PT  - JOURNAL ARTICLE
AU  - Helena Hörder
AU  - Lena Johansson
AU  - XinXin Guo
AU  - Gunnar Grimby
AU  - Silke Kern
AU  - Svante Östling
AU  - Ingmar Skoog
TI  - Midlife cardiovascular fitness and dementia
AID  - 10.1212/WNL.0000000000005290
DP  - 2018 Apr 10
TA  - Neurology
PG  - e1298--e1305
VI  - 90
IP  - 15
4099  - http://n.neurology.org/content/90/15/e1298.short
4100  - http://n.neurology.org/content/90/15/e1298.full
SO  - Neurology2018 Apr 10; 90
AB  - Objective To investigate whether greater cardiovascular fitness in midlife is associated with decreased dementia risk in women followed up for 44 years.Methods A population-based sample of 1,462 women 38 to 60 years of age was examined in 1968. Of these, a systematic subsample comprising 191 women completed a stepwise-increased maximal ergometer cycling test to evaluate cardiovascular fitness. Subsequent examinations of dementia incidence were done in 1974, 1980, 1992, 2000, 2005, and 2009. Dementia was diagnosed according to DSM-III-R criteria on the basis of information from neuropsychiatric examinations, informant interviews, hospital records, and registry data up to 2012. Cox regressions were performed with adjustment for socioeconomic, lifestyle, and medical confounders.Results Compared with medium fitness, the adjusted hazard ratio for all-cause dementia during the 44-year follow-up was 0.12 (95% confidence interval [CI] 0.03–0.54) among those with high fitness and 1.41 (95% CI 0.72–2.79) among those with low fitness. High fitness delayed age at dementia onset by 9.5 years and time to dementia onset by 5 years compared to medium fitness.Conclusions Among Swedish women, a high cardiovascular fitness in midlife was associated with a decreased risk of subsequent dementia. Promotion of a high cardiovascular fitness may be included in strategies to mitigate or prevent dementia. Findings are not causal, and future research needs to focus on whether improved fitness could have positive effects on dementia risk and when during the life course a high cardiovascular fitness is most important.CI=confidence interval; FINGER=Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability; PPSW=Prospective Population Study of Women; RCT=randomized controlled trial