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Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies.

ABSTRACT: BACKGROUND:There is considerable evidence of the favourable role of more physical activity (PA) in fighting against dementia. However, the shape of the dose-response relationship is still unclear. OBJECTIVE:To quantitatively investigate the relationship between dementia and PA. DESIGN:PubMed, EMBASE, Ovid and the Cochrane Library were searched for prospective studies published from 1 January 1995 to 15 October 2016. Two types of meta-analyses were performed with a focus on the dose-response relationship using two stage generalised least squares regression. RESULTS:The primary analysis exhibited a dose-response trend for all-cause dementia (ACD), Alzheimer's disease (AD) but not for vascular dementia (VD). In the dose-response analysis, either ACD (ptrend <0.005; pnon-linearity=0.87) or AD (p trend <0.005; pnon-linearity=0.10) exhibited a linear relationship with leisure time PA (LTPA) over the observed range (0-2000 kcal/week or 0-45 metabolic equivalent of task hours per week (MET-h/week)). Specifically, for every 500 kcal or 10 MET-h increase per week, there was, on average, 10% and 13%?decrease in the risk of ACD and AD, respectively. CONCLUSIONS:We have reported, for the first time, the dose-response relationship between LTPA and dementia, further supporting the international PA guideline from the standpoint of dementia prevention.

SUBMITTER: Xu W

PROVIDER: S-EPMC5665289 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies.

Xu Wei W Wang Hui Fu HF Wan Yu Y Tan Chen-Chen CC Yu Jin-Tai JT Yu Jin-Tai JT Tan Lan L

BMJ open 20171022 10

<h4>Background</h4>There is considerable evidence of the favourable role of more physical activity (PA) in fighting against dementia. However, the shape of the dose-response relationship is still unclear.<h4>Objective</h4>To quantitatively investigate the relationship between dementia and PA.<h4>Design</h4>PubMed, EMBASE, Ovid and the Cochrane Library were searched for prospective studies published from 1 January 1995 to 15 October 2016. Two types of meta-analyses were performed with a focus on ...[more]

PMID: 29061599

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Project description:The 2008 Physical Activity Guidelines for Americans recommended a minimum of 75 vigorous-intensity or 150 moderate-intensity minutes per week (7.5 metabolic-equivalent hours per week) of aerobic activity for substantial health benefit and suggested additional benefits by doing more than double this amount. However, the upper limit of longevity benefit or possible harm with more physical activity is unclear.To quantify the dose-response association between leisure time physical activity and mortality and define the upper limit of benefit or harm associated with increased levels of physical activity.We pooled data from 6 studies in the National Cancer Institute Cohort Consortium (baseline 1992-2003). Population-based prospective cohorts in the United States and Europe with self-reported physical activity were analyzed in 2014. A total of 661,137 men and women (median age, 62 years; range, 21-98 years) and 116,686 deaths were included. We used Cox proportional hazards regression with cohort stratification to generate multivariable-adjusted hazard ratios (HRs) and 95% CIs. Median follow-up time was 14.2 years.Leisure time moderate- to vigorous-intensity physical activity.The upper limit of mortality benefit from high levels of leisure time physical activity.Compared with individuals reporting no leisure time physical activity, we observed a 20% lower mortality risk among those performing less than the recommended minimum of 7.5 metabolic-equivalent hours per week (HR, 0.80 [95% CI, 0.78-0.82]), a 31% lower risk at 1 to 2 times the recommended minimum (HR, 0.69 [95% CI, 0.67-0.70]), and a 37% lower risk at 2 to 3 times the minimum (HR, 0.63 [95% CI, 0.62-0.65]). An upper threshold for mortality benefit occurred at 3 to 5 times the physical activity recommendation (HR, 0.61 [95% CI, 0.59-0.62]); however, compared with the recommended minimum, the additional benefit was modest (31% vs 39%). There was no evidence of harm at 10 or more times the recommended minimum (HR, 0.69 [95% CI, 0.59-0.78]). A similar dose-response relationship was observed for mortality due to cardiovascular disease and to cancer.Meeting the 2008 Physical Activity Guidelines for Americans minimum by either moderate- or vigorous-intensity activities was associated with nearly the maximum longevity benefit. We observed a benefit threshold at approximately 3 to 5 times the recommended leisure time physical activity minimum and no excess risk at 10 or more times the minimum. In regard to mortality, health care professionals should encourage inactive adults to perform leisure time physical activity and do not need to discourage adults who already participate in high-activity levels.

Project description:BackgroundPrevious cohort studies have investigated the relationship between self-reported physical activity (PA) and dementia. Evidence from objective device-measured PA data is lacking. This study aimed to explore the association of device-measured PA with the risk of dementia incidence and common subtypes (Alzheimer's disease [AD] and vascular dementia) using the UK Biobank study.Methods84,854 participants (55.8% women), invited to participate in the device-measured PA between 2013 and 2015, were included in this prospective cohort study. Wrist accelerometers were used to measure light, moderate, vigorous, moderate-to-vigorous PA (MVPA) and total PA intensity and duration (MET/min/week). Incident dementia (fatal and non-fatal) was extracted from hospital episodes records for incidence and death register for mortality. Incidence follow-up was carried out until the end of March 2021in England and Scotland and the end of March 2018 in Wales. Mortality data were available until February 2021. Nonlinear associations were first investigated using penalised cubic splines fitted in the Cox proportional hazard models. In addition, using MVPA, five categories were created. Associations of these categories with the outcomes were investigated using Cox proportional hazard models. Analyses were adjusted for sociodemographic, lifestyle and health-related factors.ResultsAfter a median follow-up of 6.3 years, 678 individuals were diagnosed with dementia. Evidence of nonlinearity was observed for all PA modes and all-cause dementia. For categories of MVPA, there was a significant trend towards a low risk of overall dementia when higher levels of MVPA were achieved (HRtrend 0.66 [95% CI 0.62 to 0.70]. The lowest risk was identified in individuals who performed more than 1200 MET/min/week, those who had 84% (95% CI 0.12 to 0.21) lower risk of incident dementia compared to those who performed < 300 MET/min/week.ConclusionsParticipants with higher PA levels had a lower risk of incident dementia than those less active, independently of sociodemographic, lifestyle factors and comorbidity. Considering that the majority of previous studies have reported this association using self-reported data, our findings highlight the strong inverse association between PA objectively measured and incident dementia.

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Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies.

Publications

Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies.

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