Physically active lifestyle not likely to prevent dementia

  • Kivimäki M & al.
  • BMJ
  • 17 Apr 2019

  • International Clinical Digest
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Takeaway

  • A meta-analysis addressing reverse causation suggests physical inactivity does not increase dementia and Alzheimer’s disease risk.

Why this matters

  • Lack of effective interventions to prevent, treat dementia.

Key results

  • Baseline prevalence of physical inactivity: 40.5%.
  • Physical inactivity measured
  • All-cause dementia (HR, 1.40; 95% CI, 1.24-1.59).
  • Alzheimer’s disease (HR, 1.36; 95% CI, 1.12-1.65).
  • But with minimization of reverse causation by assessing physical inactivity ≥10 years before dementia onset, no increased risk:
    • All-cause dementia (HR, 1.01; 95% CI, 0.89-1.14).
    • Alzheimer’s disease (HR, 0.96; 95% CI, 0.85-1.08).
  • Physical inactivity ≥10 years in past increased other risks:
    • Diabetes (HR, 1.42; 95% CI, 1.25-1.61).
    • Coronary heart disease (HR, 1.24; 95% CI, 1.13-1.36).
    • Stroke (HR, 1.16; 95% CI, 1.05-1.27).
  • Among people developing cardiometabolic disease, physical inactivity ≥10 years before dementia onset possibly increased risk (HR, 1.30; 95% CI, 0.79-2.14).
  • Study design

    • Individual-participant meta-analysis: 19 cohort studies having 404,840 US and European participants (mean age, 45.5 years) initially dementia-free.
    • Main outcomes: all-cause dementia, Alzheimer’s disease during mean 14.9 years.
    • Funding: NordForsk; others.

    Limitations

    • Single, self-reported measure of physical inactivity.
    • Milder dementia cases likely missed.
    • Unknown generalizability.

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