The Importance of Engaging in Physical Activity in Older Adulthood for Transitions between Cognitive Status Categories and Death: A Coordinated Analysis of Fourteen Longitudinal Studies

TY - JOUR

T1 - The Importance of Engaging in Physical Activity in Older Adulthood for Transitions between Cognitive Status Categories and Death: A Coordinated Analysis of Fourteen Longitudinal Studies

AU - Yoneda, Tomiko

AU - Lewis, Nathan A

AU - Knight, Jamie E

AU - Rush, Jonathan

AU - Vendittelli, Rebecca

AU - Kleineidam, Luca

AU - Hyun, Jinshil

AU - Piccinin, Andrea M

AU - Hofer, Scott M

AU - Hoogendijk, Emiel O

AU - Derby, Carol A

AU - Scherer, Martin

AU - Riedel-Heller, Steffi

AU - Wagner, Michael

AU - van den Hout, Ardo

AU - Wang, Wenyu

AU - Bennett, David A

AU - Muniz-Terrera, Graciela

N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2021/8/13

Y1 - 2021/8/13

N2 - BACKGROUND: Given increasing incidence of cognitive impairment and dementia, further understanding of modifiable factors contributing to increased healthspan is crucial. Extensive literature provides evidence that physical activity (PA) delays the onset of cognitive impairment; however, it is unclear whether engaging in PA in older adulthood is sufficient to influence progression through cognitive status categories.METHOD: Applying a coordinated analysis approach, this project independently analyzed 14 longitudinal studies (NTotal = 52 039; mean baseline age across studies = 69.9-81.73) from North America and Europe using multistate survival models to estimate the impact of engaging in PA on cognitive status transitions (nonimpaired, mildly impaired, severely impaired) and death. Multinomial regression models were fit to estimate life expectancy (LE) based on American PA recommendations. Meta-analyses provided the pooled effect sizes for the role of PA on each transition and estimated LEs.RESULTS: Controlling for baseline age, sex, education, and chronic conditions, analyses revealed that more PA is significantly associated with decreased risk of transitioning from nonimpaired to mildly impaired cognitive functioning and death, as well as substantially longer LE. Results also provided evidence for a protective effect of PA after onset of cognitive impairment (eg, decreased risk of transitioning from mild-to-severe cognitive impairment; increased likelihood of transitioning backward from severe-to-mild cognitive impairment), though between-study heterogeneity suggests a less robust association.CONCLUSIONS: These results yield evidence for the importance of engaging in PA in older adulthood for cognitive health, and a rationale for motivating older adults to engage consistently in PA.

AB - BACKGROUND: Given increasing incidence of cognitive impairment and dementia, further understanding of modifiable factors contributing to increased healthspan is crucial. Extensive literature provides evidence that physical activity (PA) delays the onset of cognitive impairment; however, it is unclear whether engaging in PA in older adulthood is sufficient to influence progression through cognitive status categories.METHOD: Applying a coordinated analysis approach, this project independently analyzed 14 longitudinal studies (NTotal = 52 039; mean baseline age across studies = 69.9-81.73) from North America and Europe using multistate survival models to estimate the impact of engaging in PA on cognitive status transitions (nonimpaired, mildly impaired, severely impaired) and death. Multinomial regression models were fit to estimate life expectancy (LE) based on American PA recommendations. Meta-analyses provided the pooled effect sizes for the role of PA on each transition and estimated LEs.RESULTS: Controlling for baseline age, sex, education, and chronic conditions, analyses revealed that more PA is significantly associated with decreased risk of transitioning from nonimpaired to mildly impaired cognitive functioning and death, as well as substantially longer LE. Results also provided evidence for a protective effect of PA after onset of cognitive impairment (eg, decreased risk of transitioning from mild-to-severe cognitive impairment; increased likelihood of transitioning backward from severe-to-mild cognitive impairment), though between-study heterogeneity suggests a less robust association.CONCLUSIONS: These results yield evidence for the importance of engaging in PA in older adulthood for cognitive health, and a rationale for motivating older adults to engage consistently in PA.

U2 - 10.1093/gerona/glaa268

DO - 10.1093/gerona/glaa268

M3 - SCORING: Journal article

C2 - 33099603

VL - 76

SP - 1661

EP - 1667

JO - J GERONTOL A-BIOL

JF - J GERONTOL A-BIOL

SN - 1079-5006

IS - 9

ER -