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ARTICLE

Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older

Eric B. Larson, MD, MPH; Li Wang, MS; James D. Bowen, MD; Wayne C. McCormick, MD, MPH; Linda Teri, PhD; Paul Crane, MD, MPH; and Walter Kukull, PhD

17 January 2006 | Volume 144 Issue 2 | Pages 73-81

Background: Alzheimer disease and other dementing disorders are major sources of morbidity and mortality in aging societies. Proven strategies to delay onset or reduce risk for dementing disorders would be greatly beneficial.

Objective: To determine whether regular exercise is associated with a reduced risk for dementia and Alzheimer disease.

Design: Prospective cohort study.

Setting: Group Health Cooperative, Seattle, Washington.

Participants: 1740 persons older than age 65 years without cognitive impairment who scored above the 25th percentile on the Cognitive Ability Screening Instrument (CASI) in the Adult Changes in Thought study and who were followed biennially to identify incident dementia.

Measurements: Baseline measurements, including exercise frequency, cognitive function, physical function, depression, health conditions, lifestyle characteristics, and other potential risk factors for dementia (for example, apolipoprotein E 4); biennial assessment for dementia.

Results: During a mean follow-up of 6.2 years (SD, 2.0), 158 participants developed dementia (107 developed Alzheimer disease). The incidence rate of dementia was 13.0 per 1000 person-years for participants who exercised 3 or more times per week compared with 19.7 per 1000 person-years for those who exercised fewer than 3 times per week. The age- and sex-adjusted hazard ratio of dementia was 0.62 (95% CI, 0.44 to 0.86; P = 0.004). The interaction between exercise and performance-based physical function was statistically significant (P = 0.013). The risk reduction associated with exercise was greater in those with lower performance levels. Similar results were observed in analyses restricted to participants with incident Alzheimer disease.

Limitations: Exercise was measured by self-reported frequency. The study population had a relatively high proportion of regular exercisers at baseline.

Conclusion: These results suggest that regular exercise is associated with a delay in onset of dementia and Alzheimer disease, further supporting its value for elderly persons.

Editors' Notes Context Some studies suggest that people with high levels of physical activity are less likely to develop dementia. Content All 1740 participants in this cohort study were 65 years of age or older and were cognitively intact at baseline. Over 6.2 years, the rate of dementia was 13.0 per 1000 person-years in those who exercised 3 or more times per week and 19.7 per 1000 person-years in those who exercised less than 3 times per week. Limitations The only measure of exercise intensity was self-reported frequency. The cohort was largely white and well-educated. Implications This study adds to the evidence that regular exercise is associated with a lower risk for dementia. However, the existing evidence does not prove that regular exercise is associated with a lower dementia risk. —The Editors

 

Author and Article Information

From the Center for Health Studies, Group Health Cooperative; University of Washington; and Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, Washington.

Grant Support: By the National Institute of Aging (grant AG06781).

Potential Financial Conflicts of Interest: Grants received: L. Teri (National Institutes of Health).

Requests for Single Reprints: Eric B. Larson, MD, MPH, Center for Health Studies, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1448; e-mail, larson.e{at}ghc.org.

Current Author Addresses: Dr. Larson: Center for Health Studies, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1448.

Ms. Wang: VA Puget Sound Health Care System, 1100 Olive Way, Seattle, WA 98101.

Dr. Bowen: Department of Neurology, University of Washington, 1959 NE Pacific, Seattle, WA 98195.

Dr. McCormick: Harborview Medical Center, 325 9th Avenue, Box 359755, Seattle, WA 91895.

Dr. Teri: University of Washington, 9709 3rd Avenue NE, Suite 507, Seattle, WA 91115.

Dr. Crane: University of Washington, 325 9th Avenue, Box 359780, Seattle, WA 91895.

Dr. Kukull: Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195.

Author Contributions: Conception and design: E.B. Larson, L. Wang, J.D. Bowen, L. Teri.

Analysis and interpretation of the data: E.B. Larson, L. Wang, J.D. Bowen, W.C. McCormick, L. Teri, P. Crane.

Drafting of the article: E.B. Larson, L. Wang, J.D. Bowen, W.C. McCormick.

Critical revision of the article for important intellectual content: J.D. Bowen, W.C. McCormick, L. Teri, P. Crane, W. Kukull.

Final approval of the article: E.B. Larson, J.D. Bowen, W.C. McCormick, L. Teri, P. Crane.

Provision of study materials or patients: E.B. Larson, J.D. Bowen, W.C. McCormick.

Statistical expertise: L. Wang, W.C. McCormick, P. Crane.

Obtaining of funding: E.B. Larson, L. Teri, W.A. Kukull.

Administrative, technical, or logistic support: E.B. Larson, L. Teri, P. Crane.

Collection and assembly of data: E.B. Larson.

Related articles in Annals:

Editorials
Mens Sana in Corpore Sano
Laura J. Podewils AND Eliseo Guallar

Annals 2006 144: 135-136. [Full Text]  

Summaries for Patients
Exercise in People Age 65 Years and Older Is Associated with Lower Risk for Dementia

Annals 2006 144: I-20. [Full Text]  

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