Objective: To examine whether engagement in physical activity might favorably alter the agedependent evolution of Alzheimer disease (AD)-related brain and cognitive changes in a cohort of at-risk, late-middle-aged adults.Methods: Three hundred seventeen enrollees in the Wisconsin Registry for Alzheimer's Prevention underwent T1 MRI; a subset also underwent 11 C-Pittsburgh compound B-PET (n 5 186) and 18 F-fluorodeoxyglucose-PET (n 5 152) imaging. Participants' responses on a self-report measure of current physical activity were used to classify them as either physically active or physically inactive based on American Heart Association guidelines. They also completed a comprehensive neuropsychological battery. Covariate-adjusted regression analyses were used to test whether the adverse effect of age on imaging and cognitive biomarkers was modified by physical activity.Results: There were significant age 3 physical activity interactions for b-amyloid burden (p 5 0.014), glucose metabolism (p 5 0.015), and hippocampal volume (p 5 0.025) such that, with advancing age, physically active individuals exhibited a lesser degree of biomarker alterations compared with the physically inactive. Similar age 3 physical activity interactions were also observed on cognitive domains of Immediate Memory (p 5 0.042) and Visuospatial Ability (p 5 0.016). In addition, the physically active group had higher scores on Speed and Flexibility (p 5 0.002) compared with the inactive group. Conclusions:In a middle-aged, at-risk cohort, a physically active lifestyle is associated with an attenuation of the deleterious influence of age on key biomarkers of AD pathophysiology. However, because our observational, cross-sectional design cannot establish causality, randomized controlled trials/longitudinal studies will be necessary for determining whether midlife participation in structured physical exercise forestalls the development of AD and related disorders in later life. Animal models of Alzheimer disease (AD) show that physical exercise represents an efficacious means for favorably altering not only cognitive trajectories but also underlying pathophysiologic processes, including b-amyloid (Ab) burden, tau phosphorylation, and neuronal loss.

The present study was designed to provide information on the relationship between self-reports of health and physicians' ratings in an aged sample, and to determine how both of these measures of health relate to longevity. Subjects were 69 survivors (median age = 84.25 years) of a sample of aged twins who had been followed longitudinally since 1947 to 1949. Self-reports of health were found to be significantly correlated with ratings assigned by a physician on the basis of medical records. Both types of measures were predictive of differences in survival time among the younger subjects in the sample, but neither was significantly related to longevity for older subjects. The results suggest that self-reports could provide a valid, cost-effective means of health assessment in studies in which other forms of health information are lacking.

Objective-To determine the extent to which individual changes in systolic blood pressure (SBP) over a 30-year interval are associated with differential neuropsychological outcomes in old age. Methods-Seven hundred seventeen survivors from the Western Collaborative Group Study, a longitudinal study of cardiovascular risk factors now in its 38th year of follow-up, with blood pressures measured in middle age (meanϭ45 years) and in old age (meanϭ75 years) and neuropsychological tests administered at follow-up were included in this analysis. Participants were grouped according to 30-year change in SBP (increased, decreased, or "normal"). Analyses focused on comparisons of neuropsychological performance of "high SBP trackers" (ie, those with persistent SBPՆ140 mm Hg throughout adult life) and of SBP "decreasers" with the performance of those whose SBP was either stable or changed in an expected way over time. Results-Only 7.5% of participants had elevated SBP in middle age, but 43.8% of participants had elevated SBP in old age. After adjustment for age, education, depression, clinically defined stroke, and use of antihypertensive medications and after exclusion of individuals with impaired cognitive performance at follow-up, high SBP trackers, 5.0% (nϭ36), performed consistently less well than the "normal" SBP subgroups on a composite measure of verbal learning and memory (Pϭ0.04). When compared with the "normal" SBP subgroup, the SBP decreasers, 5.3% (nϭ38), performed less well on speeded performance (Pϭ0.03). Conclusions-There is a relatively small group of people who maintain elevated SBP throughout their adult lives. These persons are at increased risk for reduced verbal learning and memory function. There is also a group of individuals who experience a decrease in SBP and who are at risk for decreased psychomotor speed. Delineation of these 2 SBP subgroups may lead to further clarification of the effects of SBP on neurobehavioral function in older adults. (Stroke. 1998;29:2334-2340.)Key Words: aging Ⅲ blood pressure Ⅲ cognition Ⅲ neuropsychology E levated systolic blood pressure (SBP) is associated with reduced levels of cognitive performance and increased cognitive decline in the majority of investigations of this issue. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] In a reanalysis of data reported originally as not being supportive of the SBP-cognition association, 13,14 higher baseline SBP levels and increased chronicity of hypertension were found to be associated with lower cognitive performance measured 12 to 14 years later for measurements taken when few, if any, participants were on antihypertensive medication. [15][16][17] The long-term impact of elevated midlife SBP on reduced cognitive performance has been extended from the 14-year interval first reported by Elias et al [15][16][17] to 25 years 18 and to 30 years. 19 The primary implication of these findings is that SBP in middle age that is elevated but not necessarily hypertensive may exert a measurable deleterious effect on the function of the brai...