Physical Activity and Cognitive Function in Middle-Aged and Older Adults: An Analysis of 104,909 People From 20 Countries

Objective: To examine the associations of physical activity (PA) frequency (both moderate and vigorous intensity) and PA levels with cognitive function. Patients and Methods: Data of individuals 50 years or older, from 20 European countries (along with Israel), were collected from 2004 to November 2013 in the biannual Survey of Health, Ageing and Retirement in Europe. A total of 104,909 participants were assessed for cognitive function at least once (mean follow-up length, 29.5 +/- 35.7 months). Baseline moderate- and vigorous-intensity PA were reported by participants as more than once a week, once a week, one to three times a month, or hardly ever or never. With regard to PA frequency, participants were categorized as inactive, low active, intermediate active, or high active. The main outcome measure is a cognitive composite score created by summing the z scores of 4-item temporal orientation, 10-word list for delayed recall, and verbal fluency. Results: Adjusted, 2-level mixed-effect regressions found that compared with doing no PA, doing PA more than once a week, once a week, or one to three times a month was positively associated with the composite score (beta coefficients varied from 0.52 to 0.75 for moderate-intensity PA and from 0.26 to 0.33 for vigorous-intensity PA). Similarly, compared with the inactive category, high-active, intermediate-active, and low-active categories had positive associations with the composite score (beta varied from 0.77 to 1.10). Positive associations were also obtained between PA variables and the raw scores of cognitive tests. Conclusion: Physical activity has dose-response associations with cognitive function, with even low PA frequencies (few times per month) being positively associated with cognitive function during aging. (C) 2016 Mayo Foundation for Medical Education and Research