Hostname: page-component-788cddb947-r7bls Total loading time: 0 Render date: 2024-10-14T04:45:35.390Z Has data issue: false hasContentIssue false

Physical activity and risk of neurodegenerative disease: a systematic review of prospective evidence

Published online by Cambridge University Press:  23 June 2008

M. Hamer*
Affiliation:
Psychobiology Group, Department of Epidemiology and Public Health, University College London, UK
Y. Chida
Affiliation:
Psychobiology Group, Department of Epidemiology and Public Health, University College London, UK
*
*Address for correspondence: M. Hamer, Ph.D., Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK. (Email: m.hamer@ucl.ac.uk)

Abstract

Background

The association between physical activity and risk of neurodegenerative diseases is not well established. We therefore aimed to quantify this association using meta-analytical techniques.

Method

We searched Medline, the Cochrane Database of Systematic Reviews and Web of Science databases from 1990 to 2007 for prospective epidemiological studies of physical activity and incident dementia, Alzheimer's and Parkinson's disease. We excluded studies of physical activity and cognitive decline without diagnosis of a neurodegenerative disease. Information on study design, participant characteristics, measurement of exposure and outcome variables, adjustment for potential confounding, and estimates of associations was abstracted independently by the two investigators.

Results

We included 16 prospective studies in the overall analysis, which incorporated 163797 non-demented participants at baseline with 3219 cases at follow-up. We calculated pooled relative risk (RR) using a random effects model. The RR of dementia in the highest physical activity category compared with the lowest was 0.72 [95% confidence interval (CI) 0.60–0.86, p<0.001], for Alzheimer's, 0.55 (95% CI 0.36–0.84, p=0.006), and for Parkinson's 0.82 (95% CI 0.57–1.18, p=0.28).

Conclusions

Our results suggest that physical activity is inversely associated with risk of dementia. Future studies should examine the optimal dose of physical activity to induce protection, which presently remains unclear.

Type
Review Article
Copyright
Copyright © 2008 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbott, RD, White, LR, Ross, GW, Masaki, KH, Curb, JD, Petrovitch, H (2004). Walking and dementia in physically capable elderly men. Journal of the American Medical Association 292, 14471453.CrossRefGoogle ScholarPubMed
Adlard, PA, Perreau, VM, Pop, V, Cotman, CW (2005). Voluntary exercise decreases amyloid load in a transgenic model of Alzheimer's disease. Journal of Neuroscience 25, 42174221.CrossRefGoogle Scholar
Albert, MS, Jones, K, Savage, CR, Berkman, L, Seeman, T, Blazer, D, Rowe, JW (1995). Predictors of cognitive change in older persons: MacArthur studies of successful aging. Psychology and Aging 10, 578589.CrossRefGoogle ScholarPubMed
Begg, CB, Berlin, JA (1989). Publication bias and dissemination of clinical research. Journal of the National Cancer Institute 81, 107115.CrossRefGoogle ScholarPubMed
Broe, GA, Creasey, H, Jorm, AF, Bennett, HP, Casey, B, Waite, LM, Grayson, DA, Cullen, J (1998). Health habits and risk of cognitive impairment and dementia in old age: a prospective study on the effects of exercise, smoking and alcohol consumption. Australian and New Zealand Journal of Public Health 22, 621623.CrossRefGoogle ScholarPubMed
Carmelli, D, Swan, GE, Reed, T, Miller, BL, DeCarli, C (1999). Midlife cardiovascular risk factors and brain morphology in identical older male twins. Neurology 52, 11191124.CrossRefGoogle ScholarPubMed
Chen, H, Zhang, SM, Schwarzschild, MA, Hernan, MA, Ascherio, A (2005). Physical activity and the risk of Parkinson disease. Neurology 64, 664669.CrossRefGoogle ScholarPubMed
Colcombe, S, Kramer, AF (2003). Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychological Science 14, 125130.CrossRefGoogle ScholarPubMed
Cotman, CW, Berchtold, NC (2002). Exercise: a behavioral intervention to enhance brain health and plasticity. Trends in Neurosciences 25, 295301.CrossRefGoogle Scholar
Cotman, CW, Berchtold, NC, Christie, L-A (2007). Exercise builds brain health: key roles of growth factor cascades and inflammation. Trends in Neurosciences 30, 464472.CrossRefGoogle Scholar
Day, DS (2008). Exercise physiologists talk about sex differences. Medicine and Science in Sports and Exercise 40, 646647.CrossRefGoogle ScholarPubMed
Dersimonian, R, Laird, N (1986). Meta-analysis in clinical trials. Controlled Clinical Trials 7, 177188.CrossRefGoogle ScholarPubMed
Fabrigoule, C, Letenneur, L, Dartigues, JF, Zarrouk, M, Commenges, D, Barberger-Gateau, P (1995). Social and leisure activities and risk of dementia: a prospective longitudinal study. Journal of the American Geriatrics Society 43, 485490.CrossRefGoogle ScholarPubMed
Farris, W, Mansourian, S, Chang, Y, Lindsley, L, Eckman, EA, Frosch, MP, Eckman, CB, Tanzi, RE, Selkoe, DJ, Guenette, S (2003). Insulin-degrading enzyme regulates the levels of insulin, amyloid beta-protein, and the beta-amyloid precursor protein intracellular domain in vivo. Proceedings of the National Academy of Sciences USA 100, 41624167.CrossRefGoogle ScholarPubMed
Ho, SC, Woo, J, Sham, A, Chan, SG, Yu, AL (2001). A 3-year follow-up study of social, lifestyle and health predictors of cognitive impairment in a Chinese older cohort. International Journal of Epidemiology 30, 13891396.CrossRefGoogle Scholar
Kivipelto, M, Ngandu, T, Fratiglioni, L, Viitanen, M, Kareholt, I, Winblad, B, Helkala, EL, Tuomilehto, J, Soininen, H, Nissinen, A (2005). Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Archives of Neurology 62, 15561560.CrossRefGoogle ScholarPubMed
Kramer, AF, Colcombe, SJ, McAuley, E, Scalf, PE, Erickson, KI (2005). Fitness, aging and neurocognitive function. Neurobiology of Aging 26 (Suppl. 1), 124127.CrossRefGoogle ScholarPubMed
Larson, EB, Wang, L, Bowen, JD, McCormick, WC, Teri, L, Crane, P, Kukull, W (2006). Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of Internal Medicine 144, 7381.CrossRefGoogle ScholarPubMed
Laurin, D, Verreault, R, Lindsay, J, MacPherson, K, Rockwood, K (2001). Physical activity and risk of cognitive impairment and dementia in elderly persons. Archives of Neurology 58, 498504.CrossRefGoogle ScholarPubMed
Lazarov, O, Robinson, J, Tang, YP, Hairston, IS, Korade-Mirnics, Z, Lee, VM, Hersh, LB, Sapolsky, RM, Mirnics, K, Sisodia, SS (2005). Environmental enrichment reduces Abeta levels and amyloid deposition in transgenic mice. Cell 120, 701713.CrossRefGoogle ScholarPubMed
Linn, RT, Wolf, PA, Bachman, DL, Knoefel, JE, Cobb, JL, Belanger, AJ, Kaplan, EF, D'Agostino, RB (1995). The ‘preclinical phase’ of probable Alzheimer's disease. A 13-year prospective study of the Framingham cohort. Archives of Neurology 52, 485490.CrossRefGoogle ScholarPubMed
Logroscino, G, Sesso, HD, Paffenbarger, RS Jr., Lee, IM (2006). Physical activity and risk of Parkinson's disease: a prospective cohort study. Journal of Neurology, Neurosurgery and Psychiatry 77, 13181322.CrossRefGoogle ScholarPubMed
Lytle, ME, Vander Bilt, J, Pandav, RS, Dodge, HH, Ganguli, M (2004). Exercise level and cognitive decline: the MoVIES project. Alzheimer Disease and Associated Disorders 18, 5764.CrossRefGoogle ScholarPubMed
Marks, BL, Madden, DJ, Bucur, B, Provenzale, JM, White, LE, Cabeza, R, Huettel, SA (2007). Role of aerobic fitness and aging on cerebral white matter integrity. Annals of the New York Academy of Sciences 1097, 171174.CrossRefGoogle ScholarPubMed
Masui, K (ed.) (2003). Meta-analysis Software User's Guide. Shinko-Koueki Medical Press: Tokyo, pp. 91121.Google Scholar
O'Donovan, G, Biddle, S, Blazevich, A, Boreham, C, Cooper, A, Crank, H, Ekelund, U, Fox, K, Gately, P, Gill, J, Hamer, M, McDermott, I, Murphy, M, Mutrie, N, Reilly, J, Riddoch, C, Saxton, J, Stamatakis, E (in press). Physical activity in the prevention of chronic diseases: the consensus statement of the British Association of Sports and Exercise Sciences. Journal of Sport Sciences.Google Scholar
Podewils, LJ, Guallar, E, Beauchamp, N, Lyketsos, CG, Kuller, LH, Scheltens, P (2007). Physical activity and white matter lesion progression: assessment using MRI. Neurology 68, 1223–126.CrossRefGoogle ScholarPubMed
Podewils, LJ, Guallar, E, Kuller, LH, Fried, LP, Lopez, OL, Carlson, M, Lyketsos, CG (2005). Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. American Journal of Epidemiology 161, 639651.CrossRefGoogle ScholarPubMed
Richards, M, Hardy, R, Wadsworth, ME (2003). Does active leisure protect cognition? Evidence from a national birth cohort. Social Science and Medicine 56, 785792.CrossRefGoogle ScholarPubMed
Rosendorff, C, Beeri, MS, Silverman, JM (2007). Cardiovascular risk factors for Alzheimer's disease. American Journal of Geriatric Cardiology 16, 143149.CrossRefGoogle ScholarPubMed
Rovio, S, Kareholt, I, Helkala, EL, Viitanen, M, Winblad, B, Tuomilehto, J, Soininen, H, Nissinen, A, Kivipelto, M (2005). Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease. Lancet Neurology 4, 705711.CrossRefGoogle ScholarPubMed
Schuit, AJ, Feskens, EJ, Launer, LJ, Kromhout, D (2001). Physical activity and cognitive decline, the role of the apolipoprotein e4 allele. Medicine and Science in Sports and Exercise 33, 772777.CrossRefGoogle ScholarPubMed
Singh-Manoux, A, Hillsdon, M, Brunner, E, Marmot, M (2005). Effects of physical activity on cognitive functioning in middle age: evidence from the Whitehall II prospective cohort study. American Journal of Public Health 95, 22522258.CrossRefGoogle ScholarPubMed
Small, BJ, Fratiglioni, L, Viitanen, M, Winblad, B, Backman, L (2000). The course of cognitive impairment in preclinical Alzheimer disease: 3- and 6-year follow-up of a population-based sample. Archives of Neurology 57, 839844.CrossRefGoogle Scholar
Stroup, DF, Berlin, JA, Morton, SC, Olkin, I, Williamson, GD, Rennie, D, Moher, D, Becker, BJ, Sipe, TA, Thacker, SB (2000). Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Journal of the American Medical Association 283, 20082012.CrossRefGoogle ScholarPubMed
Sturman, MT, Morris, MC, Mendes de Leon, CF, Bienias, JL, Wilson, RS, Evans, DA (2005). Physical activity, cognitive activity, and cognitive decline in a biracial community population. Archives of Neurology 62, 17501754.CrossRefGoogle Scholar
Sumic, A, Michael, YL, Carlson, NE, Howieson, DB, Kaye, JA (2007). Physical activity and the risk of dementia in oldest old. Journal of Aging and Health 19, 242259.CrossRefGoogle ScholarPubMed
van Gelder, BM, Tijhuis, MA, Kalmijn, S, Giampaoli, S, Nissinen, A, Kromhout, D (2004). Physical activity in relation to cognitive decline in elderly men: the FINE Study. Neurology 63, 23162321.CrossRefGoogle ScholarPubMed
Verghese, J, Lipton, RB, Katz, MJ, Hall, CB, Derby, CA, Kuslansky, G, Ambrose, AF, Sliwinski, M, Buschke, H (2003). Leisure activities and the risk of dementia in the elderly. New England Journal of Medicine 348, 25082516.CrossRefGoogle ScholarPubMed
Wang, JY, Zhou, DH, Li, J, Zhang, M, Deng, J, Tang, M, Gao, C, Li, J, Lian, Y, Chen, M (2006). Leisure activity and risk of cognitive impairment: the Chongqing aging study. Neurology 66, 911913.CrossRefGoogle ScholarPubMed
Weuve, J, Kang, JH, Manson, JE, Breteler, MM, Ware, JH, Grodstein, F (2004). Physical activity, including walking, and cognitive function in older women. Journal of the American Medical Association 292, 14541461.CrossRefGoogle ScholarPubMed
Wilson, RS, Bennett, DA, Bienias, JL, Aggarwal, NT, Mendes De Leon, CF, Morris, MC, Schneider, JA, Evans, DA (2002). Cognitive activity and incident AD in a population-based sample of older persons. Neurology 59, 19101914.CrossRefGoogle Scholar
Yaffe, K, Barnes, D, Nevitt, M, Lui, LY, Covinsky, K (2001). A prospective study of physical activity and cognitive decline in elderly women: women who walk. Archives of Internal Medicine 161, 17031708.CrossRefGoogle ScholarPubMed
Yamada, M, Kasagi, F, Sasaki, H, Masunari, N, Mimori, Y, Suzuki, G (2003). Association between dementia and midlife risk factors: the Radiation Effects Research Foundation Adult Health Study. Journal of the American Geriatrics Society 51, 410414.CrossRefGoogle ScholarPubMed
Yoshitake, T, Kiyohara, Y, Kato, I, Ohmura, T, Iwamoto, H, Nakayama, K, Ohmori, S, Nomiyama, K, Kawano, H, Ueda, K, Sueishi, K, Tsuneyoshi, M, Fujishima, M (1995). Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population: the Hisayama Study. Neurology 45, 11611168.CrossRefGoogle Scholar