Physical activity and dementia risk in the elderly: findings from a prospective Italian study.
OBJECTIVE
To examine the effect of physical activity on risk of developing Alzheimer disease (AD) and vascular dementia (VaD) in the elderly.


METHODS
Data are from a prospective population-based cohort of 749 Italian subjects aged 65 and older who, in 1999/2000, were cognitively normal at an extensive assessment for clinically overt and preclinical dementia and, in 2003/2004, underwent follow-up for incident dementia. Baseline physical activity was measured as energy expenditure on activities of different intensity (walking, stair climbing, moderate activities, vigorous activities, and total physical activity).


RESULTS
Over 3.9 +/- 0.7 years of follow-up there were 86 incident dementia cases (54 AD, 27 VaD). After adjustment for sociodemographic and genetic confounders, VaD risk was significantly lower for the upper tertiles of walking (hazard ratio [HR] 0.27, 95% CI 0.12 to 0.63), moderate (HR 0.29, 95% CI 0.12 to 0.66), and total physical activity (HR 0.24, 95% 0.11 to 0.56) compared to the corresponding lowest tertile. The association persisted after accounting for vascular risk factors and overall health status. After adjustment for sociodemographic and genetic confounders, AD risk was not associated with measures of physical activity and results did not change after further adjustment for vascular risk factors and overall health and functional status.


CONCLUSIONS
In this cohort, physical activity is associated with a lower risk of vascular dementia but not of Alzheimer disease. Further research is needed about the biologic mechanisms operating between physical activity and cognition.
Ravaglia
G
G
Department of Internal Medicine, University Hospital S. Orsola-Malpighi, Via Massarenti, 9-40138 Bologna, Italy. giovanni.ravaglia@unibo.it
Forti
P
P
Lucicesare
A
A
Pisacane
N
N
Rietti
E
E
Bianchin
M
M
Dalmonte
E
E
D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology*; D000544:Alzheimer Disease / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D001921:Brain / Q000378:metabolism / Q000503:physiopathology; D015331:Cohort Studies; D015140:Dementia, Vascular / Q000453:epidemiology / Q000517:prevention & control*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D009483:Neuropsychological Tests; D010809:Physical Fitness / Q000502:physiology; D011446:Prospective Studies; D012307:Risk Factors