title: Effect of a 24-Month Physical Activity Intervention vs Health Education on Cognitive Outcomes in Sedentary Older Adults: The LIFE Randomized Trial.
abstract: OBJECTIVE
  Epidemiological evidence suggests that physical activity benefits cognition, but results from randomized trials are limited and mixed.
  
  
  OBJECTIVE
  To determine whether a 24-month physical activity program results in better cognitive function, lower risk of mild cognitive impairment (MCI) or dementia, or both, compared with a health education program.
  
  
  METHODS
  A randomized clinical trial, the Lifestyle Interventions and Independence for Elders (LIFE) study, enrolled 1635 community-living participants at 8 US centers from February 2010 until December 2011. Participants were sedentary adults aged 70 to 89 years who were at risk for mobility disability but able to walk 400 m.
  
  
  METHODS
  A structured, moderate-intensity physical activity program (n = 818) that included walking, resistance training, and flexibility exercises or a health education program (n = 817) of educational workshops and upper-extremity stretching.
  
  
  METHODS
  Prespecified secondary outcomes of the LIFE study included cognitive function measured by the Digit Symbol Coding (DSC) task subtest of the Wechsler Adult Intelligence Scale (score range: 0-133; higher scores indicate better function) and the revised Hopkins Verbal Learning Test (HVLT-R; 12-item word list recall task) assessed in 1476 participants (90.3%). Tertiary outcomes included global and executive cognitive function and incident MCI or dementia at 24 months.
  
  
  RESULTS
  At 24 months, DSC task and HVLT-R scores (adjusted for clinic site, sex, and baseline values) were not different between groups. The mean DSC task scores were 46.26 points for the physical activity group vs 46.28 for the health education group (mean difference, -0.01 points [95% CI, -0.80 to 0.77 points], P = .97). The mean HVLT-R delayed recall scores were 7.22 for the physical activity group vs 7.25 for the health education group (mean difference, -0.03 words [95% CI, -0.29 to 0.24 words], P = .84). No differences for any other cognitive or composite measures were observed. Participants in the physical activity group who were 80 years or older (n = 307) and those with poorer baseline physical performance (n = 328) had better changes in executive function composite scores compared with the health education group (P = .01 for interaction for both comparisons). Incident MCI or dementia occurred in 98 participants (13.2%) in the physical activity group and 91 participants (12.1%) in the health education group (odds ratio, 1.08 [95% CI, 0.80 to 1.46]).
  
  
  CONCLUSIONS
  Among sedentary older adults, a 24-month moderate-intensity physical activity program compared with a health education program did not result in improvements in global or domain-specific cognitive function.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT01072500.
authors: Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Kaycee M
authors: KM
authors: Sink
authors: Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Mark A
authors: MA
authors: Espeland
authors: Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California.
authors: Cynthia M
authors: CM
authors: Castro
authors: Pennington Biomedical Research Center, Baton Rouge, Louisiana.
authors: Timothy
authors: T
authors: Church
authors: College of Medicine, University of Florida, Gainesville.
authors: Ron
authors: R
authors: Cohen
authors: Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York.
authors: John A
authors: JA
authors: Dodson
authors: Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore.
authors: Jack
authors: J
authors: Guralnik
authors: Department of Psychiatry and Center for Aging Research, Indiana University, Indianapolis.
authors: Hugh C
authors: HC
authors: Hendrie
authors: Department of Psychology, Wake Forest University, Winston-Salem, North Carolina.
authors: Janine
authors: J
authors: Jennings
authors: Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, North Carolina.
authors: Jeffery
authors: J
authors: Katula
authors: Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Oscar L
authors: OL
authors: Lopez
authors: Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois13Senior Editor, JAMA.
authors: Mary M
authors: MM
authors: McDermott
authors: College of Medicine, University of Florida, Gainesville.
authors: Marco
authors: M
authors: Pahor
authors: Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
authors: Kieran F
authors: KF
authors: Reid
authors: Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Julia
authors: J
authors: Rushing
authors: Departments of Neurology and Medicine, Albert Einstein College of Medicine, Bronx, New York.
authors: Joe
authors: J
authors: Verghese
authors: Department of Psychiatry, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Stephen
authors: S
authors: Rapp
authors: Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Jeff D
authors: JD
authors: Williamson
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000517:prevention & control*; D003704:Dementia / Q000453:epidemiology / Q000517:prevention & control*; D056344:Executive Function; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D008297:Male; D052580:Muscle Stretching Exercises; D055070:Resistance Training; D057185:Sedentary Behavior; D016896:Treatment Outcome; D034941:Upper Extremity; D016138:Walking