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

Abstract

Background: Physical activity (PA) is associated with a decreased dementia risk, whereas psychological distress (distress) is linked to an increased dementia risk.Objective: We investigated independent and joint associations of midlife moderate-to-vigorous PA (MVPA) and distress with incident dementia.Methods: Our study comprised 28,916 participants aged 30-60 years from the Nord-Trøndelag Health Study (HUNT1, 1984(HUNT1, -1986. Data on MVPA and distress from HUNT1 was linked to the Health and Memory Study in Nord-Trøndelag for dementia case identification. Participants were followed from 1995 until 2011. We used adjusted Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI).Results: In fully adjusted analyses, MVPA was associated with a reduced dementia risk (HR 0.81, 95% CI 0.62-1.06), compared to no MVPA. Distress was associated with an increased dementia risk (HR 1.30, 95% CI 0.99-1.70). Compared to distressed participants not taking part in MVPA, non-distressed no-MVPA participants had a reduced dementia risk (HR 0.72, 95% CI 0.54-0.96). The same applied to distressed MVPA participants (HR 0.50, 95% CI 0.22-1.14), and non-distressed MVPA participants (HR 0.63, 95% CI 0.44-0.90). Our results indicated an additive interaction between MVPA and distress on dementia risk.Conclusion: Our results suggest that midlife MVPA reduces risk of incident dementia among both distressed and non-distressed individuals.

Dementia prevention, intervention, and care: 2020 report of the Lancet Commission

“…At least weekly midlife moderate-to-vigorous physical activity (breaking into a sweat) was associated with reduced dementia risk over a 25-year period of follow-up (HR 0·8, 95% CI 0·6–1·1) but the confidence intervals were wide. 89 In contrast the Whitehall Study reporting on the 28-year follow-up of 10 308 people, found that more than 2·5 hours of self-reported moderate-to-vigorous physical activity per week, lowered dementia risk over 10, but not 28 years. 33 Very long-term studies are unusual; however, one 44-year study recruited 191 women (mean age 50) purposively to be representative of the Swedish population and reported that 32% of the participants with low baseline peak fitness, 25% with medium, and 5% with high fitness developed dementia (high vs medium HR 0·1, 95% CI 0·03–0·5, low vs medium 1·4, 0·7–2·8).…”

“…The Norwegian HUNT study, suggested that symptoms of psychological distress predicted dementia 25 years later however with wide bounds of uncertainty (HR 1·3, 95% CI 1·0–1·7). 89 Two further studies differentiate between late-life and earlier life depressive symptoms. The UK Whitehall study, in a follow-up of 10 189 people, reports that in late life these symptoms increase dementia risk but not at younger ages (follow-up 11 years HR 1·7; 95% CI 1·2–2·4; follow-up 22 years 1·0, 0·7–1·4).…”

Multifactorial 10-Year Prior Diagnosis Prediction Model of Dementia

“…Such benefits are believed to reduce neuropathological damage and increase or maintain cognitive reserve [ 67 ]. Evidence in the literature of the effects of exercise on lowering the risk of dementia shows favorable results in longitudinal observational studies of over 20 years of follow up [ 68 , 69 , 70 , 71 ]. Nevertheless, a recent systematic literature review on physical activity interventions for slowing and delaying cognitive decline, cognitive impairment and dementia in individuals without diagnosed cognitive impairments found insufficient evidence for such claims [ 72 ].…”

Environmental and Cognitive Enrichment in Childhood as Protective Factors in the Adult and Aging Brain

“…For a long time, and in particular studies on mice models (Intlekofer and Cotman, 2013), physical exercise has been thought of as neuroprotective for neurodegenerative pathologies (Paillard et al, 2015). PA could thus influence age-related decline (Hamer et al, 2018;Lerche et al, 2018;Loprinzi et al, 2018;Engeroff et al, 2019) -particularly on episodic memory (Hamer et al, 2018) -and would be related to a lower risk of later onset of dementia (Guure et al, 2017;Zotcheva et al, 2018). As for the underlying mechanisms, two modes of action are reported.…”