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Cardiorespiratory Fitness as a Predictor of Dementia Mortality in Men and Women


Medicine & Science in Sports & Exercise: February 2012 - Volume 44 - Issue 2 - p 253–259
doi: 10.1249/MSS.0b013e31822cf717

There is evidence that physical activity may reduce the risk of developing Alzheimer disease and dementia. However, few reports have examined the physical activity–dementia association with objective measures of physical activity. Cardiorespiratory fitness (hereafter called fitness) is an objective reproducible measure of recent physical activity habits.

Purpose We sought to determine whether fitness is associated with lower risk for dementia mortality in women and men.

Methods We followed 14,811 women and 45,078 men, age 20–88 yr at baseline, for an average of 17 yr. All participants completed a preventive health examination at the Cooper Clinic in Dallas, TX, during 1970–2001. Fitness was measured with a maximal treadmill exercise test, with results expressed in maximal METs. The National Death Index identified deaths through 2003. Cox proportional hazards models were used to examine the association between baseline fitness and dementia mortality, adjusting for age, sex, examination year, body mass index, smoking, alcohol use, abnormal ECGs, and health status.

Results There were 164 deaths with dementia listed as the cause during 1,012,125 person-years of exposure. Each 1-MET increase in fitness was associated with a 14% lower adjusted risk of dementia mortality (95% confidence interval (CI) = 6%–22%). With fitness expressed in tertiles, adjusted hazard ratios (HRs) for those in the middle- and high-fitness groups suggest their risk of dementia mortality was less than half that of those in the lowest fitness group (HR = 0.44, CI = 0.26–0.74 and HR = 0.49, CI = 0.26–0.90, respectively).

Conclusions Greater fitness was associated with lower risk of mortality from dementia in a large cohort of men and women.

1Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC; 2Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC; 3Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC; 4Laboratory of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA; and 5Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC

Address for correspondence: Rui Liu, Ph.D., Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Dr. PO Box 12233, Mail drop A3-05, Research Triangle Park, NC 27709; E-mail:

Submitted for publication March 2011.

Accepted for publication July 2011.

©2012The American College of Sports Medicine