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


METHODS
Prospective cohort study.


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


METHODS
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.


METHODS
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.
Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
J
J
Kulmala
A
A
Solomon
I
I
Kåreholt
T
T
Ngandu
T
T
Rantanen
T
T
Laatikainen
H
H
Soininen
J
J
Tuomilehto
M
M
Kivipelto
D000368:Aged; D053327:Apolipoprotein E4 / Q000235:genetics; D003704:Dementia / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*; D011446:Prospective Studies; D057185:Sedentary Behavior; D012649:Self Concept; D017678:Sex Distribution
D053327:Apolipoprotein E4
ageing; dementia; preventive medicine; public health; risk factors