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Assessing Exercise Capacity & Cognitive Impairment
Mayo Clin Proc; ePub 2017 Jan 9; Müller, et al
Exercise capacity is strongly associated with cognitive function, a recent study found, however, meeting the recommendations for daily activity was not associated with a delay in onset of cognitive impairment. This according to a study of 6,104 consecutive patients (mean age 59.2 years) referred for treadmill exercise testing and evaluated for the composite end point of dementia, Alzheimer disease, and cognitive impairment. Researchers found:
- After a mean follow-up of 10.3±5.5 years, 353 (5.8%) patients developed the composite end point at a mean age of 76.7±10.3 years.
- After adjustments, higher age at exercise testing (HR, 1.08) and current smoking predicted a higher likelihood of cognitive impairment(HR, 1.44), and exercise capacity predicted a lower likelihood of cognitive impairment (HR, 0.92).
- Each 1-metabolic equivalent increase in exercise capacity conferred a nearly 8% reduction in the incidence of cognitive impairment.
- Meeting the recommendations for daily activity was not associated with a delay in onset of cognitive impairment (HR, 1.07).
Müller J, Chan K, Myers JN. Association between exercise capacity and late onset of dementia, Alzheimer disease, and cognitive impairment. [Published online ahead of print January 9, 2017]. Mayo Clin Proc. doi:10.1016/j.mayocp.2016.10.020.
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Observational studies show that higher systolic blood pressure, dyslipidemia, alcohol abuse, smoking, diabetes, and physical inactivity all predict a higher likelihood of impairment in cognitive function.1,2 This trial supports that better exercise capacity leads to less cognitive impairment. Interestingly, it did not show that meeting daily activity goals was similarly related to better cognitive function, which may be due to recall bias with regard to daily activity, which is assessed by questionnaire, as opposed to exercise capacity, which is measured on a treadmill. There is little question that exercise is important to recommend as a routine part of our preventive health approach to improve cardiovascular function, decrease the risk of cardiovascular disease, improve a sense of well-being, and likely to decrease the chances of cognitive decline over time. —Neil Skolnik, MD