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Objectively Measured Physical Activity and Cognitive Function in Older Adults

ZHU, WENFEI; WADLEY, VIRGINIA G.; HOWARD, VIRGINIA J.; HUTTO, BRENT; BLAIR, STEVEN N.; HOOKER, STEVEN P.

Medicine & Science in Sports & Exercise: January 2017 - Volume 49 - Issue 1 - p 47–53
doi: 10.1249/MSS.0000000000001079
Epidemiology

Purpose: Emerging evidence suggests physical activity (PA) is associated with cognitive function. To overcome limitations of self-report PA measures, this study investigated the association of accelerometer-measured PA with incident cognitive impairment and longitudinal cognition among older adults.

Methods: Participants were recruited from the cohort study Reasons for Geographic and Racial Differences in Stroke in the United States. Accelerometers provided PA measures, including the percentage of total accelerometer wearing time spent in moderate-to-vigorous-intensity PA (MVPA%), light-intensity PA, and sedentary time for four to seven consecutive days at baseline. Cognitive impairment was defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning, and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.

Results: Participants (N = 6452, 69.7 ± 8.5 yr, 55.3% women, 30.5% Black) with usable accelerometer and cognition measures spent extremely limited time in MVPA (1.5% ± 1.9% of accelerometer wearing time). During an average of 3 yr of follow-up, 346 cases of incident cognitive impairment were observed. After adjustments, participants in higher MVPA% quartiles had a lower risk of cognitive impairment (i.e., quartile 2: odds ratio = 0.64, 95% confidence interval = 0.48–0.84) and better maintenance in executive function (≥0.03 z-score units) and memory (≥0.12 z-score units) compared with quartile 1 (P < 0.05). Stratified analyses showed the same association among White adults, but higher MVPA% was associated with better maintenance of only memory among Black adults. No significance was found for light-intensity PA or sedentary time.

Conclusion: There was a dose–response relationship between MVPA% and cognitive function in older adults, with higher levels associated with a 36% or lower risk of cognitive impairment and better maintenance of memory and executive function over time, particularly in White adults.

1School of Physical Education, Shaanxi Normal University, Xi’an, Shaanxi, CHINA; 2Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL; 4Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC; 5Departments of Exercise Science and Epidemiology/Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; and 6Exercise Science and Health Promotion Program, College of Health Solutions, Arizona State University, Phoenix, AZ

Address for correspondence: Wenfei Zhu, Ph.D., School of Physical Education, Shaanxi Normal University, No. 620, West Chang’an Avenue, Chang’an District, Xi’an, Shaanxi 710119, PR China; E-mail: wzhu@snnu.edu.cn.

Submitted for publication June 2016.

Accepted for publication August 2016.

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© 2017 American College of Sports Medicine