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Physical activity over the life course and its association with cognitive performance and impairment in old age
Laura E Middleton1, Deborah E Barnes, Li-Yung Lui
1Heart and Stroke Foundation, Center for Stroke Recovery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada. Laura.middleton@sunnybrook.ca
Objective:
To determine how physical activity at various ages over the life course is associated with cognitive impairment in late life.
Design:
Cross-sectional study.
Setting:
Four U.S. sites.
Participants:
Nine thousand three hundred forty-four women aged 65 and older (mean 71.6) who self-reported teenage, age 30, age 50, and late-life physical activity.
Measurements:
Logistic regression was used to determine the association between physical activity status at each age and likelihood of cognitive impairment (modified Mini-Mental State Examination (mMMSE) score >1.5 standard deviations below the mean, mMMSE score=22). Models were adjusted for age, education, marital status, diabetes mellitus, hypertension, depressive symptoms, smoking, and body mass index.
Results:
Women who reported being physically active had a lower prevalence of cognitive impairment in late life than women who were inactive at each time (teenage: 8.5% vs 16.7%, adjusted odds ratio (AOR)=0.65, 95% confidence interval (CI)=0.53-0.80; age 30: 8.9% vs 12.0%, AOR=0.80, 95% CI=0.67-0.96); age 50: 8.5% vs 13.1%, AOR=0.71, 95% CI=0.59-0.85; old age: 8.2% vs 15.9%, AOR=0.74, 95% CI=0.61-0.91). When the four times were analyzed together, teenage physical activity was most strongly associated with lower odds of late-life cognitive impairment (OR=0.73, 95% CI=0.58-0.92). However, women who were physically inactive as teenagers and became active in later life had lower risk than those who remained inactive.
Conclusions:
Women who reported being physically active at any point over the life course, especially as teenagers, had a lower likelihood of cognitive impairment in late life. Interventions should promote physical activity early in life and throughout the life course.
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