Physical Activity and Incident Cognitive Impairment in Elderly Persons

The INVADE Study

Thorleif Etgen, MD; Dirk Sander, MD; Ulrich Huntgeburth, MD; Holger Poppert, MD; Hans Förstl, MD; Horst Bickel, PhD 

Arch Intern Med. 2010;170(2):186-193.

Background  Data regarding the relationship between physical activity and cognitive impairment are limited and controversial. We examined whether physical activity is associated with incident cognitive impairment during follow-up.

Methods  As part of a community-based prospective cohort study in southern Bavaria, Germany, 3903 participants olderthan 55 years were enrolled between 2001 and 2003 and followed up for 2 years. Physical activity (classified as no activity,moderate activity [<3 times/wk], and high activity [3 times/wk]), cognitive function (assessed by the 6-Item Cognitive Impairment Test), and potential confounders were evaluated. The main outcome measure was incident cognitive impairment after 2 years of follow-up.

Results  At baseline, 418 participants (10.7%) had cognitive impairment. After a 2-year follow-up, 207 of 3485 initiallyunimpaired subjects (5.9%) developed incident cognitive impairment. Compared with participants without physical activity, fully adjusted multiple logistic regression analysis showed a significantly reduced risk of incident cognitive impairment after 2 years for participants with moderate or high physical activity at baseline (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.37-0.87 [P = .01]; and OR, 0.54; 95% CI, 0.35-0.83 [P = .005]; respectively). Further subanalysis includingparticipants (n = 2029) without functional impairment and without prodromal phase of dementia resulted in an even higher reduction of risk of incident cognitive impairment for participants with moderate or high physical activity (OR, 0.44; 95% CI, 0.24-0.83 [P = .01]; and OR, 0.46; 95% CI, 0.25-0.85 [P = .01]; respectively) compared with no activity.

Conclusion  Moderate or high physical activity is associated with a reduced incidence of cognitive impairment after 2 yearsin a large population-based cohort of elderly subjects.

Author Affiliations: Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany (Drs Etgen, Förstl, and Bickel); Department of Neurology, Klinikum Traunstein, Traunstein, Germany (Dr Etgen); Department of Neurology, Technische Universität München, Munich, Germany (Drs Sander and Poppert); Department of Neurology, Medical Park Hospital, Bischofswiesen, Germany (Dr Sander); and INVADE Study Group, Ebersberg, Germany (Dr Huntgeburth).