Association between sedentary behavior and the risk of dementia: a systematic review and meta-analysis

An increasing number of original studies suggest that sedentary behavior is associated with the risk of dementia, but the results remain inconsistent and inconclusive. In this meta-analysis, we analyzed available observational epidemiological evidence to identify the association between sedentary behavior and the risk of dementia. We searched PubMed and Embase from their inception to March 2019 to identify observational studies examining the association between sedentary behavior and risk of dementia. Two authors independently extracted data and assessed study quality using predefined criteria. The Q statistics and I² methods were used to test for heterogeneity. The publication bias of the included studies was also estimated using Begg's and Egger's tests. We identified 18 relevant cohort studies involving 250,063 participants and 2269 patients with dementia. Pooled result showed that sedentary behavior was significantly associated with increased risk of dementia (RR = 1.30; 95% CI: 1.12-1.51). In addition, subgroup analyses by state, and controlling for the concomitant effects of age, sex, education were conducted for the increase of dementia risk, relating to sedentary, respectively. In general, these subgroup analyses showed no statistically significant differences. The results of our meta-analysis suggested that sedentary behavior was independently associated with a significantly increased risk of dementia, which might have important implications in conducting etiological studies for dementia and developing strategies for dementia prevention.