Objective: To investigate whether greater cardiorespiratory fitness is associated with better global and domain-specific cognitive function.
Methods:We investigated 877 participants (aged 65 6 7 years, 55% women) of the Austrian Stroke Prevention Study. For cardiorespiratory fitness, the maximum oxygen consumption (VȮ 2 max) was calculated based on weight and maximum and resting heart rate on a treadmill test (mL$kg 21 $min 21 ). A test battery assessing memory (Bäumler's Lern-und Gedächtnistest), executive function (Wisconsin Card Sorting Test, Trail Making Test-Part B, Digit Span Backward, Alters Konzentrationstest, a computerized complex reaction time task) and motor skills (Purdue Pegboard Test) was administered. Summary measures for cognitive domains and for global cognition were calculated. White matter lesions, lacunes, and brain atrophy were assessed using MRI.Results: Higher VȮ 2 max was associated with better global (B 5 0.024; p 5 0.000) and domainspecific cognitive function (memory B 5 0.026, p 5 0.000; executive function B 5 0.009, p 5 0.003; motor skills B 5 0.012, p 5 0.018) after adjustment for age, sex, education years, and Ca 21 channel antagonists or b-blockers. White matter lesions, lacunes, or brain atrophy did not mediate the effect (p . 0.05 for all mediators). The interactions of VȮ 2 max with age, overweight, and APOE e4 on cognition were not statistically significant (p . 0.05 for all interaction terms) with the exception of a modulating effect of body mass index on VȮ 2 max in the memory domain.
Conclusions:Higher VȮ 2 max is associated with better global cognitive function and with better performance in the cognitive domains of memory, executive function, and motor skills in the middle-aged and elderly. The association is not mediated by the presence of white matter lesions, lacunes, and brain atrophy. LGT 5 Lern-und Gedächtnistest; TE 5 echo time; TR 5 repetition time; VȮ 2 max 5 maximum oxygen consumption; WML 5 white matter lesion.Physical activity 1 and cardiorespiratory fitness 2 have been previously associated with cognitive function in the elderly, and the reduction of Alzheimer and Parkinson disease risk.3 Nevertheless, there is a substantial amount of variability in the results linking cognitive performance to physical activity because of heterogeneity in the assessments across the studies. 4 While physical activity and cardiorespiratory fitness are intertwined, their relationships with cognitive performance may be distinct from another. Cardiorespiratory fitness is frequently assessed as the maximum oxygen consumption (VȮ 2 max), which progressively declines with age, 5 but can be increased by prolonged exercise even in the elderly. 6 Cross-sectional observational studies in the elderly found a protective effect of VȮ 2 max on memory 7 and executive function. 8 Similarly, exercise interventional trials improving VȮ 2 max reported improvements in executive function 9 and short-term memory. 10 The mechanism linking higher VȮ 2 max to cognition is, however, not well und...
