Prospective Analysis of Leisure-Time Physical Activity in Midlife and Beyond and Brain Damage on MRI in Older Adults
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Abstract
Objective To test the hypothesis that greater levels of leisure-time moderate to vigorous intensity physical activity (MVPA) in midlife or late life are associated with larger gray matter volumes, less white matter disease, and fewer cerebrovascular lesions measured in late life, we utilized data from 1,604 participants enrolled in the Atherosclerosis Risk in Communities study.
Methods Leisure-time MVPA was quantified using a past-year recall, interviewer-administered questionnaire at baseline and 25 years later and classified as none, low, middle, and high at each time point. The presence of cerebrovascular lesions, white matter hyperintensities (WMH), white matter integrity (mean fractional anisotropy [FA] and mean diffusivity [MD]), and gray matter volumes were quantified with 3T MRI in late life. The odds of cerebrovascular lesions were estimated with logistic regression. Linear regression estimated the mean differences in WMH, mean FA and MD, and gray matter volumes.
Results Among 1,604 participants (mean age 53 years, 61% female, 27% Black), 550 (34%), 176 (11%), 250 (16%), and 628 (39%) reported no, low, middle, and high MVPA in midlife, respectively. Compared to no MVPA in midlife, high MVPA was associated with more intact white matter integrity in late life (mean FA difference 0.13 per SD [95% confidence interval (CI) 0.004, 0.26]; mean MD difference −0.11 per SD [95% CI −0.21, −0.004]). High MVPA in midlife was also associated with a lower odds of lacunar infarcts (odds ratio 0.68, 95% CI 0.46, 0.99). High MVPA was not associated with gray matter volumes. High MVPA compared to no MVPA in late life was associated with most brain measures.
Conclusion Greater levels of physical activity in midlife may protect against cerebrovascular sequelae in late life.
Glossary
- AD=
- Alzheimer disease;
- ARIC=
- Atherosclerosis Risk in Communities;
- ARIC-NCS=
- Atherosclerosis Risk in Communities–Neurocognitive Study;
- BMI=
- body mass index;
- CI=
- confidence interval;
- DTI=
- diffusion tensor imaging;
- FA=
- fractional anisotropy;
- FLAIR=
- fluid-attenuation inversion recovery;
- LTPA=
- leisure-time physical activity;
- MD=
- mean diffusivity;
- MET=
- metabolic equivalent of task;
- MVPA=
- moderate to vigorous physical activity;
- OR=
- odds ratio;
- RCT=
- randomized controlled trial;
- ROI=
- region of interest;
- WM=
- white matter;
- WMH=
- white matter hyperintensity
Footnotes
Go to Neurology.org/Nhttps://n.neurology.org/lookup/doi/10.1212/WNL.0000000000011375 for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 297
- Received April 18, 2020.
- Accepted in final form October 7, 2020.
- © 2021 American Academy of Neurology
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