Lifetime physical activity and late-life cognitive function: the Rancho Bernardo study

Sports-related concussion not associated with long-term cognitive or behavioural deficits: the PROTECT-TBI study

BACKGROUND

The cognitive effects of sports-related concussion (SRC) have been the subject of vigorous debate but there has been little research into long-term outcomes in non-athlete populations.

METHODS

This cohort study of UK community-dwelling adults (aged 50-90 years) was conducted between November 2015 and November 2020, with up to 4 years annual follow-up (n=15 214). Lifetime history of concussions was collected at baseline using the Brain Injury Screening Questionnaire. The first analysis grouped participants by type of concussion (no concussion, only SRC, only non-SRC (nSRC), mixed concussions (both SRC and nSRC)) and the second grouped the participants by number (0, 1, 2 or 3+ SRC or nSRC). Mixed models were used to assess the effect of concussion on outcomes including four cognitive domains and one behavioural measure (Mild Behavioural Impairment-C).

RESULTS

Analysis of the included participants (24% male, mean age=64) at baseline found that the SRC group had significantly better working memory (B=0.113, 95% CI 0.038, 0.188) and verbal reasoning (B=0.199, 95% CI 0.092, 0.306) compared with those without concussion. Those who had suffered one SRC had significantly better verbal reasoning (B=0.111, 95% CI 0.031, 0.19) and attention (B=0.115, 95% CI 0.028, 0.203) compared with those with no SRC at baseline. Those with 3+ nSRCs had significantly worse processing speed (B=-0.082, 95% CI -0.144 to -0.019) and attention (B=-0.156, 95% CI -0.248 to -0.063). Those with 3+ nSRCs had a significantly worse trajectory of verbal reasoning with increasing age (B=-0.088, 95% CI -0.149 to -0.026).

CONCLUSIONS

Compared with those reporting no previous concussions, those with SRC had no cognitive or behavioural deficits and seemed to perform better in some tasks. As indicated by previous studies, sports participation may confer long-term cognitive benefits.

Protocol for the San Diego Nathan Shock Center Clinical Cohort: a new resource for studies of human aging

INTRODUCTION

While it is well recognised that aging is a heterogeneous process, our understanding of the determinants of biological aging and its heterogeneity remains unclear. The San Diego Nathan Shock Center (SD-NSC) Clinical Cohort aims to establish a resource of biospecimens and extensive donor clinical data such as physical, cognitive and sensory function to support other studies that aim to explore the heterogeneity of normal human aging and its biological underpinnings.

METHODS AND ANALYSIS

The SD-NSC Clinical Cohort is composed of 80 individuals across the adult human lifespan. Strict inclusion and exclusion criteria are implemented to minimise extrinsic factors that may impede the study of normal aging. Across three visits, participants undergo extensive phenotyping for collection of physical performance, body composition, cognitive function, sensory ability, mental health and haematological data. During these visits, we also collected biospecimens including plasma, platelets, peripheral blood mononuclear cells and fibroblasts for banking and future studies on aging.

ETHICS AND DISSEMINATION

Ethics approval from the UC San Diego School of Medicine Institutional Review Board (IRB #201 141 SHOCK Center Clinical Cohort, PI: Molina) was obtained on 11 November 2020. Written informed consent is obtained from all participants after objectives and procedures of the study have been fully explained. Congruent with the goal of establishing a core resource, biological samples and clinical data are made available to the research community through the SD-NSC.

The impact of physical exercise on hippocampal atrophy in mild cognitive impairment and Alzheimer's disease: a meta-analysis

Physical activity (PA) is a promising therapeutic for Alzheimer's disease (AD). Only a handful of meta-analyses have studied the impact of PA interventions on regional brain volumes, and none to date has solely included studies on effect of PA on regional brain volumes in individuals with cognitive impairment (CI). In this meta-analysis, we examined whether there is support for the hypothesis that PA interventions positively impact hippocampal volume (HV) in individuals with CI. We also assessed whether the level of CI [mild CI (MCI) vs. AD] impacted this relationship. We identified six controlled trials that met inclusion criteria. These included 236 participants with AD, MCI, or preclinical AD. Data were extracted and analyzed following Cochrane guidelines. We used a random-effects model to estimate the mean change in HV pre- and post-exercise intervention. Forest plots, Hedges' g funnel plots, and Egger's test were used to assess unbiasedness and visualize intervention effects, and Tau 2 , Cochran's Q, and I 2 were calculated to assess heterogeneity. The primary analysis revealed a significant positive effect of PA on total HV. However, sub-group analyses indicated a significant preservation of HV only in individuals with MCI, but not in those with AD. Egger's test indicated no evidence of publication bias. Subgroup analyses also revealed significant heterogeneity only within the MCI cohort for the total and left HV. PA demonstrated a moderate, significant effect in preserving HV among individuals with MCI, but not AD, highlighting a therapeutic benefit, particularly in earlier disease stages.

Cognitive reserve over the life course and risk of dementia: a systematic review and meta-analysis

Background

The number of people with dementia is soaring. Cognitive reserve has been thought to be associated with dementia risk. It is not clear at which period in the life course and which cognitive reserve proxies contribute to the reduced risk of dementia.

Methods

By scanning four databases (PubMed, Embase, Web of Science, and MEDLINE) up to Jun 3, 2023, longitudinal studies of life-course cognitive reserve and risk of dementia were found. The HRs and 95% CIs for each study were summarized using random effects models. Subgroup analyses and sensitivity analyses were conducted. Utilizing funnel plots, Begg and Egger tests, publication bias was investigated.

Results

A total of 27 studies were included, containing 10 in early-life, 10 in middle-life, and 13 in late-life. All studies used validated questionnaires to measure cognitive reserve, and dementia diagnosis followed recognized worldwide guidelines. All included studies were of medium or low risk. Cognitive reserve in early-life (Hazard ratio (HR): 0.82; 95% confidence interval (CI): 0.79-0.86), middle-life (HR: 0.91; 95% CI: 0.84-0.98) and late-life (HR: 0.81; 95% CI: 0.75-0.88) all have protective effects on dementia risk. Multiple sensitivity analyses showed consistent results.

Conclusion

Dementia risk is reduced by the buildup of cognitive reserves during life-course. Accumulation of proxies for cognitive reserve in early and late life had the greatest effect on dementia risk reduction. Social connection may be an effective approach to lower dementia risk.

Lifetime Physical Activity and Late-Life Mild Cognitive Impairment in Community-Dwelling Older Adults

OBJECTIVES

Regular physical activity throughout life is generally recommended to prevent dementia; however, there is little evidence regarding the association between lifetime physical activity and mild cognitive impairment (MCI), which often precedes dementia. This study aimed to examine the association of lifetime physical activity and their transitions with late-life MCI.

DESIGN

A population-based case-control study.

SETTING AND PARTICIPANTS

A total of 2968 Japanese community-dwelling older adults aged ≥70 years without dementia.

METHODS

We evaluated the participants' early-, mid-, and late-life physical activity habits and categorized their transitions across life stages. Cognitive functions in late life were assessed for memory, attention, executive function, and processing speed; functional impairment in one or more cognitive domains was defined as MCI.

RESULTS

Regular physical activity in early life was not significantly associated with late-life MCI [odds ratio (OR), 0.80; 95% CI, 0.63-1.02], although those in mid-life (OR, 0.64; 95% CI, 0.51-0.81) and late-life (OR, 0.74; 95% CI, 0.59-0.91) were associated with lower odds of late-life MCI. Compared with nonexercisers, participants who acquired new habits of physical activity during mid- or late-life (OR, 0.71; 95% CI, 0.55-0.91) and those who maintained physical activity throughout their life span (OR, 0.61; 95% CI, 0.42-0.87) had lower odds of late-life MCI; those who stopped regular activity during mid- or late-life did not (OR, 0.79; 95% CI, 0.58-1.06).

CONCLUSIONS AND IMPLICATIONS

While physical activity throughout the life span is associated with the lowest odds of MCI, starting regular physical activity, even later in life, confers a benefit and should be encouraged as a "lifelong approach" to MCI risk reduction.

Integrating Lifestyle Factor Science into Neuropsychological Practice: A National Academy of Neuropsychology Education Paper

OBJECTIVE

The primary aim of this paper is to review evidence and clinical implications related to lifestyle activities associated with promoting brain and cognitive health. Our review targets four key lifestyle factors: physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets.

METHOD

We conducted a critical review of the lifestyle factor literature in the four domains listed earlier. We contextualize this literature review by translating findings, when possible, into evidence-based recommendations to consider when providing neuropsychological services.

RESULTS

There is significant current evidence supporting the role of physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets on positive brain and cognitive health outcomes. While some null findings are present in all four areas reviewed, the weight of the evidence supports the notion that engaging in these activities may promote brain and cognitive functioning.

CONCLUSIONS

Clinical neuropsychologists can have confidence in recommending engagement in physical activity, social activity, and cognitively stimulating activity, and adhering to a Mediterranean-style diet to promote brain and cognitive health. We discuss limitations in existing lifestyle factor research and future directions to enhance the existing evidence base, including additional research with historically underrepresented groups and individuals with neurological conditions.

How long have you exercised in your life? The effect of motor reserve and current physical activity on cognitive performance

OBJECTIVES

Aging of the population encourages research on how to preserve cognition and quality of life. Many studies have shown that Physical Activity (PA) positively affects cognition in older adults. However, PA carried out throughout the individual's lifespan may also have an impact on cognition in old age. We hypothesize the existence of Motor Reserve (MR), a flexible and dynamic construct that increases over time and compensates for age-related motor and cognitive loss.

METHODS

Two questionnaires were developed and validated to estimate MR (Physical Activity carried out throughout the individual's lifespan) and Current Physical Activity (CPA, PA carried out in the previous 12 months). They were administered to 75 healthy individuals over 50 to verify the relation with cognition. MR and CPA include physical exercise (i.e., structured activities to improve or maintain physical fitness) and incidental PA, which we consider as any movement that leads to a metabolic cost above baseline (e.g., housekeeping, walking). In addition, the Cognitive Reserve Index questionnaire (CRI), a reliable predictor of cognitive performance, was used to measure each participant's Cognitive Reserve.

RESULTS

The factors that most influenced performance are Age and Cognitive Reserve, but also MR and CPA together and MR when it is the only factor.

CONCLUSIONS

Cognitive variability in adult and elderly populations is explained by both MR and CPA. PA training could profitably be included in new preventive and existing interventions.

The Longitudinal Association of Egg Consumption with Cognitive Function in Older Men and Women: The Rancho Bernardo Study

This study examines the prospective association of egg consumption with multiple domains of cognitive function in older, community-dwelling men and women followed for 16.3 years. Participants were 617 men and 898 women from the Rancho Bernardo Cohort aged 60 and older, who were surveyed about egg intake/week in 1972-1974, and attended a 1988-1991 research visit, where cognitive function was assessed with 12 tests. Analyses showed that egg intake ranged from 0-24/week (means: men = 4.2 ± 3.2; women = 3.5 ± 2.7; p < 0.0001). In men, covariate-adjusted regressions showed that egg intake was associated with better performance on Buschke total (p = 0.04), long-term (p = 0.02), and short-term (p = 0.05) recall. No significant associations were observed in women (p's > 0.05). Analyses showed that in those aged <60y in 1972-1974, egg intake was positively associated with scores on Heaton copying (p < 0.04) and the Mini-Mental Status Exam (MMSE; p < 0.02) in men and category fluency (p < 0.05) in women. Egg intake was not significantly associated with odds of poor performance on MMSE, Trails B, or category fluency in either sex. These reassuring findings suggest that there are no long-term detrimental effects of egg consumption on multiple cognitive function domains, and for men, there may be beneficial effects for verbal episodic memory. Egg consumption in middle age may also be related to better cognitive performance later in life.

Developing and validating a nomogram for cognitive impairment in the older people based on the NHANES

Objective

To use the United States National Health and Nutrition Examination Study (NHANES) to develop and validate a risk-prediction nomogram for cognitive impairment in people aged over 60 years.

Methods

A total of 2,802 participants (aged ≥ 60 years) from NHANES were analyzed. The least absolute shrinkage and selection operator (LASSO) regression model and multivariable logistic regression analysis were used for variable selection and model development. ROC-AUC, calibration curve, and decision curve analysis (DCA) were used to evaluate the nomogram's performance.

Results

The nomogram included five predictors, namely sex, moderate activity, taste problem, age, and education. It demonstrated satisfying discrimination with a AUC of 0.744 (95% confidence interval, 0.696-0.791). The nomogram was well-calibrated according to the calibration curve. The DCA demonstrated that the nomogram was clinically useful.

Conclusion

The risk-prediction nomogram for cognitive impairment in people aged over 60 years was effective. All predictors included in this nomogram can be easily accessed from its' user.

Association between rest-activity rhythm and cognitive function in the elderly: The U.S. National Health and Nutrition Examination Survey, 2011-2014

BACKGROUND

Circadian rhythm plays an essential role in various physiological and pathological processes related to cognitive function. The rest-activity rhythm (RAR) is one of the most prominent outputs of the circadian system. However, little is known about the relationships between RAR and different domains of cognitive function in older adults. The purpose of this study was to examine the relationships between RAR and various fields of cognitive function in older Americans.

METHODS

This study included a total of 2090 older adults ≥ 60 years old from the National Health and Nutrition Examination Survey (NHANES) in 2011-2014. RAR parameters were derived from accelerometer recordings. Cognitive function was assessed using the word learning subtest developed by the Consortium to Establish a Registry for Alzheimer's disease (CERAD W-L), the Animal Fluency Test (AFT) and the Digital Symbol Substitution Test (DSST). Linear regression was used to determine the relationships between RAR parameters (IS, IV, RA, L5, M10) and cognitive function scores (CERAD W-L, AFT, DSST).

RESULTS

After adjusting for potential confounders, lower IS and M10 were associated with lower CERAD W-L scores (P=0.033 and P=0.002, respectively). Weaker RA and higher L5 were associated with lower AFT scores (P<0.001 and P=0.001, respectively). And lower IS, RA, and higher L5 were associated with lower DSST scores (P=0.019, P<0.001 and P<0.001, respectively). In addition, the results of sensitivity analysis were similar to those of our main analyses. The main correlation results between the RAR indicators and cognitive function were robust.

CONCLUSIONS

This study suggested that the weakened and/or disrupted RAR was associated with cognitive decline in different domains in Americans over the age of 60.

Unraveling the Protective Effects of Cognitive Reserve on Cognition and Brain: A Cross-Sectional Study

This study aimed to investigate the hypothesis that brain maintenance expressed in white matter hyperintensities and brain reserves, defined as gray and white matter volumes, mediate the association between cognitive reserve (CR) and cognitive performance. A cross-sectional population-based observational study was conducted, and the final study sample consisted of 763 participants (282 men and 481 women) with a mean age of 61.11 years (±9.0). Data from different categories were collected from study participants, such as demographic, lifestyle, medical, and psycho-social characteristics. All participants underwent a detailed psychometric evaluation (MoCA and DSST) followed by a brain MRI. Volumetric measurements of the total gray matter (GMvol), total white matter (WMvol), and white matter hyperintensities (WMHvol) were performed using the Computational Anatomy Toolbox 12 (CAT12) and Statistical Parametric Maps 12 (SPM12) based on 3D T1-weighted sequence. Significant direct and indirect effects of cognitive reserve on cognitive functioning were measured with both scales-the MoCA and DSST. In each mediation model, the volumes of WMH and GM were significant mediators for the association between cognitive reserve and cognitive performance. This study confirms the importance of strengthening the cognitive reserve in the course of life through potentially modifiable effects on both cognition and the brain.

Markers of kidney function, genetic variation related to cognitive function, and cognitive performance in the UK Biobank

BACKGROUND

Chronic kidney disease has been linked to worse cognition. However, this association may be dependent on the marker of kidney function used, and studies assessing modification by genetics are lacking. This study examined associations between multiple measures of kidney function and assessed effect modification by a polygenic score for general cognitive function.

METHODS

In this cross-sectional study of up to 341,208 European ancestry participants from the UK Biobank study, we examined associations between albuminuria and estimated glomerular filtration rate based on creatinine (eGFRcre) or cystatin C (eGFRcys) with cognitive performance on tests of verbal-numeric reasoning, reaction time and visual memory. Adjustment for confounding factors was performed using multivariate regression and propensity-score matching. Interaction between kidney function markers and a polygenic risk score for general cognitive function was also assessed.

RESULTS

Albuminuria was associated with worse performance on tasks of verbal-numeric reasoning (β(points) = -0.09, p < 0.001), reaction time (β(milliseconds) = 7.06, p < 0.001) and visual memory (β(log errors) = 0.013, p = 0.01). A polygenic score for cognitive function modified the association between albuminuria and verbal-numeric reasoning with significantly lower scores in those with albuminuria and a lower polygenic score (p = 0.009). Compared to participants with eGFRcre ≥ 60 ml/min, those with eGFRcre < 60 ml/min had lower verbal-numeric reasoning scores and slower mean reaction times (verbal numeric reasoning β = -0.11, p < 0.001 and reaction time β = 6.08, p < 0.001 for eGFRcre < 60 vs eGFRcre ≥ 60). Associations were stronger using cystatin C-based eGFR than creatinine-based eGFR (verbal numeric reasoning β = -0.21, p < 0.001 and reaction time β = 11.21, p < 0.001 for eGFRcys < 60 vs eGFRcys ≥ 60).

CONCLUSIONS

Increased urine albumin is associated with worse cognition, but this may depend on genetic risk. Cystatin C-based eGFR may better predict cognitive performance than creatinine-based estimates.

Can exercise training teach us how to treat Alzheimer's disease?

Alzheimer's disease (AD) is the most common cause of dementia and there is currently no cure. Novel approaches to treat AD and curb the rapidly increasing worldwide prevalence and costs of dementia are needed. Physical inactivity is a significant modifiable risk factor for AD, estimated to contribute to 12.7% of AD cases worldwide. Exercise interventions in humans and animals have shown beneficial effects of exercise on brain plasticity and cognitive functions. In animal studies, exercise also improved AD pathology. The mechanisms underlying these effects of exercise seem to be associated mainly with exercise performance or cardiorespiratory fitness. In addition, exercise-induced molecules of peripheral origin seem to play an important role. Since exercise affects the whole body, there likely is no single therapeutic target that could mimic all the benefits of exercise. However, systemic strategies may be a viable means to convey broad therapeutic effects in AD patients. Here, we review the potential of physical activity and exercise training in AD prevention and treatment, shining light on recently discovered underlying mechanisms and concluding with a view on future development of exercise-free treatment strategies for AD.

Moderate Exercise Improves Cognitive Function in Healthy Elderly People: Results of a Randomized Controlled Trial

Background

Physical activity in the elderly is recommended by international guidelines to protect against cognitive decline and functional impairment.

Objective

This Randomized Controlled Trial (RCT) was set up to verify whether medium-intensity physical activity in elderly people living in the community is effective in improving cognitive performance.

Design

RCT with parallel and balanced large groups.

Setting

Academic university hospital and Olympic gyms.

Subjects

People aged 65 years old and older of both genders living at home holding a medical certificate for suitability in non-competitive physical activity.

Methods

Participants were randomized to a 12-week, 3 sessions per week moderate physical activity program or to a control condition focused on cultural and recreational activities in groups of the same size and timing as the active intervention group. The active phase integrated a mixture of aerobic and anaerobic exercises, including drills of "life movements", strength and balance. The primary outcome was: any change in Addenbrooke's Cognitive Examination Revised (ACE-R) and its subscales.

Results

At the end of the trial, 52 people completed the active intervention, and 53 people completed the control condition. People in the active intervention improved on the ACE-R (ANOVA: F(1;102)=4.32, p=0.040), and also showed better performances on the memory (F(1;102)=5.40 p=0.022) and visual-space skills subscales of the ACE-R (F(1;102)=4.09 p=0.046).

Conclusion

A moderate-intensity exercise administered for a relatively short period of 12 weeks is capable of improving cognitive performance in a sample of elderly people who live independently in their homes.Clinical Trials Registration No: NCT03858114.

Lifestyle-dependent microglial plasticity: training the brain guardians

Lifestyle is one of the most powerful instruments shaping mankind; the lifestyle includes many aspects of interactions with the environment, from nourishment and education to physical activity and quality of sleep. All these factors taken in complex affect neuroplasticity and define brain performance and cognitive longevity. In particular, physical exercise, exposure to enriched environment and dieting act through complex modifications of microglial cells, which change their phenotype and modulate their functional activity thus translating lifestyle events into remodelling of brain homoeostasis and reshaping neural networks ultimately enhancing neuroprotection and cognitive longevity.

A proof-of-concept sub-study exploring feasibility and preliminary evidence for the role of physical activity on neural activity during executive functioning tasks among young adults after cancer treatment

Background

Executive functioning (EF) deficits are troubling for adolescents and young adults (AYAs) after cancer treatment. Physical activity (PA) may enhance neural activity underlying EF among older adults affected by cancer. Establishing whether PA enhances neural activity among AYAs is warranted. As part of a two-arm, mixed-methods pilot randomized controlled trial (RCT), this proof-of-concept sub-study sought to answer the following questions: (1) is it feasible to use neuroimaging with EF tasks to assess neural activity changes following a 12-week PA intervention? And (2) is there preliminary evidence that a 12-week PA intervention enhances neural activity among AYAs after cancer treatment?

Methods

AYAs in the pilot RCT were approached for enrollment into this sub-study. Those who were eligible and enrolled, completed functional magnetic resonance imaging (fMRI) with EF tasks (letter n-back, Go/No Go) pre- and post-PA intervention. Sub-study enrollment, adherence to scheduled fMRI scans, outliers, missing data, and EF task performance data were collected. Data were analyzed with descriptive statistics, blood oxygen level dependent (BOLD) analyses, and paired sample t-tests.

Results

Nine eligible participants enrolled into this sub-study; six attended scheduled fMRI scans. One outlier was identified and was subsequently removed from the analytical sample. Participants showed no differences in EF task performance from pre- to post-PA intervention. Increases in neural activity in brain regions responsible for motor control, information encoding and processing, and decision-making were observed post-PA intervention (p < 0.05; n = 5).

Conclusions

Findings  show that fMRI scans during EF tasks detected neural activity changes (as assessed by the BOLD signal) from pre- to post-PA intervention. Results thus suggest future trials confirming that PA enhances neural activity underlying EF are needed, though feasibility issues require careful consideration to ensure trial success.

Trial registration

clinicaltrials.gov, NCT03016728. Registered January 11, 2017, clinicaltrials.gov/ct2/show/NCT03016728.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12883-021-02280-y.

Mitigating the negative impacts of aging on cognitive function; modifiable factors associated with increasing cognitive reserve

Research suggests that social, physical, and cognitively challenging activities during lifetime, could mitigate the negative effects of aging on cognitive function. This effect is explained by the increased cognitive reserve (CR) resulting from such factors; in fact, such activities, by altering structural and functional properties of the human brain, equip one with more effective compensatory mechanisms to resist brain damage before the presentation of severe clinical symptoms. Therefore, applying appropriate modifications in one's lifestyle and activities may be effective in lowering the risk of developing dementia and cognitive dysfunction in old age, especially in brain areas that are susceptible to aging. In this paper, we are going to review relevant studies discussing the association between important modifiable factors, known as CR proxies (i.e., educational attainment, occupational complexity, physical activity, social engagement, bilingualism, leisure activities, and Mediterranean diet), and different domains of cognitive function, which are affected either in the process of healthy aging or neurodegenerative diseases.

Physical Activity and Trajectory of Cognitive Change in Older Persons: Mayo Clinic Study of Aging

BACKGROUND

Little is known about the association between physical activity (PA) and cognitive trajectories in older adults.

OBJECTIVE

To examine the association between PA and change in memory, language, attention, visuospatial skills, and global cognition, and a potential impact of sex or Apolipoprotein E (APOE) ɛ4 status.

METHODS

Longitudinal study derived from the population-based Mayo Clinic Study of Aging, including 2,060 cognitively unimpaired males and females aged ≥70 years. Engagement in midlife (ages 50-65) and late-life (last year) PA was assessed using a questionnaire. Neuropsychological testing was done every 15 months (mean follow-up 5.8 years). We ran linear mixed-effect models to examine whether mid- or late-life PA at three intensities (mild, moderate, vigorous) was associated with cognitive z-scores.

RESULTS

Light intensity midlife PA was associated with less decline in memory function compared to the no-PA reference group (time x light PA; estimate [standard error] 0.047 [0.016], p = 0.004). Vigorous late-life PA was associated with less decline in language (0.033 [0.015], p = 0.030), attention (0.032 [0.017], p = 0.050), and global cognition (0.039 [0.016], p = 0.012). Females who were physically inactive in midlife experienced more pronounced cognitive decline than females physically active in midlife and males regardless of PA (p-values for time interaction terms with midlife PA levels and sex were all p < 0.05 for global cognition). APOE ɛ4 carriership did not moderate the association between PA and cognition.

CONCLUSION

Engaging in PA, particularly of vigorous intensity in late-life, was associated with less pronounced decline in global and domain-specific cognition. This association may differ by sex.

Physical Activity and Trajectories of Cognitive Change in Community-Dwelling Older Adults: The Rancho Bernardo Study

BACKGROUND

Although physical activity has been associated with better cognitive function and reduced dementia risk, its association with cognitive decline in normal aging remains uncertain.

OBJECTIVE

To determine whether physical activity in youth and older age are associated with age-related cognitive change.

METHODS

Over a period of 27 years, 2,027 community-dwelling adults (mean age 73.5; 60% women) of the Rancho Bernardo Study of Healthy Aging completed up to seven cognitive assessments, including tests of global cognitive function, executive function, verbal fluency, and episodic memory. At each visit, participants reported concurrent physical activity. At baseline (1988- 1992), participants additionally reported physical activity as a teenager and at age 30. For each age period, participants were classified as regularly active (3+ times/week) or inactive.

RESULTS

Associations between concurrent physical activity and better cognitive function were stronger with advancing age on all tests, even after accounting for education, health, and lifestyle factors, as well as survival differences (ps < 0.05). Baseline physical activity did not predict rates of cognitive decline (ps > 0.40). Individuals who were physically active at age 30 and older age maintained the highest global cognitive function with advancing age (p = 0.002).

CONCLUSION

Regular physical activity is associated with better cognitive function with advancing age. Physical activity in young adulthood may contribute to cognitive reserve, which together with physical activity in later years, may act to preserve cognitive function with age.

The Association between Longest-Held Lifetime Occupation and Late-Life Cognitive Impairment: Korean Longitudinal Study of Aging (2006-2016)

The association between longest-held lifetime occupation and late-life cognitive impairment: Korean Longitudinal Study of Aging (2006–2016). Backgrounds: Our study hypothesized that occupation in adulthood may be one of the modifiable factors in cognitive performance. This follow-up study aimed to examine whether there was an association between the longest-held occupation in a lifetime and cognitive impairment. Methods: This study used data from the 2006, 2012, and 2016 waves of the Korean Longitudinal Study of Aging, and a total of 1733 subjects aged over 65 were included. Longest-held occupation in a lifetime was classified into blue-collar, pink-collar, and white-collar. Cognitive function was evaluated using the Korean version of the Mini-Mental State Examination. Results: In males, no significant associations were observed. In females, on the contrary, risk of cognitive impairment in the blue-collar occupation was consistently higher than in the white-collar occupation over the 10-year follow-up (2006, OR = 2.49, 95% CI 1.05–5.88; 2016, OR = 2.17, 95% CI 1.02−4.65). Conclusions: Lifetime occupation should be taken into consideration in the process of screening for cognitive decline in the elderly, especially females. This study needs to be interpreted cautiously in view of inherent data and methodological limitations.

Physical activity and successful aging among middle-aged and older adults: a systematic review and meta-analysis of cohort studies

Background: We aimed to investigate the association between physical activity and successful aging among middle-aged and older adults and study how this association changes with age and time.

Results: The mean score of Newcastle-Ottawa Scale assessment was 8.0±0.8. Physically active middle-aged and older adults were more likely to age successfully than sedentary adults (OR=1.64, 95%CI: 1.40–1.94). The effect of physical activity was stronger in the younger group (OR=1.71, 95%CI: 1.41–2.08) than on the older group (OR=1.54, 95%CI: 1.13–2.08). However, the protective effect of physical activity reduced annually by approximately 3%.

Conclusions: Physical activity promotes successful aging among middle-aged and older adults especially in the younger population. Being physically active at middle and old age is beneficial to successful aging.

Methods: We searched for the relevant studies in three online databases: Pubmed, Web of Science, and Embase. Fifteen community-based cohort studies were included. The Newcastle-Ottawa Scale assessment Form was used for quality assessment. Overall, 189,192 participants aged 43.9-79.0 years were analyzed. The odds ratio for successful aging of the most physically active group compared with sedentary group was analyzed. Subgroup analysis was conducted by age group. Univariate Meta-regression was performed according to follow-up years.

Effect of Frequency of Exercise on Cognitive Function in Older Adults: Serial Mediation of Depression and Quality of Sleep

BACKGROUND

Sleep quality and depression are two reciprocal causation socioemotional factors and their roles in the relationship between physical exercise and cognition are still unclear.

METHODS

A face-to-face survey of 3230 older adults aged 60+ was conducted in Xiamen, China, in 2016. Frequency of exercise (FOE) referred to the number of days of exercise per week. Quality of sleep (QOS) was categorized into five levels: very poor/poor/fair/good/excellent. The 15-item Geriatric Depression Scale (GDS-15) and the Montreal Cognitive Assessment (MoCA) were used to measure depression (DEP) and cognitive function (CF), respectively. Serial multiple mediator models were used. All mediation analyses were analyzed using the SPSS PROCESS macro.

RESULTS

2469 respondents had valid data with mean scores for GDS-15 and MoCA being 1.87 and 21.61, respectively. The direct path from FOE to CF was significant (c'= 0.20, p < 0.001). A higher FOE was associated with better QOS (B = 0.04, p < 0.01), which in turn was associated with fewer symptoms of DEP (B = -0.40, p < 0.001), and further contributed to better CF (B = -0.24, p < 0.001). Similarly, a higher FOE was associated with lower GDS-15 scores (B = -0.17, p < 0.001) which then resulted in higher MoCA scores (B = -0.24, p < 0.001). However, QOS alone did not alter the relationship between FOE and CF.

CONCLUSIONS

FOE is a protective factor of CF in older adults. Moreover, CF is influenced by QOS through DEP, without which the working path may disappear.

Distinct Functional Connectivity Patterns Are Associated With Social and Cognitive Lifestyle Factors: Pathways to Cognitive Reserve

The importance of diverse lifestyle factors in sustaining cognition during aging and delaying the onset of decline in Alzheimer's disease and related dementias cannot be overstated. We explored the influence of cognitive, social, and physical lifestyle factors on resting-state lagged linear connectivity (LLC) in high-density electroencephalography (EEG) in adults, ages 35-75 years. Diverse lifestyle factors build cognitive reserve (CR), protecting cognition in the presence of physical brain decline. Differences in LLC were examined between high- and low-CR groups formed using cognitive, social, and exercise lifestyle factors. LLC is a measure of lagged coherence that excludes zero phase contributions and limits the effects of volume conduction on connectivity estimates. Significant differences in LLC were identified for cognitive and social factors, but not exercise. Participants high in social CR possessed greater local and long-range connectivity in theta and low alpha for eyes-open and eyes-closed recording conditions. In contrast, participants high in cognitive CR exhibited greater eyes-closed long-range connectivity between the occipital lobe and other cortical regions in low alpha. Greater eyes-closed local LLC in delta was also present in men high in cognitive CR. Cognitive factor scores correlated with sustained attention, whereas social factors scores correlated with spatial working memory. Gender was a significant covariate in our analyses, with women displaying higher local and long-range LLC in low beta. Our findings support distinct relationships between CR and LLC, as well as CR and cognitive function for cognitive and social subcomponents. These patterns reflect the importance of diverse lifestyle factors in building CR.

Leisure-Time Physical Activity and Metabolic Syndrome in Older Adults

BACKGROUND

Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease, atherosclerosis and diabetes mellitus type 2 which may be reduced by practicing regular physical activity.

OBJECTIVE

To assess the leisure-time physical activity (LTPA) of older adults with MetS and without MetS.

METHODS

Cross-sectional study of older adults (55-80 years old) from Balearic Islands (Spain) with MetS (n = 333; 55% men) and without MetS (n = 144; 43.8% men). LTPA was assessed with the validated Spanish version of the Minnesota LTPA Questionnaire. Two criteria of physically active were used: >150 min/week of moderate physical activity or >75 min/week of vigorous physical activity or a combination of both, and total leisure-time energy expenditure of >300 MET·min/day. Sociodemographic and lifestyle characteristics, anthropometric variables, MetS components, and adherence to the Mediterranean diet (MD) were also measured.

RESULTS

MetS subjects showed lower energy expenditure in LTPA, lower adherence to the MD, higher obesity and waist circumference, and were less active than non-MetS peers. LTPA increased as participants got older and there was higher LTPA intensity as educational level increased. Adherence to MD was as high as LTPA was.

CONCLUSIONS

MetS is associated with physical inactivity and unhealthy diet. To increase LTPA recommendations and raise awareness in the population about the health benefits of PA and high adherence to MD is highly recommended.

Functional Fitness and Quality of Life among Women over 60 Years of Age Depending on Their Level of Objectively Measured Physical Activity

The aim of this study was to identify the differences in functional fitness and quality of life among women over 60 years of age depending on their level of objectively measured physical activity (PA) according to Global Recommendations on Physical Activity for health. The study used a cross-sectional design with 213 female volunteers over 60 years of age. Physical activity was monitored for 7 days of the week using an Actigraph Gt3X monitor. The Senior Fitness Test battery and hand-grip strength tests were performed to assess functional fitness. Quality of life was self-reported using a short version of the World Health Organization Quality of Life questionnaire WHOQOL-bref. Women who met the PA recommendations achieved slightly better results in most functional tests and in all domains of quality of life. Significant differences were found in the upper body strength, dynamic balance, and social relationships domains of quality of life. Physical activity programs developed on the basis of World Health Organization (WHO) recommendations have the potential to improve functional fitness and quality of life. However, further experimental studies in this area are required.