Physical activity and cognitive functioning: translating research to practice with a public health approach

A growing body of research, from retrospective cross-sectional studies to randomized clinical trials, suggests that physical activity among the elderly has positive effects on a wide range of physiologic systems and tissues, including the cardiovascular, immune, and endocrine systems, and even cognitive functioning. The latter is particularly relevant to the management of Alzheimer's disease and other forms of dementia. There is increasing support that the positive effects of physical activity on cognitive functioning have been obtained at the primary (cognitively healthy older adults), secondary (persons with some loss of cognitive functioning to mild cognitive impairment), and tertiary (older adults with significant cognitive impairment) prevention levels. However, there are several specific components and potential roles for physical activity in the field of cognitive health and functioning that have not been addressed. Moreover, we argue that a population-based public health perspective is needed as efforts to investigate the physical activity/cognitive health relationship are developed and disseminated for large-scale implementation. This perspective discusses some of the problems that might be faced when translating basic research findings into public health practice for cognitive impairment and/or dementia in older adults and addresses how some of these problems might be overcome.