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Abstract
Objective: To determine whether poor cardiovascular (CV) fitness and exaggerated exercise blood pressure (BP) and heart rate (HR) were associated with worse brain morphology in later life.
Methods: Framingham Offspring participants (n = 1,094, 53.9% female) free from dementia and CV disease (CVD) underwent an exercise treadmill test at a mean age of 40 ± 9 years. A second treadmill test and MRI scans of the brain were administered 2 decades later at mean age of 58 ± 8 years.
Results: Poor CV fitness and greater diastolic BP and HR response to exercise at baseline were associated with a smaller total cerebral brain volume (TCBV) almost 2 decades later (all p < 0.05) in multivariable adjusted models; the effect of 1 SD lower fitness was equivalent to approximately 1 additional year of brain aging in individuals free of CVD. In participants with prehypertension or hypertension at baseline, exercise systolic BP was also associated with smaller TCBV (p < 0.05).
Conclusion: Our results suggest that lower CV fitness and exaggerated exercise BP and HR responses in middle-aged adults are associated with smaller brain volume nearly 2 decades later. Promotion of midlife CV fitness may be an important step towards ensuring healthy brain aging.
GLOSSARY
- BP=
- blood pressure;
- CARDIA=
- Coronary Artery Risk Development in Young Adults Study;
- CV=
- cardiovascular;
- CVD=
- cardiovascular disease;
- DBP=
- diastolic blood pressure;
- DEC=
- duration-based exercise capacity;
- ETT=
- exercise treadmill test;
- HR=
- heart rate;
- NP=
- neuropsychological;
- SBP=
- systolic blood pressure;
- TCBV=
- total cerebral brain volume;
- WMHV=
- white matter hyperintensity volume
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received August 11, 2015.
- Accepted in final form December 14, 2015.
- © 2016 American Academy of Neurology
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