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Lifetime Physical Activity and White Matter Hyperintensities in Cognitively Intact Adults

Torres, Elisa R.; Hoscheidt, Siobhan M.; Bendlin, Barbara B.; Magnotta, Vincent A.; Lancaster, Gabriel D.; Brown, Roger L.; Paradiso, Sergio

doi: 10.1097/NNR.0000000000000341

Background White matter hyperintensities (WMHs) observed on magnetic resonance images are associated with depression and increase the risk of stroke, dementia, and death. The association between physical activity and WMHs has been inconsistently reported in the literature, perhaps because studies did not account for a lifetime of physical activity or depression.

Objectives The aim of this study was to determine the extent to which a lifetime of leisure-time physical activity is associated with less WMHs while accounting for depression.

Methods Face-to-face interviews were conducted with the Lifetime Total Physical Activity Questionnaire, where the metabolic equivalent of task hours per week per year was calculated. Cognitively intact participants also underwent magnetic resonance imaging, where WMHs as a percentage of intracranial volume was obtained. Hierarchical multiple linear regression was performed to compare WMHs in a more active group with a group with no psychiatric history (n = 20, mean age = 62.2 years), with a less active group with no psychiatric history (n = 13, mean age = 64.0 years), and a less active group with history of late-onset depression (n = 14, mean age = 62.8 years).

Results There was not a statistically significant difference in WMHlg10 between the more and less active groups without a psychiatric history (b = .09, p > .05) or between the more active group without a psychiatric history and the less active group with a history of depression (b = .01, p > .05). The model was predictive of WMHlg10, explaining an adjusted 15% of the variance in WMHs (p = .041).

Discussion A lifetime of leisure-time physical activity was not associated with WMHs when accounting for depression.

Elisa R. Torres, PhD, RN, is Professor, University of Mississippi Medical Center School of Nursing, Jackson. At the time this data was collected, she was Associate Faculty, University of Iowa College of Nursing.

Siobhan M. Hoscheidt, PhD, is Assistant Professor, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Barbara B. Bendlin, PhD, is Associate Professor, University of Wisconsin–Madison School of Medicine and Public Health.

Vincent A. Magnotta, PhD, is Professor, University of Iowa College of Medicine.

Gabriel D. Lancaster, MS, is Medical Student, University of Iowa College of Medicine.

Roger L. Brown, PhD, is Professor, University of Wisconsin–Madison School of Nursing.

Sergio Paradiso, MD, PhD, is Physician in Private Practice specializing in Psychiatry and Pyschotherapy, Catania, Italy.

Accepted for publication January 13, 2019.

Acknowledgments: We would like to acknowledge the contribution of Amalia Gedney-Lose, DNP, ARNP, and Pauline Ngo, BSN, RN, in performing the physical activity calculations and Jennifer Oh at the Wisconsin Alzheimer's Disease Research Center for her technical assistance.

This work was supported by the Hartford Center of Geriatric Nursing Excellence pilot award; National Center for Advancing Translational Sciences (UL1TR000427 and KL2TR000428), National Institute on Aging (5K23AG027837, R01AG037639, and P50AG033514), National Institute of Nursing Research (T32NR007110), National Center for Research Resources (UL1RR024979), and Mississippi Center for Clinical and Translational Research (5U54GM115428). The funding sources have no role in the study design, collection, analysis, interpretation of data, writing of the report, or the decision to submit for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors have no conflicts of interests to disclose.

Ethical conduct of research: Institutional review board (IRB) approval was obtained from the University of Iowa. Individuals were sent an IRB-approved letter about the current study, with the principal investigator's contact information. Informed consent was obtained from all participants.

Corresponding author: Elisa R. Torres, PhD, RN, University of Mississippi Medical Center School of Nursing, 2500 North State Street, Jackson, MS 39216 (e-mail:

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