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April 18, 2012
Letter to the Editor

Total daily physical activity and the risk of AD and cognitive decline in older adults

A.S. Buchman, MD, P.A. Boyle, PhD, L. Yu, PhD, R.C. Shah, MD, R.S. Wilson, PhD, and D.A. Bennett, MDAuthors Info & Affiliations
April 24, 2012 issue
78 (17) 1323-1329
https://doi.org/10.1212/WNL.0b013e3182535d35
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Abstract

Objective:

Studies examining the link between objective measures of total daily physical activity and incident Alzheimer disease (AD) are lacking. We tested the hypothesis that an objective measure of total daily physical activity predicts incident AD and cognitive decline.

Methods:

Total daily exercise and nonexercise physical activity was measured continuously for up to 10 days with actigraphy (Actical®; Philips Healthcare, Bend, OR) from 716 older individuals without dementia participating in the Rush Memory and Aging Project, a prospective, observational cohort study. All participants underwent structured annual clinical examination including a battery of 19 cognitive tests.

Results:

During an average follow-up of about 4 years, 71 subjects developed clinical AD. In a Cox proportional hazards model adjusting for age, sex, and education, total daily physical activity was associated with incident AD (hazard ratio = 0.477; 95% confidence interval 0.273–0.832). The association remained after adjusting for self-report physical, social, and cognitive activities, as well as current level of motor function, depressive symptoms, chronic health conditions, and APOE allele status. In a linear mixed-effect model, the level of total daily physical activity was associated with the rate of global cognitive decline (estimate 0.033, SE 0.012, p = 0.007).

Conclusions:

A higher level of total daily physical activity is associated with a reduced risk of AD.

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Supplementary Material

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Letters to the Editor
9 May 2012
Total Daily Activity and Incident AD
Aron S. Buchman, MD
Aron S. Buchman,MD, Lei Yu, PhD, Patricia A. Boyle, PhD, Robert S. Wilson, PhD, David A. Bennett, MD, Chicago, IL

We agree that many prior publications have stressed the importance of physical activity and healthy aging and that a longer observational period would improve our understanding of the interrelationship of physical activity, cognition, and age.

While our study included several sensitivity analyses to control for individuals who may have had mild cognitive impairment, we agree that an optimal study would include only individuals without any cognitive impairment with repeated objective measures of total daily physical activity. The current study incorporated several novel features including actigraphy, which provided objective measures of physical activity circumventing recall bias that may affect self-reported measures. Since activity was recorded 24hrs a day, we were able to determine total daily physical activity including all exercise and non-exercise physical activity.

Our findings that total daily physical activity is associated with cognition is particularly important for very old adults, since it suggests that the cognitive benefits which accrue from physical activity may not be limited to exercise. Thus, even older adults who cannot participate in formal exercise may nonetheless derive benefit from a more active lifestyle. Finally, controlling for total daily non-exercise activity may be important for interpreting results of exercise intervention studies and cognition in old age.

For disclosures, contact the editorial office at [email protected].

1 May 2012
Longer follow up
Kazuo Abe, Professor
Kazuo Abe, Osaka, Japan

I read with interest the article on risk of Alzheimer disease (AD) and cognitive decline and it is clear that increased activity may be beneficial for older adults. [1] The authors described that studies examining the link between objective measures of total daily physical activity and incident AD are lacking. However, other articles [2] did develop a definition of healthy aging and emphasized the need for daily activities.

Using actinography, the authors showed positive correlation between physical activity and risk of developing AD. I agree with their conclusion but the follow-up period seemed too short. The patients who were developing AD already had mild cognitive impairment at study entry. This would have decreased their physical activities and increased the risk of developing AD.

Longer observational periods are needed to address these concerns.

1. Buchman AS, Boyle PA, Yu L, Shah RC, Wilson RS, Bennett DA. Total daily physical activity and the risk of AD and cognitive decline in older adults. Neurology 2012; 78: 1323-1329.

2. Tyas SL, Snowdon DA, Desrosiers MF, Riley KP, Markesberry WR. Healthy ageing in the Nun Study: Definition and neuropathologic correlates. Age and Ageing 2007; 36: 650-655.

Disclosures: For disclosure information, contact Editorial Office [email protected]

Information & Authors

Information

Published In

Neurology®
Volume 78 • Number 17 • April 24, 2012
Pages: 1323-1329
PubMed: 22517108

Copyright

Copyright © 2012 by AAN Enterprises, Inc.

Publication History

Received: September 13, 2011
Accepted: December 8, 2011
Published online: April 18, 2012
Published in print: April 24, 2012

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Disclosure

The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Authors

Affiliations & Disclosures

A.S. Buchman, MD
From the Rush Alzheimer's Disease Center (A.S.B., P.A.B., L.Y., R.C.S., R.S.W., D.A.B.), Neurological Sciences (A.S.B., L.Y., D.A.B.), and Department of Family Medicine (P.A.B., R.C.S.), Rush University Medical Center, Chicago, IL.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers’ Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NIH R01AG17917, co-I, 2001-13; NIH R01AG24480, PI, 2005-10
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
P.A. Boyle, PhD
From the Rush Alzheimer's Disease Center (A.S.B., P.A.B., L.Y., R.C.S., R.S.W., D.A.B.), Neurological Sciences (A.S.B., L.Y., D.A.B.), and Department of Family Medicine (P.A.B., R.C.S.), Rush University Medical Center, Chicago, IL.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers’ Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NIH/NIA R01AG034374, PI; NIH/NIA R01AG033678, PI
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
L. Yu, PhD
From the Rush Alzheimer's Disease Center (A.S.B., P.A.B., L.Y., R.C.S., R.S.W., D.A.B.), Neurological Sciences (A.S.B., L.Y., D.A.B.), and Department of Family Medicine (P.A.B., R.C.S.), Rush University Medical Center, Chicago, IL.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers’ Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
R.C. Shah, MD
From the Rush Alzheimer's Disease Center (A.S.B., P.A.B., L.Y., R.C.S., R.S.W., D.A.B.), Neurological Sciences (A.S.B., L.Y., D.A.B.), and Department of Family Medicine (P.A.B., R.C.S.), Rush University Medical Center, Chicago, IL.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers’ Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Ceregene, Inc.; Danone Research B.V.; Eisai, Inc.; Elan Pharmaceuticals,Inc.; Merck & Co., Inc.; Metabolic Solutions Development Company; Pamlab, L.L.C.; Orasi, Inc.; Pfizer, Inc.
Research Support, Government Entities:
1.
NIH P30 AG101061, Education and Information Transfer Core Leader, Clinical Core Coinvestigator; NIH P01 AG009466, Coinvestigator, Administrative Core; NIH R01 NR009543, Coinvestigator; NIH R01 AG11101, Coinvestigator; NIH R01 AG029824, Coinvestigator; NIH U01 AG010483, Site Investigator; NIH U01 AG029824, Coinvestigator, Site Investigator; NIH U01 AG024904, Site Coinvestigator; Illinois Department of Public Aid Alzheimer’s Disease Assistance Center.
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
R.S. Wilson, PhD
From the Rush Alzheimer's Disease Center (A.S.B., P.A.B., L.Y., R.C.S., R.S.W., D.A.B.), Neurological Sciences (A.S.B., L.Y., D.A.B.), and Department of Family Medicine (P.A.B., R.C.S.), Rush University Medical Center, Chicago, IL.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Aging, Neuropsychology, and Cognition, Consulting Editor, 2004-present; Psychology and Aging, Consulting Editor, 2007-present
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Pain Therapeutics, Inc.
Speakers’ Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NIH/NIA R01AG024871, PI, 2006-2011; NIH/NIA P30AG10161, Co-I, 1991-2011; NIH/NIA R01AG11101, Co-I, 1993-2011; NIH/NIA R01AG15819, Co-I, 1998-2013
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
D.A. Bennett, MD
From the Rush Alzheimer's Disease Center (A.S.B., P.A.B., L.Y., R.C.S., R.S.W., D.A.B.), Neurological Sciences (A.S.B., L.Y., D.A.B.), and Department of Family Medicine (P.A.B., R.C.S.), Rush University Medical Center, Chicago, IL.
Disclosure
Scientific Advisory Boards:
1.
Vigorous Minds, Scientific Advisory Board
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Neurology, Editorial Board; Current Alzheimer Research, Editorial Board; Neuroepidemiology, Editorial Board
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Danone, Inc.; Wilmar Schwabe GmbH & Co.; Eli Lilly, Inc.; Schlesinger Associates; the Gerson Lehrman Group
Speakers’ Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Danone Inc., PI
Research Support, Government Entities:
1.
NIH R01AG017917, PI; NIH R01AG015819, PI; NIH R01AG036042, PI; NIH RC2AG036547, PI; NIH U01AG032984, Co-PI, Leader of Epidemiologic Cohort Studies; NIH R01AG024480, Co-I; NIH R01AG024871, Co-I; NIH P01AG009466, Co-I; NIH U24AG026395, Co- I; NIH R01AG030142, Co-I; NIH P01AG01449, Co-I; NIH R01HL096944, Co-I; NIH R01AG033678, Co-I; NIH R01AG034374, Co-I; NIH R01AG032755, Co-I; NIH P30AG010161, PI-Administrative core leader, Religious Orders Study core leader; Illinois Department Public Health
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author

Notes

Study funding: Supported by the NIH/NIA (R01AG17917, R01AG24480, and R01AG34374), the Illinois Department of Public Health, and the Robert C. Borwell Endowment Fund.
Correspondence & reprint requests to Dr. Buchman: [email protected]

Author Contributions

Study concept or design: Dr. Buchman, Dr. Wilson, Dr. Bennett. Analysis or interpretation of the data: Dr. Buchman, Dr. Boyle, Dr. Yu, Dr. Shah, Dr. Wilson, Dr. Bennett. Drafting of the manuscript: Dr. Buchman, Dr. Boyle, Dr. Yu, Dr. Shah, Dr. Wilson, Dr. Bennett. Statistical analysis: Dr. Buchman, Dr. Yu. Obtaining funding: Dr. Buchman, Dr. Bennett.

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