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February 02, 2016; 86 (5) Article

Fitness and cognition in the elderly

The Austrian Stroke Prevention Study

Paul Freudenberger, Katja Petrovic, Abhijit Sen, Anna Maria Töglhofer, André Fixa, Edith Hofer, Sabine Perl, Robert Zweiker, Sudha Seshadri, Reinhold Schmidt, Helena Schmidt
First published January 6, 2016, DOI: https://doi.org/10.1212/WNL.0000000000002329
Paul Freudenberger
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Katja Petrovic
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Abhijit Sen
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Anna Maria Töglhofer
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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André Fixa
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Edith Hofer
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Sabine Perl
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Robert Zweiker
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Sudha Seshadri
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Reinhold Schmidt
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Helena Schmidt
From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Citation
Fitness and cognition in the elderly
The Austrian Stroke Prevention Study
Paul Freudenberger, Katja Petrovic, Abhijit Sen, Anna Maria Töglhofer, André Fixa, Edith Hofer, Sabine Perl, Robert Zweiker, Sudha Seshadri, Reinhold Schmidt, Helena Schmidt
Neurology Feb 2016, 86 (5) 418-424; DOI: 10.1212/WNL.0000000000002329

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Abstract

Objective: To investigate whether greater cardiorespiratory fitness is associated with better global and domain-specific cognitive function.

Methods: We investigated 877 participants (aged 65 ± 7 years, 55% women) of the Austrian Stroke Prevention Study. For cardiorespiratory fitness, the maximum oxygen consumption (V̇o2max) was calculated based on weight and maximum and resting heart rate on a treadmill test (mL·kg−1·min−1). A test battery assessing memory (Bäumler's Lern-und Gedächtnistest), executive function (Wisconsin Card Sorting Test, Trail Making Test–Part B, Digit Span Backward, Alters Konzentrationstest, a computerized complex reaction time task) and motor skills (Purdue Pegboard Test) was administered. Summary measures for cognitive domains and for global cognition were calculated. White matter lesions, lacunes, and brain atrophy were assessed using MRI.

Results: Higher V̇o2max was associated with better global (B = 0.024; p = 0.000) and domain-specific cognitive function (memory B = 0.026, p = 0.000; executive function B = 0.009, p = 0.003; motor skills B = 0.012, p = 0.018) after adjustment for age, sex, education years, and Ca2+ channel antagonists or β-blockers. White matter lesions, lacunes, or brain atrophy did not mediate the effect (p > 0.05 for all mediators). The interactions of V̇o2max with age, overweight, and APOE ε4 on cognition were not statistically significant (p > 0.05 for all interaction terms) with the exception of a modulating effect of body mass index on V̇o2max in the memory domain.

Conclusions: Higher V̇o2max is associated with better global cognitive function and with better performance in the cognitive domains of memory, executive function, and motor skills in the middle-aged and elderly. The association is not mediated by the presence of white matter lesions, lacunes, and brain atrophy.

GLOSSARY

BMI=
body mass index;
BPF=
brain parenchymal fraction;
LGT=
Lern-und Gedächtnistest;
TE=
echo time;
TR=
repetition time;
V̇o2max=
maximum oxygen consumption;
WML=
white matter lesion

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

  • Editorial, page 408

  • Received March 13, 2015.
  • Accepted in final form August 10, 2015.
  • © 2016 American Academy of Neurology
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