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J Intern Med. 2014 Sep;276(3):296-307. doi: 10.1111/joim.12202. Epub 2014 Apr 4.

Association between mid- to late life physical fitness and dementia: evidence from the CAIDE study.

Author information

1
Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.

Abstract

OBJECTIVES:

This study investigated the association between perceived physical fitness at midlife, changes in perceived fitness during the three decades from mid- to late life and dementia risk.

DESIGN:

Prospective cohort study.

SETTING:

Cardiovascular risk factors, ageing and incidence of dementia (CAIDE) study.

SUBJECTS:

Subjects were selected from four independent, random samples of population-based cardiovascular surveys and were first examined in 1972, 1977, 1982 or 1987, when they were on average 50 years old. The CAIDE target population included 3559 individuals. A random sample of 2000 individuals still alive in 1997 was drawn for re-examinations (performed in 1998 and 2005-2008) that consisted of cognitive assessments, with 1511 subjects participating in at least one re-examination. Dementia diagnoses were also confirmed from national registers for the entire target population.

MAIN OUTCOME MEASURE:

All-cause dementia.

RESULTS:

Poor physical fitness at midlife was associated with increased dementia risk in the entire target population [hazard ratio (HR), 1.5; 95% confidence interval (CI), 1.1-2.0]. In participants, odds ratio (OR) was 2.0 (95% CI, 0.9-4.0). This association was significant in apolipoprotein E ε4 allele (APOEε4) noncarriers (OR, 4.3; 95% CI, 1.4-13.3), men (HR, 1.8; 95% CI, 1.1-3.0) and people with chronic conditions (HR, 2.9; 95% CI, 1.3-6.6). A decline in fitness after midlife was also associated with dementia (OR, 3.0; 95% CI, 1.7-5.1), which was significant amongst both men and women and more pronounced in APOEε4 carriers (OR, 4.4; 95% CI, 2.1-9.1).

CONCLUSIONS:

Perceived poor physical fitness reflects a combination of biological and lifestyle-related factors that can increase dementia risk. A simple question about perceived physical fitness may reveal at-risk individuals who could benefit from preventive interventions.

KEYWORDS:

ageing; dementia; preventive medicine; public health; risk factors

PMID:
24444031
DOI:
10.1111/joim.12202
[Indexed for MEDLINE]
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