Although it has been hypothesized that the association of physical activity with depressive and anxiety symptoms is bidirectional, few studies have examined this issue in a prospective setting. We studied this bidirectional association using data on physical activity and symptoms of anxiety and depression at three points in time over 8 years. A total of 9,309 participants of the British Whitehall II prospective cohort study provided data on physical activity, anxiety and depression symptoms and 10 covariates at baseline in 1985. We analysed the associations of physical activity with anxiety and/or depression symptoms using multinomial logistic regression (with anxiety and depression symptoms as dependent variables) and binary logistic regression (with physical activity as the dependent variable). There was a cross-sectional inverse association between physical activity and anxiety and/or depressive symptoms at baseline (ORs between 0.63 and 0.72). In cumulative analyses, regular physical activity across all three data waves, but not irregular physical activity, was associated with reduced likelihood of depressive symptoms at follow-up (OR = 0.71, 95 % CI 0.54, 0.99). In a converse analysis, participants with anxiety and depression symptoms at baseline had higher odds of not meeting the recommended levels of physical activity at follow-up (OR = 1.79, 95 % CI 1.17, 2.74). This was also the case in individuals with anxiety and/or depression symptoms at both baseline and follow-up (OR = 1.70, 95 % CI 1.10, 2.63). The association between physical activity and symptoms of anxiety and/or depression appears to be bidirectional.

Objective: Our aim was to compare 2 Framingham vascular risk scores with a dementia risk score in relation to 10-year cognitive decline in late middle age.Methods: Participants were men and women with mean age of 55.6 years at baseline, from the Whitehall II study, a longitudinal British cohort study. We compared the Framingham general cardiovascular disease risk score and the Framingham stroke risk score with the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) risk score that uses risk factors in midlife to estimate risk of late-life dementia. Cognitive tests included reasoning, memory, verbal fluency, vocabulary, and global cognition, assessed 3 times over 10 years.Results: Higher cardiovascular disease risk and higher stroke risk were associated with greater cognitive decline in all tests except memory; higher dementia risk was associated with greater decline in reasoning, vocabulary, and global cognitive scores. Compared with the dementia risk score, cardiovascular and stroke risk scores showed slightly stronger associations with 10-year cognitive decline; these differences were statistically significant for semantic fluency and global cognitive scores. Along with attempts to identify risk factors for dementia, there is increasing interest in studying predictors of cognitive decline as it is now widely accepted that dementia has a long preclinical phase. Vascular risk factors are hypothesized to be the key modifiable risk factors for dementia and adverse cognitive outcomes.1-5 Mid-rather than late-life vascular risk factors are considered to be important for late-life cognitive impairment and dementia.2,5-9 Moreover, individuals may be at higher risk of cognitive impairment from accumulation of risk, with the clustering of risk factors being associated with the risk of dementia in a cumulative manner. 7,10 Recognizing the role of multiple risk factors, a number of mostly cross-sectional and prospective studies have examined the utility of risk scores to assess risk of cognitive impairment and dementia.11-18 The Framingham cardiovascular risk algorithms, in particular the Framingham stroke risk profile, initially developed to predict cerebrovascular disease, have been shown to be associated with brain pathology and cognitive dysfunction. 11,13,14,16,17 A dementia risk score based on the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study that uses midlife risk factors to predict risk of late-life dementia has recently been proposed.