Leisure-time physical activity sustained since midlife and preservation of cognitive function: The Atherosclerosis Risk in Communities Study

Alzheimers Dement. 2019 Feb;15(2):273-281. doi: 10.1016/j.jalz.2018.08.008. Epub 2018 Oct 12.


Introduction: We tested the hypotheses that higher levels of and persistence of midlife leisure-time physical activity (LTPA) are associated long-term with lower cognitive decline and less incident dementia.

Methods: A total of 10,705 participants (mean age: 60 years) had LTPA (no, low, middle, or high) measured in 1987-1989 and 1993-1995. LTPA was assessed in relation to incident dementia and 14-year change in general cognitive performance.

Results: Over a median follow-up of 17.4 years, 1063 dementia cases were observed. Compared with no LTPA, high LTPA in midlife was associated with lower incidence of dementia (hazard ratio [95% confidence interval], 0.71 [0.61, 0.86]) and lower declines in general cognitive performance (-0.07 standard deviation difference [-0.12 to -0.04]). These associations were stronger when measured against persistence of midlife LTPA over 6 years.

Discussion: LTPA is a readily modifiable factor associated inversely with long-term dementia incidence and cognitive decline.

Keywords: Cognitive decline; Cohort study; Dementia; Epidemiology; Physical activity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Atherosclerosis / epidemiology*
  • Cognition / physiology*
  • Exercise / physiology*
  • Female
  • Humans
  • Leisure Activities*
  • Male
  • Middle Aged
  • Risk Factors