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Association of the volume, duration, and intensity of physical activity with incident dementia: A COSMIC collaborative cohort study
Author(s) -
Wu Wanqing,
Ding Ding,
Zhao Qianhua,
Xiao Zhenxu,
Ganguli Mary,
Haan Mary,
LimaCosta Maria Fernanda,
Costa Erico,
Ng Tze Pin,
Gureje Oye,
Scarmeas Nikolaos,
Brodaty Henry,
Lipton Richard B,
Katz Mindy J,
Lipnicki Darren M,
Sachdev Perminder S
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.055359
Subject(s) - dementia , medicine , hazard ratio , cohort , confounding , body mass index , proportional hazards model , cohort study , demography , metabolic equivalent , stroke (engine) , gerontology , confidence interval , physical therapy , physical activity , disease , mechanical engineering , sociology , engineering
Background Consistent evidence suggested that physical activity (PA) may delay dementia onset. However, the dose‐response association between PA and dementia remains unclear. This study aimed to examine the association between the volume, duration, and intensity of PA and incident dementia among older adults across diverse geographic regions. Method We harmonized longitudinal data from nine community‐based cohorts in seven countries covering five continents in the Cohort Studies of Memory in an International Consortium (COSMIC). The frequency and duration of performing various PAs per week were collected through questionnaires. Each activity was assigned a metabolic equivalent value (MET). The volume of each PA (MET‐hours) was calculated as the MET multiplied by the hours spent performing the activity. The average PA intensity was calculated as the total volume divided by the total duration hours of PA. Incident dementia was diagnosed after a median of 5.4 years of follow‐up. To explore the dose‐response associations, participants who reported doing regular PA were categorized into subgroups with stratified levels of the volume, duration, or intensity of PA. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) of incident dementia in each group with the lowest volume, duration, or intensity as the reference group. Age, sex, educational year, cohort, APOE, body mass index, smoking, hypertension, diabetes, stroke, and depression were adjusted as the confounders. Result A total of 8849 participants (51921 person‐years of follow‐up) were included in our analysis. Compared to engaging in low‐intensity activities (2.3≤MET≤3), engaging in moderate to high‐intensity activities was associated with a lower risk of incident dementia (3.004, adjusted HR=0.58, 95% CI=0.40‐0.84; p for trend=0.004) . There was no significant dose‐response relationship between the volume or duration of PA and the risk of incident dementia. Conclusion Our analysis demonstrated a dose‐response association between PA intensity (but not volume or duration) and dementia risk. This evidence could potentially enrich the current recommendations for the protective effect of PA on dementia onset. While waiting for additional evidence from randomized interventions, older adults may be encouraged to perform a higher intensity of PA to preserve cognition.