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Danielle Laurin, MSc; René Verreault, MD, PhD; Joan Lindsay, PhD; Kathleen MacPherson, MD; Kenneth Rockwood, MD

Arch Neurol. 2001;58:498-504.

Context  Dementia is common, costly, and highly age related. Little attention has been paid to the identification of modifiable lifestyle habits for its prevention.

Objective  To explore the association between physical activity and the risk of cognitive impairment and dementia.

Design, Setting, and Subjects  Data come from a community sample of 9008 randomly selected men and women 65 years or older, who were evaluated in the 1991-1992 Canadian Study of Health and Aging, a prospective cohort study of dementia. Of the 6434 eligible subjects who were cognitively normal at baseline, 4615 completed a 5-year follow-up. Screening and clinical evaluations were done at both waves of the study. In 1996-1997, 3894 remained without cognitive impairment, 436 were diagnosed as having cognitive impairment–no dementia, and 285 were diagnosed as having dementia.

Main Outcome Measure  Incident cognitive impairment and dementia by levels of physical activity at baseline.

Results  Compared with no exercise, physical activity was associated with lower risks of cognitive impairment, Alzheimer disease, and dementia of any type. Significant trends for increased protection with greater physical activity were observed. High levels of physical activity were associated with reduced risks of cognitive impairment (age-, sex-, and education-adjusted odds ratio, 0.58; 95% confidence interval, 0.41-0.83), Alzheimer disease (odds ratio, 0.50; 95% confidence interval, 0.28-0.90), and dementia of any type (odds ratio, 0.63; 95% confidence interval, 0.40-0.98).

Conclusion  Regular physical activity could represent an important and potent protective factor for cognitive decline and dementia in elderly persons.

From the Laval University Geriatric Research Unit, Centre d'hébergement St-Augustin du Centre hospitalier affilié universitaire de Québec, Beauport, and Department of Social and Preventive Medicine, Laval University, Sainte-Foy, Quebec (Ms Laurin and Dr Verreault); Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, and Aging-Related Diseases Division, Laboratory Center for Disease Control, Health Canada, Ottawa (Dr Lindsay); and Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, and Division of Geriatric Medicine, Dalhousie University, Queen Elizabeth II Health Sciences Center, Halifax (Drs MacPherson and Rockwood).

Corresponding author and reprints: René Verreault, MD, PhD, Laval University Geriatric Research Unit, Centre d'hébergement St-Augustin du Centre hospitalier affilié universitaire de Québec, 2135 Terrasse Cadieux, Beauport, Quebec, Canada G1C 1Z2 (e-mail: Rene.Verreault{at}msp.ulaval.ca).

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