Leisure-Time Physical Activity Is Associated With Reduced Risk of Dementia-Related Mortality in Adults With and Without Psychological Distress: The Cohort of Norway

Abstract

Background: Leisure-time physical activity (PA) has been proposed as a protective factor against dementia, whereas psychological distress is associated with an increased risk of dementia. We investigated the associations of leisure-time PA and psychological distress with dementia-related mortality, and whether the association between leisure-time PA and dementia-related mortality differs according to level of psychological distress.Methods: 36,945 individuals from the Cohort of Norway aged 50-74 years at baseline (1994–2002) were included and followed up until January 1st 2015. Leisure-time PA and psychological distress were assessed through questionnaires, whereas dementia-related mortality was obtained through the Norwegian Cause of Death Registry. Adjusted Cox regression analyses were used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI).Results: Compared to inactivity, leisure-time PA was associated with a decreased risk of dementia-related mortality; low intensity leisure-time PA (HR = 0.73, 95% CI 0.59–0.89); high intensity leisure-time PA (HR = 0.61, 95%CI 0.49-0.77). A statistically significant difference in dementia-related mortality risk was observed between low and high intensity leisure-time PA (p < 0.05). Psychological distress was associated with an increased risk of dementia-related mortality (HR = 1.45, 95% CI 1.16–1.81). Among non-distressed, leisure-time PA was associated with a decreased dementia-related mortality risk; low intensity leisure-time PA (HR = 0.77, 95% CI 0.61–0.97); high intensity leisure-time PA (HR = 0.65, 95% CI 0.51–0.84). The same applied for those with psychological distress; low intensity leisure-time PA (HR = 0.57, 95% CI 0.35–0.94); high intensity leisure-time PA (HR = 0.42, 95% CI 0.22–0.82). The interaction between leisure-time PA and psychological distress on dementia-related mortality was not statistically significant (p = 0.38).Conclusions: Participating in leisure-time PA was associated with a reduced risk of dementia-related mortality, whereas psychological distress was associated with an increased risk of dementia-related mortality. Leisure-time PA appears to be equally strongly related with dementia-related mortality among those with and without psychological distress, underlining the importance of leisure-time PA for various groups of middle-aged and older adults.

Midlife Physical Activity, Psychological Distress, and Dementia Risk: The HUNT Study

“…However, there were only six dementia cases in this group, providing low precision with wide confidence intervals. Our results nevertheless suggest that MVPA reduces the risk of dementia among individuals with distress, supporting findings from a prospective study in which high intensity PA markedly reduced the risk of dementia-related mortality among individuals with distress [20].…”

“…Studies suggest a link between PA, cognitive function, and depressive symptoms [18,19], indicating that PA may improve cognitive function among individuals suffering from depression [18] or with high levels of depressive symptoms [19]. A large prospective study found that both low and high intensity leisure-time PA reduces the risk of dementia-related mortality among individuals with and without distress [20]. However, the latter study was limited by using dementia-related mortality as endpoint.…”

Shared Risk Factors between Dementia and Atherosclerotic Cardiovascular Disease

“…Most observational studies investigating the association between physical activity and a risk of all-cause dementia have found that physical activity early in life reduces the risk of developing all-cause dementia later in life [ 2 , 99 ]. In a study by Zotcheva et al that included approximately 29,000 individuals aged 30–60 years and 25 years of follow-up, they observed a reduced risk of all-cause dementia in those who were physically active [ 100 ]. In the Whitehall study that included approximately 10,000 individuals with a follow-up of 28 years, the results were less clear [ 101 ].…”

Exploring experiences of times without care and encounters in persons with dementia: A three-year multi-method exploration in the Swiss and German nursing home and domiciliary care setting (Preprint)

“…Times without care and encounters can also have a negative impact. Low levels of physical or cognitive activity may have a long-term influence on the progression of cognitive impairment and mortality in persons with dementia [58,59]. During periods of low social involvement, Cohen-Mansfield et al found an increase in challenging behaviors, e.g., agitation [15] and hallucinations [60].…”