Published: Sep 24, 2013
By Cole Petrochko, Staff Writer, MedPage Today
Full Story: http://www.medpagetoday.com/MeetingCoverage/WCN/41829
- This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
- This longitudinal study of patients with white matter changes revealed that baseline physical activity was associated with better executive function at 3-year follow-up.
- Be aware that other cognitive domains were not strongly associated with physical activity levels.
VIENNA — Older patients with cerebrovascular pathology had improved executive function and information processing speed if they stayed active, researchers reported here.
At a 3-year follow-up in the LADIS (Leukoaraiosis And Disability) study, dementia-free older patients who lived an active lifestyle had better executive function (beta=0.24, P=0.001) and information processing speed (beta=0.15,P=0.02) than those who were not active, according to Kristian Frederiksen, MD, a PhD candidate at Copenhagen University Hospital in Denmark, and colleagues.
However at baseline, patients who were physically active had worse memory (beta=-0.74, P=0.007), though this association lost significance at the 3-year follow-up, Frederiksen said during an oral presentation at the World Congress of Neurology.
Frederiksen noted that other research has shown physical activity to have a protective effect against cognitive decline and against the accumulation of neurological pathology. Group exercise has also been shown to improve cognition in patients with dementia.
“The frontal temporal behavioral exercise paradigm may be very important, as frontal executive function determines social interaction more than memory,” noted Benjamin Rix Brooks, MD, of Carolinas Neuromuscular/ALS-MDA Center in Charlotte, N.C.
This may be associated with better behavioral outcomes among patients with mild cognitive impairment (MCI) who participate in physical activities over the long-term, he told MedPage Today.
The authors studied the effects of physical activity on executive function, processing speed, and memory in a population of 282 older patients, ages 64 to 85, who were enrolled in the LADIS cohort and had age-related white matter changes on MRI or CT scan.
Participants needed to be available for cognitive assessment at baseline and at a 3-year follow-up. Those who had progressed to dementia or MCI were excluded.
Those in the study were considered physically active if they were active more than 30 minutes a day for at least 3 days a week, and physically inactive if they spent less time engaged. Physical activity was assessed at baseline with cognition. This distinction grouped participants 213 to 69 in the active and inactive arms, respectively. The type of physical activity was not specified.
Additionally, researchers assessed age, sex, years of education, history of stroke, diabetes status, and white matter changes.
There was no statistical difference between groups for age (mean of 73), proportion of female subjects, education, Mini-Mental State Examination score, proportion of subjects with diabetes, and the proportion of subjects who had suffered a stroke.
At baseline, physically active participants had significantly higher executive function (beta=0.39, P=0.008) and processing speed (beta=0.48, P=0.005) versus inactive participants, but significantly worse memory. The latter finding would be worth additional study, according to the authors.
After 3 years, follow-up scores showed no change in memory, but improvements in executive function and processing speed remained significant.
In an adjusted model, only executive function remained significantly associated with active lifestyle (beta=0.11, P=0.04).
Physical activity reduces a number of comorbid factors in older patients and its effects on cognition were not surprising, though the confirmation of this finding was important, noted session moderator Uta Meyding-Lamadé, MD, PhD, of Krankenhaus Nordwest in Frankfurt, Germany.
“We really need tools to determine which patients will develop dementia, though for now clinical data is all we have,” she told MedPage Today, noting that there are many — if not too many — different ways of measuring cognitive outcomes in patients who may present dementia.
Frederiksen said future observational studies of similar populations were necessary to confirm their data along with intervention studies in physically inactive patients to note any changes in cognition.
The authors reported no conflicts of interest.
Primary source: World Congress of Neurology
Source reference: Frederiksen K, et al “Being physically active is associated with improved executive function and processing speed but not memory: the LADIS study” WCN 2013.