title: Physical activity and Alzheimer disease course.
abstract: OBJECTIVE
  To examine the association between physical activity (PA) and Alzheimer disease (AD) course.
  
  
  BACKGROUND
  PA has been related to lower risk for AD. Whether PA is associated with subsequent AD course has not been investigated.
  
  
  METHODS
  In a population-based study of individuals aged 65 years and older in New York who were prospectively followed up with standard neurologic and neuropsychological evaluations (every ~1.5 years), 357 participants i) were nondemented at baseline and ii) were diagnosed with AD during follow-up (incident AD). PA (sum of participation in a variety of physical activities, weighted by the type of activity [light, moderate, and severe]) obtained 2.4 (standard deviation [SD], 1.9) years before incidence was the main predictor of mortality in Cox models and of cognitive decline in generalized estimating equation models that were adjusted for age, gender, ethnicity, education, comorbidities, and duration between PA evaluation and dementia onset.
  
  
  RESULTS
  One hundred fifty incident AD cases (54%) died during the course of 5.2 (SD, 4.4) years of follow-up. When compared with incident AD cases who were physically inactive, those with some PA had lower mortality risk, whereas incident AD participants with much PA had an even lower risk. Additional adjustments for apolipoprotein genotype, smoking, comorbidity index, and cognitive performance did not change the associations. PA did not affect rates of cognitive or functional decline.
  
  
  CONCLUSIONS
  Exercise may affect not only risk for AD but also subsequent disease duration: more PA is associated with prolonged survival in AD.
authors.affiliation: Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, NY 10032, USA. ns257@columbia.edu
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Scarmeas
authors.forename: Jose A
authors.initials: JA
authors.lastname: Luchsinger
authors.forename: Adam M
authors.initials: AM
authors.lastname: Brickman
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cosentino
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.forename: Ming
authors.initials: M
authors.lastname: Xin-Tang
authors.forename: Yian
authors.initials: Y
authors.lastname: Gu
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D000544:Alzheimer Disease / Q000401:mortality* / Q000503:physiopathology; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009043:Motor Activity; D009483:Neuropsychological Tests; D009518:New York / Q000453:epidemiology; D010809:Physical Fitness; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012959:Socioeconomic Factors; D016019:Survival Analysis
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