title: Physical activity prevents progression for cognitive impairment and vascular dementia: results from the LADIS (Leukoaraiosis and Disability) study.
abstract: OBJECTIVE
  We aimed to study if physical activity could interfere with progression for cognitive impairment and dementia in older people with white matter changes living independently.
  
  
  METHODS
  The LADIS (Leukoaraiosis and Disability) prospective multinational European study evaluates the impact of white matter changes on the transition of independent elderly subjects into disability. Subjects were evaluated yearly during 3 years with a comprehensive clinical protocol and cognitive assessment with classification of cognitive impairment and dementia according to usual clinical criteria. Physical activity was recorded during the clinical interview. MRI was performed at entry and at the end of the study.
  
  
  RESULTS
  Six hundred thirty-nine subjects were included (74.1±5 years old, 55% women, 9.6±3.8 years of schooling, 64% physically active). At the end of follow-up, 90 patients had dementia (vascular dementia, 54; Alzheimer disease with vascular component, 34; frontotemporal dementia, 2), and 147 had cognitive impairment not dementia. Using Cox regression analysis, physical activity reduced the risk of cognitive impairment (dementia and not dementia: β=-0.45, P=0.002; hazard ratio, 0.64; 95% CI, 0.48-0.85), dementia (β=-0.49, P=0.043; hazard ratio, 0.61; 95% CI, 0.38-0.98), and vascular dementia (β=-0.86, P=0.008; hazard ratio, 0.42; 95% CI, 0.22-0.80), independent of age, education, white matter change severity, medial temporal atrophy, previous and incident stroke, and diabetes.
  
  
  CONCLUSIONS
  Physical activity reduces the risk of cognitive impairment, mainly vascular dementia, in older people living independently.
authors.affiliation: Department of Neurosciences, University of Lisbon, Santa Maria Hospital, Av Prof Egas Moniz 1649-028 Lisbon, Portugal. averdelho@fm.ul.pt
authors.forename: Ana
authors.initials: A
authors.lastname: Verdelho
authors.forename: Sofia
authors.initials: S
authors.lastname: Madureira
authors.forename: José M
authors.initials: JM
authors.lastname: Ferro
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Baezner
authors.forename: Christian
authors.initials: C
authors.lastname: Blahak
authors.forename: Anna
authors.initials: A
authors.lastname: Poggesi
authors.forename: Michael
authors.initials: M
authors.lastname: Hennerici
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pantoni
authors.forename: Franz
authors.initials: F
authors.lastname: Fazekas
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
authors.forename: Anders
authors.initials: A
authors.lastname: Wallin
authors.forename: Timo
authors.initials: T
authors.lastname: Erkinjuntti
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control*; D015140:Dementia, Vascular / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000453:epidemiology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D056784:Leukoencephalopathies / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D008279:Magnetic Resonance Imaging; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology