"Physical Activity and Cognitive Health, Revisited"
Information sourced from Journal Watch

Rx: 30 minutes of brisk walking daily to maintain cognition despite vascular risk factors

Cerebrovascular disease risk factors are known to be associated with cognitive decline. Recent epidemiologic, cohort, and clinical-trial data support a role for physical activity in maintaining cognitive health. To assess the effect of physical activity on cognition in the setting of cerebrovascular disease, researchers conducted a retrospective subgroup analysis of more than 2800 female health professionals (age=65) with at least three vascular risk factors (e.g., diabetes mellitus, hypertension, hyperlipidemia, body-mass index=30, family history of premature myocardial infarction). Participants reported mean one-year physical activity levels a mean of 3.5 years before an initial global cognitive evaluation. The cognitive evaluation was conducted via telephone; 81% of the respondents completed at least three assessments at 2-year intervals. All instruments were previously validated.

Women in the two highest quintiles of physical activity level — equivalent to brisk walking=30 minutes daily — had significantly slower rates of cognitive decline than those in the lowest quintile. When the data were compared to an analysis of age-associated cognitive decline, participants in the two highest quintiles of physical activity were cognitively 5 to 7 years "younger" than those in the lowest quintile. A secondary analysis specific to walking showed a possible threshold effect, with at least 30 minutes of brisk daily walking required for significant cognitive benefit.

Comment: This analysis adds to a growing body of literature emphasizing the role of physical exercise throughout the life span as an important modifiable risk factor in maintaining cognitive health, even in the context of cerebrovascular risk factors. Although the self-report of physical activity is a potential confounder in this study, another study published in the same journal issue used an objective measure of energy expenditure and showed similar results in a mixed-sex cohort (Arch Intern Med 2011; 171:1251). On the basis of the accumulating evidence correlating physical exercise with cognitive health, a prescription for a daily walk should quite literally be "just what the doctor ordered."

— Brandy R. Matthews, MD

Published in Journal Watch Neurology August 2, 2011

Citation:
Vercambre M-N et al. Physical activity and cognition in women with vascular conditions. Arch Intern Med 2011 Jul 25; 171:1244. [Medline® Abstract]

Copyright © 2011. Massachusetts Medical Society. All rights reserved.

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