Influence of Cardiorespiratory Fitness on Risk of Dementia and Dementia Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

in Journal of Aging and Physical Activity
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The purpose of this meta-analysis was to investigate the influence of cardiorespiratory fitness (CF) levels on dementia risk and dementia mortality. MEDLINE and EMBASE databases were used to search for eligible studies from January 1990 to September 2019. To be included, the study was required to be a prospective cohort study that provided CF measurements and indicated relative risk and confidence intervals for the associations between CF and dementia risk and mortality. A total of six studies were selected for this meta-analysis. Low-level CF was associated with nearly three times greater risk of dementia (2.93, 95% confidence interval [1.31, 6.57]; p < .05) compared with a high-level CF. Enhanced CF levels decreased the risk of dementia, and an increase of one metabolic equivalent of task in the CF level reduced the risk of dementia and dementia mortality. Maintaining more than 12 metabolic equivalents of task of CF level was required to substantially decrease dementia risk and dementia mortality.

The author (junga613@gmail.com) is with the Sports Medicine and Science, Kyung Hee University, Gyeonggi-do, South Korea.

  • Bouchard, C., & Rankinen, T. (2001). Individual differences in response to regular physical activity. Medicine & Science in Sports & Exercise, 33(Suppl.), S446S451; discussion S452–S443. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cabral, D.F., Rice, J., Morris, T.P., Rundek, T., Pascual-Leone, A., & Gomes-Osman, J. (2019). Exercise for brain health: An investigation into the underlying mechanisms guided by dose. Neurotherapeutics, 16(3), 580599. PubMed ID: 31197642 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cristi-Montero, C., Ramirez-Campillo, R., Alvarez, C., Garrido Mendez, A., Martinez, M.A., Diaz Martinez, X., … Celis-Morales, C. (2016). Inverse association of cardiorespiratory fitness with cardiovascular risk factors in Chilean adults. Revista Medica de Chile, 144(8), 980989. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Defina, L.F., Willis, B.L., Radford, N.B., Gao, A., Leonard, D., Haskell, W.L., … Berry, J.D. (2013). The association between midlife cardiorespiratory fitness levels and later-life dementia: A cohort study. Annals of Internal Medicine, 158(3), 162168. PubMed ID: 23381040 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dougherty, R.J., Boots, E.A., Lindheimer, J.B., Stegner, A.J., Van Riper, S., Edwards, D.F., … Cook, D.B. (2020). Fitness, independent of physical activity is associated with cerebral blood flow in adults at risk for Alzheimer’s disease. Brain Imaging and Behavior. 14(4), 11541163. PubMed ID: 30852709 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Eadie, B.D., Redila, V.A., & Christie, B.R. (2005). Voluntary exercise alters the cytoarchitecture of the adult dentate gyrus by increasing cellular proliferation, dendritic complexity, and spine density. The Journal of Comparative Neurology, 486(1), 3947. PubMed ID: 15834963 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Foster, P.P., Rosenblatt, K.P., & Kuljis, R.O. (2011). Exercise-induced cognitive plasticity, implications for mild cognitive impairment and Alzheimer’s disease. Frontiers in Neurology, 2, 28. PubMed ID: 21602910 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gates, N., Fiatarone Singh, M.A., Sachdev, P.S., & Valenzuela, M. (2013). The effect of exercise training on cognitive function in older adults with mild cognitive impairment: A meta-analysis of randomized controlled trials. The American Journal of Geriatric Psychiatry, 21(11), 10861097. PubMed ID: 23831175 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hillman, C.H., Erickson, K.I., & Kramer, A.F. (2008). Be smart, exercise your heart: Exercise effects on brain and cognition. Nature Reviews Neuroscience, 9(1), 5865. PubMed ID: 18094706 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Horder, H., Johansson, L., Guo, X., Grimby, G., Kern, S., Ostling, S., & Skoog, I. (2018). Midlife cardiovascular fitness and dementia: A 44-year longitudinal population study in women. Neurology, 90(15), e1298e1305. PubMed ID: 29540588 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Imboden, M.T., Harber, M.P., Whaley, M.H., Finch, W.H., Bishop, D.L., Fleenor, B.S., & Kaminsky, L.A. (2019). The association between the change in directly measured cardiorespiratory fitness across time and mortality risk. Progress in Cardiovascular Diseases, 62(2), 157162. PubMed ID: 30543812 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kulmala, J., Solomon, A., Kareholt, I., Ngandu, T., Rantanen, T., Laatikainen, T., … Kivipelto, M. (2014). Association between mid- to late life physical fitness and dementia: evidence from the CAIDE study. Journal of Internal Medicine, 276(3), 296307. PubMed ID: 24444031 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kurdi, F.N., & Flora, R. (2019). Physical exercise increased brain-derived neurotrophic factor in elderly population with depression. Open Access Macedonian Journal of Medical Sciences, 7(13), 20572061. PubMed ID: 31456825 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kurl, S., Laukkanen, J.A., Lonnroos, E., Remes, A.M., & Soininen, H. (2018). Cardiorespiratory fitness and risk of dementia: A prospective population-based cohort study. Age and Ageing, 47(4), 611614. PubMed ID: 29718064 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lautenschlager, N.T., Cox, K.L., Flicker, L., Foster, J.K., van Bockxmeer, F.M., Xiao, J., … Almeida, O.P. (2008). Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: A randomized trial. JAMA, 300(9), 10271037. PubMed ID: 18768414 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lavie, C.J., Arena, R., Swift, D.L., Johannsen, N.M., Sui, X., Lee, D.C., … Blair, S.N. (2015). Exercise and the cardiovascular system: Clinical science and cardiovascular outcomes. Circulation Research, 117(2), 207219. PubMed ID: 26139859 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lee, J. (2018). The relationship between physical activity and dementia: A systematic review and meta-analysis of prospective cohort studies. Journal of Gerontological Nursing, 44(10), 2229. PubMed ID: 30257021 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Liberati, A., Altman, D.G., Tetzlaff, J., Mulrow, C., Gotzsche, P.C., Ioannidis, J.P., … Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Journal of Clinical Epidemiology, 62(10), e1e34. PubMed ID: 19631507 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Liu, R., Sui, X., Laditka, J.N., Church, T.S., Colabianchi, N., Hussey, J., & Blair, S.N. (2012). Cardiorespiratory fitness as a predictor of dementia mortality in men and women. Medicine & Science in Sports & Exercise, 44(2), 253259. PubMed ID: 21796048 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lortie, G., Bouchard, C., Leblanc, C., Tremblay, A., Simoneau, J.A., Theriault, G., & Savoie, J.P. (1982). Familial similarity in aerobic power. Human Biology, 54(4), 801812. PubMed ID: 7166301

    • Search Google Scholar
    • Export Citation
  • Mandsager, K., Harb, S., Cremer, P., Phelan, D., Nissen, S.E., & Jaber, W. (2018). Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Network Open, 1(6), e183605. PubMed ID: 30646252 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Muller, J., Chan, K., & Myers, J.N. (2017). Association between exercise capacity and late onset of dementia, Alzheimer disease, and cognitive impairment. Mayo Clinic Proceedings, 92(2), 211217. PubMed ID: 28082018 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nyberg, J., Aberg, M.A., Schioler, L., Nilsson, M., Wallin, A., Toren, K., & Kuhn, H.G. (2014). Cardiovascular and cognitive fitness at age 18 and risk of early-onset dementia. Brain, 137(5), 15141523. PubMed ID: 24604561 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pollock, M.L. (1985). Exercise regimens after myocardial revascularization surgery: Rationale and results. Cardiovascular Clinics, 15(2), 159174. PubMed ID: 3912047

    • Search Google Scholar
    • Export Citation
  • Raichlen, D.A., Klimentidis, Y.C., Bharadwaj, P.K., & Alexander, G.E. (2020). Differential associations of engagement in physical activity and estimated cardiorespiratory fitness with brain volume in middle-aged to older adults. Brain Imaging Behavior, 14(5), 19942003. PubMed ID: 31209836 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Roxburgh, B.H., Nolan, P.B., Weatherwax, R.M., & Dalleck, L.C. (2014). Is moderate intensity exercise training combined with high intensity interval training more effective at improving cardiorespiratory fitness than moderate intensity exercise training alone? Journal of Sports Science and Medicine, 13(3), 702707. PubMed ID: 25177202

    • Search Google Scholar
    • Export Citation
  • Schimidt, H.L., Garcia, A., Izquierdo, I., Mello-Carpes, P.B., & Carpes, F.P. (2019). Strength training and running elicit different neuroprotective outcomes in a beta-amyloid peptide-mediated Alzheimer’s disease model. Physiology & Behavior, 206, 206212. PubMed ID: 30995451 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sobol, N.A., Dall, C.H., Hogh, P., Hoffmann, K., Frederiksen, K.S., Vogel, A., … Beyer, N. (2018). Change in fitness and the relation to change in cognition and neuropsychiatric symptoms after aerobic exercise in patients with mild Alzheimer’s disease. Journal of Alzheimer's Disease, 65(1), 137145. PubMed ID: 30040719 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Solomon, A., Borodulin, K., Ngandu, T., Kivipelto, M., Laatikainen, T., & Kulmala, J. (2018). Self-rated physical fitness and estimated maximal oxygen uptake in relation to all-cause and cause-specific mortality. Scandinavian Journal of Medicine & Science in Sports, 28(2), 532540. PubMed ID: 28543703 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stranahan, A.M., Khalil, D., & Gould, E. (2007). Running induces widespread structural alterations in the hippocampus and entorhinal cortex. Hippocampus, 17(11), 10171022. PubMed ID: 17636549 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thomas, A.G., Dennis, A., Rawlings, N.B., Stagg, C.J., Matthews, L., Morris, M., … Johansen-Berg, H. (2016). Multi-modal characterization of rapid anterior hippocampal volume increase associated with aerobic exercise. Neuroimage, 131, 162170. PubMed ID: 26654786 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • World Health Organization. (2019). Dementia. Retrieved from https://www.who.int/news-room/fact-sheets/detail/dementia

  • Wu, C.W., Chang, Y.T., Yu, L., Chen, H.I., Jen, C.J., Wu, S.Y., … Kuo, Y.M. (2008). Exercise enhances the proliferation of neural stem cells and neurite growth and survival of neuronal progenitor cells in dentate gyrus of middle-aged mice. Journal of Applied Physiology, 105(5), 15851594. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Yoon, M.C., Shin, M.S., Kim, T.S., Kim, B.K., Ko, I.G., Sung, Y.H., … Kim, C.J. (2007). Treadmill exercise suppresses nigrostriatal dopaminergic neuronal loss in 6-hydroxydopamine-induced Parkinson’s rats. Neuroscience Letters, 423(1), 1217. PubMed ID: 17644250 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
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