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Physical fitness in middle age reduces risk of dementia

Women who are extremely fit during middle age are nearly 90 per cent less likely to develop dementia

Ingrid Torjesen

Friday, 16 March 2018

Middle-aged women who have a high physical fitness are nearly 90% less likely to develop dementia decades later, compared to those who were moderately fit, according to a study* published in Neurology.

When women who are highly fit during middle age go on to develop dementia, they develop the disease an average of 11 years later than women who were moderately fit – at age 90 instead of age 79 – the study found.

The study included 191 women with an average age of 50 who took a bicycle exercise test until they were exhausted to measure their peak cardiovascular capacity. The average peak workload was measured at 103 watts.

A total of 40 women met the criteria for a high fitness level, or 120 watts or higher; 92 women were in the medium fitness category; and 59 women were in the low fitness category, defined as a peak workload of 80 watts or less, or having their exercise tests stopped because of high blood pressure, chest pain or other cardiovascular problems.

Over the next 44 years, the women were tested for dementia six times. During that time, 44 of the women developed dementia. Only 5% of the highly fit women developed dementia, compared to 25% of moderately fit women and 32% of the women with low fitness. This meant that the highly fit women were 88% less likely to develop dementia than the moderately fit women.

Researcher Helena Hörder, of the University of Gothenburg, Sweden, said: "These findings are exciting because it's possible that improving people's cardiovascular fitness in middle age could delay or even prevent them from developing dementia."

She added that the study does not show cause and effect between cardiovascular fitness and dementia, but only an association: “More research is needed to see if improved fitness could have a positive effect on the risk of dementia and also to look at when during a lifetime a high fitness level is most important," she said.

The group most likely to develop dementia were the women who had to stop the test due to problems, in which 45% developed dementia decades later.

"This indicates that negative cardiovascular processes may be happening in midlife that could increase the risk of dementia much later in life," Hörder said.

*Hörder H, Johansson L, Guo X, et al. Midlife cardiovascular fitness and dementia. Neurology Mar 2018, 10.1212/WNL.0000000000005290; DOI: 10.1212/WNL.0000000000005290

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