Assessment of Leisure Time Physical Activity and Brain Health in a Multiethnic Cohort of Older Adults

Abstract

IMPORTANCE Results from longitudinal studies suggest that regular leisure time physical activity (LTPA) is associated with reduced risk of dementia or Alzheimer disease. Data on the association between LTPA and brain magnetic resonance imaging (MRI) measures remain scarce and inconsistent. OBJECTIVE To examine the association of LTPA and MRI-assessed brain aging measures in a multiethnic elderly population. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included 1443 older (Ն65 years) adults without dementia who were participants of the Washington/Hamilton Heights-Inwood Columbia Aging Project study. LTPA, from self-reported questionnaire, was calculated as metabolic equivalent of energy expenditure. Both moderate to vigorous LTPA, assessed as meeting Physical Activity Guidelines for Americans (Ն150 minutes/week) or not, and light-intensity LTPA were also examined. EXPOSURES LTPA. MAIN OUTCOMES AND MEASURES Primary outcomes included total brain volume (TBV), cortical thickness, and white matter hyperintensity volume, all derived from MRI scans with established methods and adjusted for intracranial volume when necessary. We examined the association of LTPA with these imaging markers using regression models adjusted for demographic, clinical, and vascular risk factors. RESULTS The 1443 participants of the study had a mean (SD) age of 77.2 (6.4) years; 921 (63.8%) were women; 27.0%, 34.4%, and 36.3% were non-Hispanic White, non-Hispanic African American, and Hispanic individuals, respectively; and 27.3% carried the apolipoprotein E (APOE) ε4 allele. Compared with the LTPA of nonactive older adults, those with the most LTPA had larger (in cm 3) TBV

Apolipoprotein E Genotype Moderation of the Association Between Physical Activity and Brain Health. A Systematic Review and Meta-Analysis

“…Meta-analyses indicated that physical activity was associated with better outcomes for HDL, GM and brain activation, but not for LDL and Aβ. Narrative syntheses revealed that one of three studies demonstrated an association between physical activity and WM volume (Gu et al, 2020); one study reported an association between physical activity and WM integrity (Smith et al, 2016); one of two studies demonstrated an association between physical activity and cerebrovascular health (Boots et al, 2015); and two of two studies reported an association between physical activity and functional connectivity (Kerestes et al, 2015;de Frutos-Lucas et al, 2020a).…”

“…From the three studies which assessed WM volume, four of the six effect sizes for e4 carriers and non-carriers were not reported, and neither were their physical activity main effects. One study (Gu et al, 2020) only reported stratified APOE data and showed significant positive associations between physical activity and WM volume for both e4 carriers and non-carriers. Highly active e4 carriers had 17.5 cm 3 higher WM volume compared to inactive e4 carriers, whereas active non-carriers had 31.6 cm 3 higher WM volume compared to inactive non-carriers.…”

“…There was no significant physical activity by APOE interaction, suggesting that both e4 carriers and non-carriers benefited from being physically active. The other study (Gu et al, 2020) assessed the association between physical activity and WMH stratified by APOE, but neither e4 carriers nor non-carriers demonstrated an association between physical activity and cerebrovascular health.…”

“…Visual inspection of the funnel plot did not suggest publication bias (Supplementary Figure 1). Honea et al (2009), Vemuri et al (2016), andGu et al (2020). a Calculated using high active vs. inactive to Pearson's r using Campbell collaboration calculator.…”

Association of Life's Simple 7 with incident dementia and its modification by the apolipoprotein E genotype

“…using similar study procedures. 6,26 Briefly, participants were recruited from a probability sample of Medicare recipients who were 65 years of age or older, socioeconomically and racially diverse, and residing in northern Manhattan. At the study entry, each subject underwent a structured in-person interview of general health and function, followed by a comprehensive assessment including medical and neurological histories, and standardized physical, neurological, and neuropsychological examinations.…”