Prospective Analysis of Leisure-Time Physical Activity in Midlife and Beyond and Brain Damage on MRI in Older Adults

Abstract

Objective: To test the hypothesis that greater levels of leisure-time moderate to vigorous intensity physical activity (MVPA) in midlife or late life are associated with larger gray matter volumes, less white matter disease, and fewer cerebrovascular lesions measured in late life, we utilized data from 1,604 participants enrolled in the Atherosclerosis Risk in Communities study.

Methods: Leisure-time MVPA was quantified using a past-year recall, interviewer-administered questionnaire at baseline and 25 years later and classified as none, low, middle, and high at each time point. The presence of cerebrovascular lesions, white matter hyperintensities (WMH), white matter integrity (mean fractional anisotropy [FA] and mean diffusivity [MD]), and gray matter volumes were quantified with 3T MRI in late life. The odds of cerebrovascular lesions were estimated with logistic regression. Linear regression estimated the mean differences in WMH, mean FA and MD, and gray matter volumes.

Results: Among 1,604 participants (mean age 53 years, 61% female, 27% Black), 550 (34%), 176 (11%), 250 (16%), and 628 (39%) reported no, low, middle, and high MVPA in midlife, respectively. Compared to no MVPA in midlife, high MVPA was associated with more intact white matter integrity in late life (mean FA difference 0.13 per SD [95% confidence interval (CI) 0.004, 0.26]; mean MD difference -0.11 per SD [95% CI -0.21, -0.004]). High MVPA in midlife was also associated with a lower odds of lacunar infarcts (odds ratio 0.68, 95% CI 0.46, 0.99). High MVPA was not associated with gray matter volumes. High MVPA compared to no MVPA in late life was associated with most brain measures.

Conclusion: Greater levels of physical activity in midlife may protect against cerebrovascular sequelae in late life.

Figure 1. Flow Chart of Study Exclusions and Analytic Sample

ARIC = Atherosclerosis Risk in Communities; CeVD = cerebrovascular disease; DTI = diffusion tensor imaging.

Figure 2. Weighted, Adjusted Association of Persistently Meeting vs Not Meeting 2008/2018 Physical Activity Guidelines in Midlife With Cerebrovascular Lesions in Late Life (n = 1,097)

Persistently meeting 2008/2018 physical activity guidelines in midlife, n = 391; not persistently meeting physical activity guidelines in midlife, n = 706. Persistently meeting 2008/2018 physical activity guidelines in midlife = meeting PA guidelines at both visits 1 (1987–1989) and 3 (1993–1995). Adjusted for age, sex, education, race–center, APOE ε4, ever smoking; bolded estimates indicate p < 0.05. CI = confidence interval.

Figure 3. Weighted, Adjusted Association of Persistently Meeting vs Not Meeting 2008/2018 Physical Activity Guidelines in Midlife With Gray Matter Volumes, White Matter (WM) Microstructural Integrity, and WM Disease in Late Life (n = 1,097)

Persistently meeting 2008/2018 physical activity guidelines in midlife (meeting 2008/2018 physical activity guidelines at both visits 1 [1987–1989] and 3 [1993–1995]), n = 391; not persistently meeting physical activity guidelines in midlife, n = 706. Adjusted for age, sex, education, race–center, APOE ε4, ever smoking, intracranial volume (in volumetric analyses); bolded estimate indicates p < 0.05. Reference: not persistently meeting physical activity 2008/2018 guidelines. 1 SD = total cortical: 42.00 cm³; Alzheimer disease (AD) signature region: 6.85 cm³; deep gray matter: 4.22 cm³; log (white matter hyperintensity [WMH] volume): 0.88; mean fractional anisotropy: 0.0205635; mean diffusivity: 0.0000535. CI = confidence interval.