Physical inactivity in older adults with cognitive impairment without dementia: room for improvement

Aging Clin Exp Res. 2022 Apr;34(4):837-845. doi: 10.1007/s40520-021-01999-5. Epub 2021 Oct 21.


Background: Persons with cognitive impairment without dementia are at high risk of adverse health outcomes. Tailored intervention targeting moderate-vigorous physical activity (MVPA) may reduce these risks.

Aims: To identify the prevalence and predictors of physical inactivity among older adults with cognitive impairment, no dementia (CIND); and estimate the proportion of inactive people with CIND who are capable of greater MVPA.

Methods: We studied 1875 community dwelling participants (over age 65) with CIND in the Health and Retirement Study. Physical inactivity was defined as MVPA ≤ 1x/week. Associations of physical inactivity with sociodemographic, health, and physical function were examined using chi-square and modified Poisson regression. We considered physically inactive participants capable of greater MVPA if they reported MVPA at least 1-3x/month, no difficulty walking several blocks, or no difficulty climbing several flights of stairs.

Results: Fifty-six percent of participants with CIND were physically inactive. Variables with the highest age, sex, and race/ethnicity adjusted risk ratio (ARR) for physical inactivity were self-rated health (poor [76.9%]vs. excellent [34.2%]; ARR [95% CI] 2.27 [1.56-3.30]), difficulty walking (across the room [86.5%] vs. none [40.5%]; ARR [95% CI] 2.09 [1.87-2.35]), total assets (lowest quartile [62.6%] vs. highest quartile [43.1%]; ARR [95% CI] 1.54 [1.29-1.83]), and lower education attainment (less than high school [59.6%] vs college graduate [42.8%]; ARR [95% CI] 1.46 [1.17-1.83]). Among physically inactive older adults with CIND, 61% were estimated to be capable of greater MVPA.

Conclusions: Although physical inactivity is prevalent among older adults with CIND, many are capable of greater MVPA. Developing tailored physical activity interventions for this vulnerable population may improve cognitive, health, and quality of life outcomes.

Keywords: Cognitive impairment; Disability; Physical activity; Physical function.

MeSH terms

  • Aged
  • Cognitive Dysfunction* / epidemiology
  • Dementia* / epidemiology
  • Dementia* / psychology
  • Exercise
  • Humans
  • Quality of Life
  • Sedentary Behavior