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Physical fitness at midlife lowers risk for dementia among women
Longitudinal study findings published in Neurology indicated that high cardiovascular fitness at midlife decreased the risk for subsequent dementia in women by 88% compared with those with medium fitness.
“Presently, no [randomized controlled trials] and very few long-term prospective studies have been able to relate fitness to dementia incidence,” Helena Hörder, PhD, of the University of Gothenburg in Sweden, and colleagues wrote. “Thus, there is a need for studies that examine objective fitness before old age with follow-up of dementia until very old age.”
Using data from a 44-year longitudinal population study, researchers examined whether greater cardiovascular fitness in midlife lead to a lower risk for dementia in 191 women aged 38 to 60 years. Women completed a bicycle exercise test to measure their cardiovascular capacity. The investigators assessed dementia incidence among participants in 1974, 1980, 1992, 2000, 2005 and 2009 and ascertained diagnosis from neuropsychiatric examinations, interviews, hospital records and registry data up to 2012. Adjustments were made for socioeconomic, lifestyle and medical confounders.
Forty-four women developed dementia between 1968 and 2012. Based on the cycling test results, 40 women had high physical fitness, 92 had medium fitness and 59 had low fitness at midlife and the cumulative incidence of all-cause dementia was 5% for high fitness, 25% for medium fitness and 32% for low fitness.
Women with the highest levels of fitness at midlife experienced the most marked reduction in dementia risk. Specifically, high physical fitness at midlife decreased the risk of dementia by 88% compared with medium fitness. Among women with high fitness, the mean time to dementia onset was 5 years longer, and they had delayed age at dementia onset by 9.5 years vs. those with medium fitness. Compared with medium cardiovascular fitness, the adjusted HR for all-cause dementia was 0.12 (95% CI, 0.03-0.54) among those with high fitness and 1.41 (95% CI, 0.72–2.79) for those with low fitness.
"These findings are exciting because it's possible that improving people's cardiovascular fitness in middle age could delay or even prevent them from developing dementia," Hörder said in a press release. "However, this study does not show cause and effect between cardiovascular fitness and dementia, it only shows an association. More research is needed to see if improved fitness could have a positive effect on the risk of dementia and also to look at when during a lifetime a high fitness level is most important." – by Savannah Demko
Disclosures: The authors report no relevant financial disclosures.