Physical Activity Prevents Progression for Cognitive Impairment and Vascular Dementia

Results From the LADIS (Leukoaraiosis and Disability) Study

Ana Verdelho, MD,
Sofia Madureira, PsyD,
José M. Ferro, MD, PhD,
Hansjörg Baezner, MD, PhD,
Christian Blahak, MD,
Anna Poggesi, MD,
Michael Hennerici, MD,
Leonardo Pantoni, MD, PhD,
Franz Fazekas, MD,
Philip Scheltens, MD, PhD,
Gunhild Waldemar, MD, DMSc,
Anders Wallin, MD, PhD,
Timo Erkinjuntti, MD, PhD,
Domenico Inzitari, MD and
on behalf of the LADIS Study

+ Author Affiliations

From the Department of Neurociences, University of Lisbon, Santa Maria Hospital, Lisbon, Portugal (A.V., S.M., J.M.F.); the Department of Neurology, University of Heidelberg, Klinikum Mannheim, Mannheim, Germany (H.B., C.B., M.H.); the Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy (A.P., L.P., D.I.); the Department of Neurology and MRI Institute, Karl Franzens University Graz, Graz, Austria (F.F.); the Department of Neurology, VU Medical Center, Amsterdam, The Netherlands (P.S.); the Memory Disorders Research Unit, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark (G.W.); the Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden (A.W.); and the Memory Research Unit, Department of Clinical Neurosciences, Helsinki University, Helsinki, Finland (T.E.).

Correspondence to Ana Verdelho, MD, Department of Neurosciences, University of Lisbon, Santa Maria Hospital, Av Prof Egas Moniz 1649-028 Lisbon, Portugal. E-mail averdelho@fm.ul.pt

Abstract

Background and Purpose—We aimed to study if physical activity could interfere with progression for cognitive impairment and dementia in older people with white matter changes living independently.

Methods—The LADIS (Leukoaraiosis and Disability) prospective multinational European study evaluates the impact of white matter changes on the transition of independent elderly subjects into disability. Subjects were evaluated yearly during 3 years with a comprehensive clinical protocol and cognitive assessment with classification of cognitive impairment and dementia according to usual clinical criteria. Physical activity was recorded during the clinical interview. MRI was performed at entry and at the end of the study.

Results—Six hundred thirty-nine subjects were included (74.1±5 years old, 55% women, 9.6±3.8 years of schooling, 64% physically active). At the end of follow-up, 90 patients had dementia (vascular dementia, 54; Alzheimer disease with vascular component, 34; frontotemporal dementia, 2), and 147 had cognitive impairment not dementia. Using Cox regression analysis, physical activity reduced the risk of cognitive impairment (dementia and not dementia: β=−0.45, P=0.002; hazard ratio, 0.64; 95% CI, 0.48–0.85), dementia (β=−0.49, P=0.043; hazard ratio, 0.61; 95% CI, 0.38–0.98), and vascular dementia (β=−0.86, P=0.008; hazard ratio, 0.42; 95% CI, 0.22–0.80), independent of age, education, white matter change severity, medial temporal atrophy, previous and incident stroke, and diabetes.

Conclusions—Physical activity reduces the risk of cognitive impairment, mainly vascular dementia, in older people living independently.

Key Words: