Physical activity and dementia risk in the elderly

痴呆 医学 前瞻性队列研究 混淆 危险系数 血管性痴呆 队列 队列研究 人口 内科学 疾病 低风险 物理疗法 老年学 置信区间 环境卫生
作者
Giovanni Ravaglia,Paola Forti,A. Lucicesare,Nicoletta Pisacane,Elisa Rietti,Marisa Bianchin,Edoardo Dalmonte
出处
期刊:Neurology [Ovid Technologies (Wolters Kluwer)]
卷期号:70 (19_part_2): 1786-1794 被引量:182
标识
DOI:10.1212/01.wnl.0000296276.50595.86
摘要

Objective: To examine the effect of physical activity on risk of developing Alzheimer disease (AD) and vascular dementia (VaD) in the elderly. Methods: Data are from a prospective population-based cohort of 749 Italian subjects aged 65 and older who, in 1999/2000, were cognitively normal at an extensive assessment for clinically overt and preclinical dementia and, in 2003/2004, underwent follow-up for incident dementia. Baseline physical activity was measured as energy expenditure on activities of different intensity (walking, stair climbing, moderate activities, vigorous activities, and total physical activity). Results: Over 3.9 ± 0.7 years of follow-up there were 86 incident dementia cases (54 AD, 27 VaD). After adjustment for sociodemographic and genetic confounders, VaD risk was significantly lower for the upper tertiles of walking (hazard ratio [HR] 0.27, 95% CI 0.12 to 0.63), moderate (HR 0.29, 95% CI 0.12 to 0.66), and total physical activity (HR 0.24, 95% 0.11 to 0.56) compared to the corresponding lowest tertile. The association persisted after accounting for vascular risk factors and overall health status. After adjustment for sociodemographic and genetic confounders, AD risk was not associated with measures of physical activity and results did not change after further adjustment for vascular risk factors and overall health and functional status. Conclusions: In this cohort, physical activity is associated with a lower risk of vascular dementia but not of Alzheimer disease. Further research is needed about the biologic mechanisms operating between physical activity and cognition.
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