Author response: Midlife cardiovascular fitness and dementia
Helena M.Hörder, Reg Physiotherapist, Institute of Neuroscience and Physiology, University of Gothenburg, Age Cap
Lena M.Johansosn, Reg Nurse, Institute of Neuroscience and Physiology, University of Gothenburg, Age Cap
XinXinGuo, Med Dr, Institute of Neuroscience and Physiology, University of Gothenburg, Age Cap
GunnarGrimby, Med Dr, Institute of Neuroscience and Physiology, University of Gothenburg
SilkeKern, Med Dr, Institute of Neuroscience and Physiology, University of Gothenburg, Age Cap
IngmarSkoog, Med Dr, Institute of Neuroscience and Physiology, University of Gothenburg, Age Cap
Submitted April 10, 2018
We are grateful for the comments by Kivimäki et al. on our article. [1] We agree that the effect of dementia prevention in our study is probably overoptimistic. However, the results still suggest that there is a strong effect of midlife cardiovascular fitness on dementia risk in old age. Kivimäki et al. conclude that results based on two individuals with dementia is entirely based on chance. However, 44 individuals developed dementia during the 44-year follow-up. Two of those were in the highest quintile of fitness. The low number of dementia cases in the highest fitness group is thus the consequence of the strong effect of high midlife fitness on dementia risk. However, as Kivimäki et al. point out, this makes the exact estimation of the benefit of fitness less robust, but it still suggests a strong effect. Kivimäki et al. report that with two more cases, the population attributable fraction would decrease from 78% to about 60%. We would argue that this is also a very strong effect. Additionally, high fitness could be regarded as a sum of a number of beneficial factors related to dementia risk (e.g. genetics, exercise, diet, non-smoking, and blood pressure).
1. Hörder H, Johansson L, Guo X, et al. Midlife cardiovascular fitness and dementia: A 44-year longitudinal population study in women. Neurology Epub 2018 Mar 14.
For disclosures, please contact the editorial office at [email protected].
We are grateful for the comments by Kivimäki et al. on our article. [1] We agree that the effect of dementia prevention in our study is probably overoptimistic. However, the results still suggest that there is a strong effect of midlife cardiovascular fitness on dementia risk in old age. Kivimäki et al. conclude that results based on two individuals with dementia is entirely based on chance. However, 44 individuals developed dementia during the 44-year follow-up. Two of those were in the highest quintile of fitness. The low number of dementia cases in the highest fitness group is thus the consequence of the strong effect of high midlife fitness on dementia risk. However, as Kivimäki et al. point out, this makes the exact estimation of the benefit of fitness less robust, but it still suggests a strong effect. Kivimäki et al. report that with two more cases, the population attributable fraction would decrease from 78% to about 60%. We would argue that this is also a very strong effect. Additionally, high fitness could be regarded as a sum of a number of beneficial factors related to dementia risk (e.g. genetics, exercise, diet, non-smoking, and blood pressure).
1. Hörder H, Johansson L, Guo X, et al. Midlife cardiovascular fitness and dementia: A 44-year longitudinal population study in women. Neurology Epub 2018 Mar 14.
For disclosures, please contact the editorial office at [email protected].