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May 17, 2016; 86 (20) Article

Leisure-time physical activity associates with cognitive decline

The Northern Manhattan Study

Joshua Z. Willey, Hannah Gardener, Michelle R. Caunca, Yeseon Park Moon, Chuanhui Dong, Yuen K. Cheung, Ralph L. Sacco, Mitchell S.V. Elkind, Clinton B. Wright
First published March 23, 2016, DOI: https://doi.org/10.1212/WNL.0000000000002582
Joshua Z. Willey
From the Departments of Neurology (J.Z.W., Y.P.M., M.S.V.E.), Biostatistics (Y.K.C.), and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (H.G., M.R.C., C.D., C.B.W., R.L.S.) and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami; and Evelyn F. McKnight Brain Institute (R.L.S., C.B.W.), University of Miami, FL.
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Hannah Gardener
From the Departments of Neurology (J.Z.W., Y.P.M., M.S.V.E.), Biostatistics (Y.K.C.), and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (H.G., M.R.C., C.D., C.B.W., R.L.S.) and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami; and Evelyn F. McKnight Brain Institute (R.L.S., C.B.W.), University of Miami, FL.
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Michelle R. Caunca
From the Departments of Neurology (J.Z.W., Y.P.M., M.S.V.E.), Biostatistics (Y.K.C.), and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (H.G., M.R.C., C.D., C.B.W., R.L.S.) and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami; and Evelyn F. McKnight Brain Institute (R.L.S., C.B.W.), University of Miami, FL.
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Yeseon Park Moon
From the Departments of Neurology (J.Z.W., Y.P.M., M.S.V.E.), Biostatistics (Y.K.C.), and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (H.G., M.R.C., C.D., C.B.W., R.L.S.) and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami; and Evelyn F. McKnight Brain Institute (R.L.S., C.B.W.), University of Miami, FL.
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Chuanhui Dong
From the Departments of Neurology (J.Z.W., Y.P.M., M.S.V.E.), Biostatistics (Y.K.C.), and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (H.G., M.R.C., C.D., C.B.W., R.L.S.) and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami; and Evelyn F. McKnight Brain Institute (R.L.S., C.B.W.), University of Miami, FL.
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Yuen K. Cheung
From the Departments of Neurology (J.Z.W., Y.P.M., M.S.V.E.), Biostatistics (Y.K.C.), and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (H.G., M.R.C., C.D., C.B.W., R.L.S.) and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami; and Evelyn F. McKnight Brain Institute (R.L.S., C.B.W.), University of Miami, FL.
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Ralph L. Sacco
From the Departments of Neurology (J.Z.W., Y.P.M., M.S.V.E.), Biostatistics (Y.K.C.), and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (H.G., M.R.C., C.D., C.B.W., R.L.S.) and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami; and Evelyn F. McKnight Brain Institute (R.L.S., C.B.W.), University of Miami, FL.
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Mitchell S.V. Elkind
From the Departments of Neurology (J.Z.W., Y.P.M., M.S.V.E.), Biostatistics (Y.K.C.), and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (H.G., M.R.C., C.D., C.B.W., R.L.S.) and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami; and Evelyn F. McKnight Brain Institute (R.L.S., C.B.W.), University of Miami, FL.
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Clinton B. Wright
From the Departments of Neurology (J.Z.W., Y.P.M., M.S.V.E.), Biostatistics (Y.K.C.), and Epidemiology (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (H.G., M.R.C., C.D., C.B.W., R.L.S.) and Human Genetics (R.L.S.), Miller School of Medicine, University of Miami; and Evelyn F. McKnight Brain Institute (R.L.S., C.B.W.), University of Miami, FL.
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Citation
Leisure-time physical activity associates with cognitive decline
The Northern Manhattan Study
Joshua Z. Willey, Hannah Gardener, Michelle R. Caunca, Yeseon Park Moon, Chuanhui Dong, Yuen K. Cheung, Ralph L. Sacco, Mitchell S.V. Elkind, Clinton B. Wright
Neurology May 2016, 86 (20) 1897-1903; DOI: 10.1212/WNL.0000000000002582

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Abstract

Objective: Because leisure-time physical activity (LTPA) is protective against incident dementia, we hypothesized that LTPA is protective against decline in domain-specific cognitive performance.

Methods: As part of the Northern Manhattan Study, LTPA was ascertained at enrollment using a validated in-person questionnaire. We assessed cognition in participants in the Northern Manhattan Study MRI substudy using a standard neuropsychological examination (NPE) (n = 1,228), and a repeat examination was performed 5 years later (n = 876). LTPA was summarized as the maximum intensity of any activity performed, classified as none to light intensity (physical inactivity) (90%) vs moderate to heavy intensity (10%). The NPE was subcategorized using standardized z scores over validated domains: processing speed, semantic memory, episodic memory, and executive function. We used multivariable linear regression models to examine the association of LTPA with initial and change in cognitive performance. Analyses were adjusted for sociodemographics, cardiovascular disease risk factors, and MRI findings (white matter hyperintensity volume, silent brain infarcts, cerebral volume).

Results: No/low levels of LTPA were associated with worse executive function, semantic memory, and processing speed scores on the first NPE. The associations were slightly attenuated and no longer significant after adjusting for vascular risk factors. Cognitively unimpaired participants reporting no/low LTPA vs moderate/high levels declined more over time in processing speed (β = −0.231 ± 0.112, p = 0.040) and episodic memory (β = −0.223 ± 0.117, p = 0.057) adjusting for sociodemographic and vascular risk factors.

Conclusions: A low level of LTPA is independently associated with greater decline in cognitive performance over time across domains.

GLOSSARY

Gc=
crystallized abilities;
LTPA=
leisure-time physical activity;
MET=
metabolic equivalent;
NOMAS=
Northern Manhattan Study;
NPE=
neuropsychological examination

Footnotes

  • ↵* These authors contributed equally to this work.

  • 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 June 15, 2015.
  • Accepted in final form February 4, 2016.
  • © 2016 American Academy of Neurology
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