BACKGROUND:

Individuals with vascular disease or risk factors have substantially higher rates of cognitive decline, yet little is known about means of maintaining cognition in this group.

METHODS:

We examined the relation between physical activity and cognitive decline in participants of the Women's Antioxidant Cardiovascular Study, a cohort of women with prevalent vascular disease or at least 3 coronary risk factors. Recreational physical activity was assessed at baseline (October 1995 through June 1996) and every 2 years thereafter. Between December 1998 and July 2000, a total of 2809 women 65 years or older underwent a cognitive battery by telephone interview, including 5 tests of global cognition, verbal memory, and category fluency. Tests were administered 3 additional times over 5.4 years. We used multivariable-adjusted general linear models for repeated measures to compare the annual rates of cognitive score changes across levels of total physical activity and energy expended in walking, as assessed at Women's Antioxidant Cardiovascular Study baseline.

RESULTS:

We found a significant trend (P < .001 for trend) toward decreasing rates of cognitive decline with increasing energy expenditure. Compared with the bottom quintile of total physical activity, significant differences in rates of cognitive decline were observed from the fourth quintile (P = .04 for the fourth quintile and P < .001 for the fifth quintile), or the equivalent of daily 30-minute walks at a brisk pace. This was equivalent to the difference in cognitive decline observed for women who were 5 to 7 years younger. Regularly walking for exercise was strongly related to slower rates of cognitive decline (P = .003 for trend).

CONCLUSION:

Regular physical activity, including walking, was associated with better preservation of cognitive function in older women with vascular disease or risk factors.