battery (1944). Manual of directions and scoring. Washington, DC: War Department, Adjutant General’s Office.
Baldereschi, M., Amato, M.P., Nencini, P., Pracucci, G., Lippi, A., & Amaducci, L., WHO-PRA Age-Associated Dementia working group, WHO-Program for Research on Aging, Health of Elderly Program (1994). Cross-national interrater agreement on the clinical diagnostic criteria for dementia. Neurology, 44(2), 239242.
Baldereschi, M., Meneghini, F., Quiroga, P., Albala, C., Mamo, J., & Muscat, P. (1994). Cognitive versus functional screening for dementia across different countries: Cross-cultural validation of the Mini-Mental State Examination (MMSE) and the Pfeffer activities questionnaire (PFAQ) against the standardised clinical diagnosis of dementia. Neurology, 44(Suppl. 2), A365.
Beeri, M.S., & Middleton, L. (2012). Being physically active may protect the brain from Alzheimer disease. Neurology, 78(17), 290291.
Bermejo-Pareja, F., Benito-León, J., Vega, S., Medrano, M.J., & Román, G.C. (2008). Incidence and subtypes of dementia in three elderly populations of central Spain. Journal of the Neurological Sciences, 264(1-2), 6372.
Bermejo, F., Gabriel, R., Vega, S., Morales, J.M., Rocca, W.A., & Anderson, D.W. (2001). Problems and issues with door-to-door, two-phase surveys: An illustration from central Spain. Neuroepidemiology, 20(4), 225231.
Bermejo, F., Alom, J., Pena-Casanova, J., del Ser, T., Acarin, N., Manubens, J.M., & Gabriel, R. (1994). Multicenter register of index cases of dementia. A study by the Spanish Neurological Society's dementia group. Neurologia, 9(9), 401406.
Brock, D.B., Lemke, J.H., Branch, L.G., Evans, D.A., & Berkman, L.F. (1994). Mortality and physical functioning in epidemiologic studies of three older populations. Journal of Aging and Social Policy, 6(3), 2137.
Buchman, A.S., Boyle, P.A., Yu, L., Shah, R.C., Wilson, R.S., & Bennett, D.A. (2012). Total daily physical activity and the risk of AD and cognitive decline in older adults. Neurology, 78(17), 13231329.
Chatfield, M.D., Brayne, C.E., & Matthews, F.E. (2005). A systematic literature review of attrition between waves in longitudinal studies in the elderly shows a consistent pattern of dropout between differing studies. Journal of Clinical Epidemiology, 58(1), 13e9.
Contador, I., Bermejo-Pareja, F., Del Ser, T., & Benito-León, J. (2015). Effects of education and word reading on cognitive scores in a community-based sample of Spanish elders with diverse socioeconomic status. Journal of Clinical and Experimental Neuropsychology, 37(1), 92101.
Cornoni-Huntley, J., Brock, D.B., Ostfeld, A., Taylor, J.O., & Wallace, R.B. (1986). Established populations for epidemiologic studies of the elderly, resource data book (NIH Pub. No. 86-2443. Bethesda, MD: National Institutes of Health.
Denkinger, M.D., Nikolaus, T., Denkinger, C., & Lukas, A. (2012). Physical activity for the prevention of cognitive decline: Current evidence from observational and controlled studies. Archives of Gerontology and Geriatrics, 45(1), 1116.
Erickson, K.L., Voss, M.W., Prakash, R.S., Basak, C., Szabo, A., Chaddock, L., & Kramer, A.F. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of National Academy of Sciences of the United States of America, 108(7), 30173022.
Ferri, C.P., Prince, M., Brayne, C., Brodaty, H., Fratiglioni, L., Ganguli, M., & Sacazufca, M. (2005). Global prevalence of dementia: A Delphi consensus study. Lancet, 366(9503), 21122117.
Hamer, M., & Chida, Y. (2009). Physical activity and risk of neurodegenerative disease: A systematic review of prospective evidence. Psychological Medicine, 39(1), 311.
Hayes, S.M., Alosco, M.S., & Forman, D.E. (2014). The effects of aerobic exercise on cognitive and neural decline in aging and cardiovascular disease. Current Geriatrics Reports, 3(4), 282290.
Isaacs, B., & Kennie, A.T. (1973). The Set test as an aid to the detection of dementia in old people. The British Journal of Psychiatry, 123(575), 467470.
Lamont, A.J., Mortby, M.E., Anstey, K.J., Sachdev, P.S., & Cherbuin, N. (2014). Using sulcal and gyral measures of brain structure to investigate benefits of an active lifestyle. Neuroimage, 91, 5359.
Larson, E.B. (2010). Prospects for delaying the rising tide of worldwide, late-life dementias. International Psychogeriatrics, 22(8), 11961202.
Larson, E.B., Wang, L., Bowen, J.D., McCormick, W.C., Teri, L., Crane, P., & Kukull, W. (2014). Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of Internal Medicine, 144(2), 7382.
Laurin, D., Verreault, R., Lindsay, J., MacPherson, K., & Rockwood, K. (2001). Physical activity and risk of cognitive impairment and dementia in elderly persons. Archives of Neurology, 58(3), 498504.
Lautenschlager, N.T., Cox, K., & Kurz, A.F. (2010). Physical activity and mild cognitive impairment and Alzheimer’s disease. Current Neurology and Neuroscience Reports, 10(5), 352358.
Liu, I.Y., LaCroix, A.Z., White, L.R., Kittner, S.J., & Wolf, P.A. (1990). Cognitive impairment and mortality: A study of possible confounders. American Journal of Epidemiology, 132(1), 136143.
Mace, C.J., Kerse, N., Maddison, R., Olds, T., Jatrana, S., Wham, C., & Broad, J. (2015, in press). Descriptive epidemiology of physical activity levels and patterns in New Zealanders in advanced age; LiLACs NZ. Journal of Aging and Physical Activity.
Matthews, C.E., Chen, K.Y., Freedson, P.S., Buchowski, M.S., Beech, B.M., Pate, R.R., & Troiano, R.P. (2008). Amount of time spent in sedentary behaviors in the United States, 2003–2004. American Journal of Epidemiology, 167(7), 875881.
Morales, J.M., Bermejo, F.P., Benito-León, J., Rivera-Navarro, J., Trincado, R., Gabriel, S.R., & Vega, S. (2004). Methods and demographic findings of the baseline survey of the NEDICES cohort. Public Health, 118(6), 426433.
Morris, J.C. (1993). The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology, 43(11), 24122414.
Murtagh, E.M., Nichols, L., Mohammed, M.A., Holder, R., Nevill, A.M., & Murphy, M.H. (2015). The effect of walking on risk factors for cardiovascular disease: An updated systematic review and meta-analysis of randomised control trials. Preventive Medicine, 72, 3443.
Olazaran, J., Mouronte, P., & Bermejo, F. (2005). Clinical validity of two scales of instrumental activities in Alzheimer’s disease. Neurologia, 20(8), 395401.
Peña-Casanova, J., Guardia, J., Bertran-Serra, I., Manero, R.M., & Jarne, A. (1997). Shortened version of the Barcelona test (I): Subtests and normal profiles. Neurologia, 12(3), 99111.
Prieto, G., Contador, I., Tapias-Merino, E., Mitchell, A.J., & Bermejo-Pareja, F. (2012). The Mini-Mental-37 Test for Dementia Screening in the Spanish Population: An analysis using the Rasch Model. The Clinical Neuropsychologist, 26(6), 10031018.
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W., & Ferri, C.P. (2013). The global prevalence of dementia: A systematic review and meta-analysis. Alzheimer’s & Dementia, 9(1), 6375.
Radak, Z., Hart, N., Sarga, L., Koltai, E., Atalay, M., Ohno, H., & Boldogh, I. (2010). Exercise plays a preventive role against Alzheimer’s disease. Journal of Alzheimer’s Disease, 20(3), 777783.
Reuben, D.B., & Siu, A.L. (1990). An objective measure of physical function of elderly outpatients. The Physical Performance Test. Journal of the American Geriatrics Society, 38(10), 11051112.
Rogers, R.L., Meyer, J.S., & Mortel, K.F. (1990). After reaching retirement age physical activity sustains cerebral perfusion and cognition. Journal of the American Geriatrics Society, 38(2), 123128.
Rolland, Y., Abellan Van Kan, G., & Vellas, B. (2008). Physical activity and Alzheimer’s disease: From prevention to therapeutic perspectives. Journal of the American Medical Directors Association, 9(6), 390405.
Romano, P.S., Roos, L.L., & Jollis, J.G. (1993). Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: Differing perspectives. Journal of Clinical Epidemiology, 46(10), 10751079.
Rosow, I., & Breslau, N. (1966). A Guttman health scale for the aged. The Journals of Gerontology, 21, 556559.
Rothman, K.J., Greenland, S., Greenland, S., & Lash, T.L. (2008). Modern epidemiology (3rd ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
SAS Institute Inc. (2011). SAS® 9.3 DS2 language reference: Getting started. Cary, NC: SAS Institute Inc.
Serna, A., Contador, I., Bermejo-Pareja, F., Mitchell, A.J., Fernández-Calvo, B., Ramos, F., & Benito-León, J. (2015, in press). Accuracy of a brief neuropsychological battery for the diagnosis of dementia and mild cognitive impairment: An analysis of the NEDICES cohort. Journal of Alzheimer’s Disease.
Scarmeas, N., Luchsinger, J., Schupf, N., Brickman, A.M., Cosentino, S., Tang, M.X., & Stern, Y. (2009). Physical activity, diet, and risk of Alzheimer disease. The Journal of the American Medical Association, 302(6), 627637.
Smith, P.J., Blumenthal, J.A., Hoffman, B.M., Cooper, H., Strauman, T.A., Welsh-Bohmer, K., & Sherwood, A. (2011). Aerobic exercise and neurocognitive performance: A meta-analytic review of randomized controlled trials. Psychosomatic Medicine, 72(3), 239252.
Smith, L.A., Branch, L.G., Scherr, P.A., Wetle, T., Evans, D.A., Hebert, L., & Taylor, J.O. (1990). Short-term variability of measures of physical function in older people. The Journal of the American Geriatrics Society, 38(9), 993998.
Smith, J.C., Nierlson, K.A., Woodard, J.L., Seidenberg, M., Durgerian, S., Hazlett, K.E., & Rao, M.S. (2014). Physical activity reduces hippocampal atrophy in elders at genetic risk for Alzheimer’s disease. Frontiers in Aging Neuroscience, 6, 61.
Snowden, M., Steinman, L., Mochan, K., Grodstein, F., Prohaska, T.R., Thurman, D.J., & Anderson, L.A. (2011). Effect of exercise on cognitive performance in community-dwelling older adults: Review of intervention trials and recommendations for public health practice and research. Journal of the American Geriatrics Society, 59(4), 704716.
Sofi, F., Valecchi, D., Bacci, D., Abbate, R., Gensini, G.F., Casini, A., & Macchi, C. (2010). Physical activity and risk of cognitive decline: A meta-analysis of prospective studies. Journal of Internal Medicine, 269(1), 107117.
Tapias-Merino, E., Puertas-Martín, V., Vera-García, C., Lora-Pablos, D., Revuelta-Alonso, A., & Bermejo-Pareja, F. (2010). Test-retest and interobserver reliability of a Spanish version (MMSE-37) of the Folstein minimental test, adapted to populations with a low level of schooling. Revista de Neurologia, 50(11), 646652.
Thomas, J.W., & Lichtenstein, R. (1986). Functional health measure for adjusting health maintenance organization capitation rates. Health Care Financing Review, 7(3), 8595.
Tortosa-Martínez, J., & Clow, A. (2012). Does physical activity reduce risk for Alzheimer ´s disease through interaction with the stress neuroendocrine system? Stress, 15(3), 243261.
Vega, S., Benito-León, J., Bermejo-Pareja, F., Medrano, M.J., Vega-Valderrama, L.M., Rodríguez, C., & Louis, E.D. (2010). Several factors influenced attrition in a population-based elderly cohort: Neurological disorders in Central Spain Study. Journal of Clinical Epidemiology, 63(2), 215222.
Wang, H.X., Xu, W., & Pei, J.J. (2012). Leisure activities, cognition and dementia. Biochimica et Biophysica Acta, 1822(3), 482491.
Wilson, R.S., Bennett, D.A., Bienias, J.L., Aggarwal, N.T., Mendes De Leon, C.F., Morris, M.C., & Evans, D.A. (2002). Cognitive activity and incident AD in a population-based sample of older persons. Neurology, 59(12), 19101914.
World Health Organization (1980). International classification of impairments, disabilities and handicaps: A manual of classification relating to the consequences of disease. Geneva: World Health Organization.
World Medical Association (1989). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Hong Kong: 41st WMA General Assembly.
Yamada, M., Kasagi, F., Sasaki, H., Masunari, N., Mimori, Y., & Suzuki, G. (2003). Association Between Dementia and Midlife Risk Factors: The Radiation Effects Research Foundation Adult Health Study. Journal of the American Geriatrics Society, 51(3), 410414.
Yuki, A., Lee, S., Kim, H., Kozakai, R., Ando, F., & Shimokata, H. (2012). Relationship between physical activity and brain atrophy progression. Medicine & Science in Sports & Exercise, 44(12), 23622368.

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