Longitudinal Assessment of Physical Activity and Cognitive Outcomes Among Women at Midlife.

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  • Additional Information
    • Source:
      Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
    • Publication Information:
      Original Publication: Chicago, IL : American Medical Association, [2018]-
    • Subject Terms:
    • Abstract:
      Importance: The increasing prevalence of cognitive decline, impairment, and dementia spurs intense interest in cognitive preservation strategies.
      Objective: To explore the longitudinal association between physical activity (PA) and cognitive performance among women at midlife.
      Design, Setting, and Participants: This cohort study is an analysis from the Study of Women's Health Across the Nation. Enrollment occurred from 1996 through 1997, and follow-up extended into 2017. Included individuals were those who had undergone cognitive measures during the first 3 cognitive test visits and had at least 1 additional cognitive measurement. Stroke prior to baseline was an exclusion, and observations were censored for subsequent stroke. Data were analyzed from June 2018 through August 2019.
      Exposures: Engaging in sport or exercise PA (self-reported).
      Main Outcomes and Measures: The Symbol Digit Modalities Test (SDMT) was used to assess cognitive processing speed. The East Boston Memory Test-Delayed (EBMT-D) was used to measure verbal episodic memory. The digit span backwards (DSB) test was used to evaluate working memory.
      Results: Among 1718 women with a median (range) observation time of 11.9 (0.60-13.5) years, the mean (SD) baseline age was 45.7 (2.5) years. From baseline through age 61 years, mean change in SDMT score was -0.20 annually (95% CI, -0.26 to -0.15; P < .001). After age 61 years, the mean change in SDMT was -0.51 yearly (95% CI, -0.54 to -0.41; P < .001). Beginning at age 58 years of the mean change in EBMT was -0.03 yearly (95% CI, -0.04 to -0.02; P < .001). Starting at age 61 years, mean (SD) change in DSB was -0.03 annually (95% CI, -0.04 to -0.01; P = .001). When adjusted for attrition and practice effect, PA was associated with higher concurrent SDMT and EBMT scores and a smaller decrease in SDMT score. For each unit increment in PA, there was a 0.36 increment in concurrent SDMT score (95% CI, 0.14 to 0.59; P = .002) and a 0.10 increment in concurrent EBMT score (95% CI, 0.05 to 0.15; P < .001). Greater PA was associated with a smaller annual mean decrease in SDMT score (0.06 yearly; 95% CI, 0.02 to 0.09; P = .001). After additional adjustment for demographic characteristics, menopause symptoms, hormone therapy use, and the presence of diabetes and hypertension, PA was not associated with trajectories (ie, levels or slopes) of any cognitive outcome.
      Conclusions and Relevance: This cohort study found no association between greater PA levels and cognitive outcomes among women in midlife, unlike cohort studies that begin observations at later ages, which may be associated with confounding by reverse causation (ie, cognitive decline associated with an outcome of lower PA levels).
    • Comments:
      Comment in: JAMA Netw Open. 2021 Mar 1;4(3):e215153. (PMID: 33787914)
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    • Grant Information:
      U01 AG012495 United States AG NIA NIH HHS; U01 AG012553 United States AG NIA NIH HHS; P30 AG024824 United States AG NIA NIH HHS; U01 AG012531 United States AG NIA NIH HHS; U01 AG012554 United States AG NIA NIH HHS; U01 AG012505 United States AG NIA NIH HHS; U01 AG012535 United States AG NIA NIH HHS; U19 AG063720 United States AG NIA NIH HHS; U01 AG012539 United States AG NIA NIH HHS; U01 AG012546 United States AG NIA NIH HHS
    • Publication Date:
      Date Created: 20210331 Date Completed: 20210608 Latest Revision: 20220324
    • Publication Date:
      20221213
    • Accession Number:
      PMC8013795
    • Accession Number:
      10.1001/jamanetworkopen.2021.3227
    • Accession Number:
      33787912