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Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Research Article

Physical Work and Exercise Reduce the Risk of Cognitive Impairment in Older Adults: A Population-based Longitudinal Study

Author(s): Fan He, Junfen Lin, Fudong Li, Yujia Zhai, Tao Zhang, Xue Gu and Genming Zhao*

Volume 18, Issue 8, 2021

Published on: 17 November, 2021

Page: [638 - 645] Pages: 8

DOI: 10.2174/1567205018666211118100451

Price: $65

Abstract

Background: The independent effect of physical work on the risk of cognitive impairment in older Chinese older adults living in rural areas remains to be elucidated.

Objective: We aimed to determine whether physical work and physical exercise can reduce the risk of cognitive impairment.

Methods: We collected data from 7,000 permanent residents without cognitive impairment (age ≥60 years) over a follow-up period of 2 years. We used the Chinese version of the Mini-Mental State Examination (MMSE) to assess cognitive function. We performed multivariate Cox regression analyses to calculate adjusted Hazard Ratios (HRs) and 95% Confidence Intervals (%95 CIs) as measures of the association between physical work/exercise and cognitive impairment while controlling for potential confounders.

Results: Over a median follow-up period of 1.93 years, 1,224 (17.5%) of 7,000 participants developed cognitive impairment, with a total incidence of 97.69 per 1,000 person-years. After adjustment for potential confounders, participating in physical work (HR: 0.51; 95% CI: 0.43-0.60) or physical exercise (HR: 0.53; 95% CI: 0.44-0.65) was associated with a reduced risk of cognitive impairment. Stratified analyses suggested additive and multiplicative interactions between physical work and exercise. Agricultural work (HR: 0.46; 95% CI: 0.38-0.55), walking/tai chi (HR: 0.54; 95% CI: 0.44-0.67), and brisk walking/yangko (HR: 0.57; 95% CI: 0.33-0.97) exerted significant protective effects against cognitive impairment.

Conclusion: Both physical work and exercise can reduce the risk of cognitive impairment in older adults. Reasonable types and appropriate intensities of physical activity are recommended to prevent or delay the progression of cognitive impairment.

Keywords: Physical activity, cognitive impairment, longitudinal study, hazard ratio, older adults, aging.

[1]
World Population Prospects: The 2017 Revision 2017. Available from: https://www.un.org/development/desa/publications/worldpopulation-prospects-the-2017-revision.html
[2]
Prince M, Ali GC, Guerchet M, Prina AM, Albanese E, Wu YT. Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimers Res Ther 2016; 8(1): 23.
[http://dx.doi.org/10.1186/s13195-016-0188-8] [PMID: 27473681]
[3]
Wu YT, Ali GC, Guerchet M, et al. Prevalence of dementia in mainland China, Hong Kong and Taiwan: An updated systematic review and meta-analysis. Int J Epidemiol 2018; 47(3): 709-19.
[http://dx.doi.org/10.1093/ije/dyy007] [PMID: 29444280]
[4]
Wimo A, Guerchet M, Ali GC, et al. The worldwide costs of dementia 2015 and comparisons with 2010. Alzheimers Dement 2017; 13(1): 1-7.
[http://dx.doi.org/10.1016/j.jalz.2016.07.150] [PMID: 27583652]
[5]
Parra MA, Baez S, Allegri R, et al. Dementia in Latin America: Assessing the present and envisioning the future. Neurology 2018; 90(5): 222-31.
[http://dx.doi.org/10.1212/WNL.0000000000004897] [PMID: 29305437]
[6]
Zhang Y, Gu Y, Zhang Y, et al. Effect of sociodemographic and physical activity on cognitive function in older adults: A nationwide cross-sectional survey. Int J Geriatr Psychiatry 2019; 34(2): 243-8.
[http://dx.doi.org/10.1002/gps.4932] [PMID: 29984420]
[7]
Blondell SJ, Hammersley-Mather R, Veerman JL. Does physical activity prevent cognitive decline and dementia?: A systematic review and meta-analysis of longitudinal studies. BMC Public Health 2014; 14: 510.
[http://dx.doi.org/10.1186/1471-2458-14-510] [PMID: 24885250]
[8]
Beydoun MA, Beydoun HA, Gamaldo AA, Teel A, Zonderman AB, Wang Y. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health 2014; 14: 643.
[http://dx.doi.org/10.1186/1471-2458-14-643] [PMID: 24962204]
[9]
Grande G, Vanacore N, Maggiore L, et al. Physical activity reduces the risk of dementia in mild cognitive impairment subjects: A cohort study. J Alzheimers Dis 2014; 39(4): 833-9.
[http://dx.doi.org/10.3233/JAD-131808] [PMID: 24296815]
[10]
Lee J. The relationship between physical activity and dementia: A systematic review and meta-analysis of prospective cohort studies. J Gerontol Nurs 2018; 44(10): 22-9.
[http://dx.doi.org/10.3928/00989134-20180814-01] [PMID: 30257021]
[11]
Voss MW, Vivar C, Kramer AF, van Praag H. Bridging animal and human models of exercise-induced brain plasticity. Trends Cogn Sci 2013; 17(10): 525-44.
[http://dx.doi.org/10.1016/j.tics.2013.08.001] [PMID: 24029446]
[12]
Wang Z, van Praag H. Exercise and the brain: Neurogenesis, synaptic plasticity, spine density, and angiogenesis. In: Boecker H, Hillman C, Scheef L, Strüder H, Eds. Functional neuroimaging in exercise and sport sciences. New York: Springer 2012; pp. 3-24.
[http://dx.doi.org/10.1007/978-1-4614-3293-7_1]
[13]
World Health Organization. Noncommunicable diseases and their risk factors Available from: http://www.who.int/ncds/prevention/physical-activity/introduction/en/ [Accessed 28 Feb 2019].
[14]
China's 13th five-year plan for the development of national aging undertakings and the construction of the aging care system Available from: http://www.cncaprc.gov.cn/contents/2/179240.html
[15]
Sheng Y, He F, Lin JF, Shen W, Qiu YW. Tea and risk of age-related cataracts: A cross-sectional study in zhejiang province, China. J Epidemiol 2016; 26(11): 587-92.
[http://dx.doi.org/10.2188/jea.JE20150223] [PMID: 27180932]
[16]
Li FD, He F, Chen TR, et al. Reproductive history and risk of cognitive impairment in elderly women: A cross-sectional study in eastern China. J Alzheimers Dis 2016; 49(1): 139-47.
[http://dx.doi.org/10.3233/JAD-150444] [PMID: 26444784]
[17]
Wang Y, Ed. The rating scales for neurology. Beijing: China Friendship Publishing Company 2005.
[18]
Wang T, Xiao S, Chen K, et al. Prevalence, incidence, risk and protective factors of amnestic mild cognitive impairment in the elderly in shanghai. Curr Alzheimer Res 2017; 14(4): 460-6.
[http://dx.doi.org/10.2174/1567205013666161122094208] [PMID: 27875948]
[19]
Ravaglia G, Forti P, Montesi F, et al. Mild cognitive impairment: epidemiology and dementia risk in an elderly Italian population. J Am Geriatr Soc 2008; 56(1): 51-8.
[http://dx.doi.org/10.1111/j.1532-5415.2007.01503.x] [PMID: 18028343]
[20]
Bae JB, Kim YJ, Han JW, et al. Incidence of and risk factors for Alzheimer’s disease and mild cognitive impairment in Korean elderly. Dement Geriatr Cogn Disord 2015; 39(1-2): 105-15.
[http://dx.doi.org/10.1159/000366555] [PMID: 25401488]
[21]
Chaves ML, Camozzato AL, Godinho C, Piazenski I, Kaye J. Incidence of mild cognitive impairment and Alzheimer disease in Southern Brazil. J Geriatr Psychiatry Neurol 2009; 22(3): 181-7.
[http://dx.doi.org/10.1177/0891988709332942] [PMID: 19307320]
[22]
Caracciolo B, Palmer K, Monastero R, Winblad B, Bäckman L, Fratiglioni L. Occurrence of cognitive impairment and dementia in the community: A 9-year-long prospective study. Neurology 2008; 70(19 Pt 2): 1778-85.
[http://dx.doi.org/10.1212/01.wnl.0000288180.21984.cb] [PMID: 18184916]
[23]
Manly JJ, Tang MX, Schupf N, Stern Y, Vonsattel JP, Mayeux R. Frequency and course of mild cognitive impairment in a multiethnic community. Ann Neurol 2008; 63(4): 494-506.
[http://dx.doi.org/10.1002/ana.21326] [PMID: 18300306]
[24]
World Health Organization. Global Strategy on Diet, Physical Activity and Health Available from: https://www.who.int/dietphysicalactivity/pa/en/
[25]
Ma F, Wang T, Yin J, et al. A case-control study on the influencing factors to mild cognitive impairment among the community-based elderly population. Zhonghua Liu Xing Bing Xue Za Zhi 2008; 29(9): 873-7.
[PMID: 19173847]
[26]
Zhu YP, Chen MF, Shen BH. A prevalence study on mild cognitive impairment among elderly populations in Zhejiang province. Zhonghua Liu Xing Bing Xue Za Zhi 2013; 34(5): 475-7.
[PMID: 24016438]
[27]
Solfrizzi V, Capurso C, D’Introno A, et al. Lifestyle-related factors in predementia and dementia syndromes. Expert Rev Neurother 2008; 8(1): 133-58.
[http://dx.doi.org/10.1586/14737175.8.1.133] [PMID: 18088206]
[28]
Wang S, Lv W, Zhang H, et al. Aging exacerbates impairments of cerebral blood flow autoregulation and cognition in diabetic rats. Geroscience 2020; 42(5): 1387-410.
[http://dx.doi.org/10.1007/s11357-020-00233-w] [PMID: 32696219]
[29]
Farias Quipildor GE, Mao K, Hu Z, et al. Central IGF-1 protects against features of cognitive and sensorimotor decline with aging in male mice. Geroscience 2019; 41(2): 185-208.
[http://dx.doi.org/10.1007/s11357-019-00065-3] [PMID: 31076997]
[30]
Pallàs M, Pizarro JG, Gutierrez-Cuesta J, et al. Modulation of SIRT1 expression in different neurodegenerative models and human pathologies. Neuroscience 2008; 154(4): 1388-97.
[http://dx.doi.org/10.1016/j.neuroscience.2008.04.065] [PMID: 18538940]
[31]
Kiss T, Balasubramanian P, Valcarcel-Ares MN, et al. Nicotinamide mononucleotide (NMN) treatment attenuates oxidative stress and rescues angiogenic capacity in aged cerebromicrovascular endothelial cells: A potential mechanism for the prevention of vascular cognitive impairment. Geroscience 2019; 41(5): 619-30.
[http://dx.doi.org/10.1007/s11357-019-00074-2] [PMID: 31144244]
[32]
Tarantini S, Yabluchanskiy A, Csipo T, et al. Treatment with the poly(ADP-ribose) polymerase inhibitor PJ-34 improves cerebromicrovascular endothelial function, neurovascular coupling responses and cognitive performance in aged mice, supporting the NAD+ depletion hypothesis of neurovascular aging. Geroscience 2019; 41(5): 533-42.
[http://dx.doi.org/10.1007/s11357-019-00101-2] [PMID: 31679124]
[33]
Abbott RD, White LR, Ross GW, Masaki KH, Curb JD, Petrovitch H. Walking and dementia in physically capable elderly men. JAMA 2004; 292(12): 1447-53.
[http://dx.doi.org/10.1001/jama.292.12.1447] [PMID: 15383515]
[34]
Weuve J, Kang JH, Manson JE, Breteler MM, Ware JH, Grodstein F. Physical activity, including walking, and cognitive function in older women. JAMA 2004; 292(12): 1454-61.
[http://dx.doi.org/10.1001/jama.292.12.1454] [PMID: 15383516]
[35]
Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K. Physical activity and risk of cognitive impairment and dementia in elderly persons. Arch Neurol 2001; 58(3): 498-504.
[http://dx.doi.org/10.1001/archneur.58.3.498] [PMID: 11255456]
[36]
Schlosser Covell GE, Hoffman-Snyder CR, Wellik KE, et al. Physical activity level and future risk of mild cognitive impairment or dementia: A critically appraised topic. Neurologist 2015; 19(3): 89-91.
[http://dx.doi.org/10.1097/NRL.0000000000000013] [PMID: 25692517]
[37]
Krell-Roesch J, Feder NT, Roberts RO, et al. Leisure-time physical activity and the risk of incident dementia: The mayo clinic study of aging. J Alzheimers Dis 2018; 63(1): 149-55.
[http://dx.doi.org/10.3233/JAD-171141] [PMID: 29614667]
[38]
Lam FM, Huang MZ, Liao LR, Chung RC, Kwok TC, Pang MY. Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: A systematic review. J Physiother 2018; 64(1): 4-15.
[http://dx.doi.org/10.1016/j.jphys.2017.12.001] [PMID: 29289581]

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