Physical activity reduces dementia risk in elderly

Physical activity reduces the risk for cognitive impairment, particularly vascular dementia, in older people who have developed white matter changes (WMCs), shows research.

"We strongly suggest physical activity of moderate intensity at least 30 minutes three times a week to prevent cognitive impairment," said lead author Ana Verdelho from the University of Lisbon in Portugal in a press statement.

The team found that, among nondisabled older people (mean age 74 years) with WMCs, physical activity reduced the risk for cognitive impairment and vascular dementia independently of the severity of WMC and even after controlling for educational level, age, temporal atrophy, and risk factors found to be predictive for dementia.

The team conducted a 3-year follow up of 638 individuals who had WMCs of any degree (according to the scale of Fazekas) on a baseline magnetic resonance imaging (MRI) scan.

"Damage of the cerebral white matter is implicated in cognitive problems including depression, walking difficulties and urinary complaints," said Verdelho. The changes are very common in older people and mainly associated with vascular risk factors such as hypertension and stroke.

Physical activity status was established at baseline according to the American Heart Association Scientific Position (at least 30 minutes of activity at least 3 days per week) and patients were categorized as either active or inactive.

As reported in Stroke, by the end of the study, 90 individuals developed dementia, 54 of whom had vascular dementia, 34 Alzheimer's disease with a vascular component, and two frontotemporal dementia. In addition, 147 patients developed cognitive impairment without dementia, of whom 86 had vascular cognitive impairment without dementia, while 61 had mild cognitive impairment.

Cox regression analysis showed that a physically active status at baseline reduced the risk for any cognitive impairment (with and without dementia) by 36%, the risk for dementia by 39%, and the risk for vascular dementia by 58%, after adjustment for age, education, WMC severity, medial temporal atrophy, previous and incident stroke, and diabetes.

"Even taking into consideration the effect of severe WMC, physical activity implicated a reduced risk for the transition to vascular dementia," said Verdelho.

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