Aging Clinical and Experimental Research

, Volume 19, Issue 5, pp 410–416 | Cite as

Physical activity and risk of cognitive impairment among older persons living in the community

  • Francesco Landi
  • Andrea Russo
  • Christian Barillaro
  • Matteo Cesari
  • Marco Pahor
  • Paola Danese
  • Roberto Bernabei
  • Graziano Onder
Original Articles


Background and aims: Despite growing interest in the physical and environmental factors associated with the risk of cognitive decline, there is still a lack of information explaining whether they are related to each other. The aim of the present study was to evaluate the relationship of lifetime physical activity with cognitive performance in older persons aged 80 years or older. Methods: Data are from the baseline evaluationof the ilSIRENTE Study (n=364). Cognitive performance was assessed using a 6-item, 7-category scale [Cognitive Performance Scale (CPS)]. The questionnaire in the ilSIRENTE study form contained one item asking respondents about the frequency of light and high physical activity. Analysis of covariance (ANCOVA) was used to examine the effect of different levels of physical activity on cognitive performance, after adjustment for potential confounding variables. Results: The mean age of 364 subjects participating in the study was 85.9 (standard deviation [SD] 4.9) years, and 244 (67.0%) were women. Of the total sample, 158 subjects (43%) had a history of high intensity physical activity during young age; the rate of high intensity physical activity was lower during adult age and old age (125 and 67 subjects, respectively). After adjustment for potential confounders, individuals with a history of high intensity physical activity had a significantly lower CPS score (indicating better performance) than other participants, independently of the age period considered. Conclusions: The present study suggests that, among old-old subjects living in the community, a history of high physical activity is associated with better cognitive performance.


Aging cognitive performance ilSIRENTE study physical activity 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fratiglioni L, De Ronchi D, Aguero-Torres H. Worldwide prevalence and incidence of dementia. Drugs Aging 1999; 15: 365–75.PubMedCrossRefGoogle Scholar
  2. 2.
    Jorm AF, Jolley D. The incidence of dementia: a meta-analysis. Neurology 1998; 51: 728–33.PubMedCrossRefGoogle Scholar
  3. 3.
    Engelhart MJ, Geerlings MI, Ruitenberg A, et al. Dietary intake of antioxidants and risk of Alzheimer disease. JAMA 2002; 287: 3223–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Morris MC, Evans DA, Bienias JL, et al. Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study. JAMA 2002; 287: 3230–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Neeper SA, Gomez-Pinilla F, Choi J, Cotman C. Exercise and brain neurotrophins. Nature 1995; 373: 109.PubMedCrossRefGoogle Scholar
  6. 6.
    Gomez-Pinilla F, Dao L, So V. Physical exercise induces FGF-2 and its mRNA in the hippocampus. Brain Res 1997; 764: 1–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Backmand H, Kaprio J, Kujala UM, Sarna S, Fogelholm M. Physical and psychological functioning of daily living in relation to physical activity. A longitudinal study among former elite male athletes and controls. Aging Clin Exp Res 2006; 18: 40–9.Google Scholar
  8. 8.
    Verghese J, Lipton RB, Katz MJ, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003; 348: 2508–16.PubMedCrossRefGoogle Scholar
  9. 9.
    Weuve J, Kang JH, Manson JE, Breteler MM, Ware JH, Grodstein F. Physical activity, including walking, and cognitive function in older women. JAMA 2004; 292: 1454–61.PubMedCrossRefGoogle Scholar
  10. 10.
    Abbott RD, White LR, Ross GW, Masaki KH, Curb JD, Petrovitch H. Walking and dementia in physically capable elderly men. JAMA 2004; 292: 1447–53.PubMedCrossRefGoogle Scholar
  11. 11.
    Podewils LJ, Guallar E, Kuller LH, et al. Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. Am J Epidemiol 2005; 161: 639–51.PubMedCrossRefGoogle Scholar
  12. 12.
    Wilson RS, Mendes De Leon CF, et al. Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA 2002; 287: 742–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Wilson RS, Bennett DA, Bienias JL, et al. Cognitive activity and incident AD in a population-based sample of older persons. Neurology 2002; 59: 1910–4.PubMedCrossRefGoogle Scholar
  14. 14.
    Morris JN, Fries BE, Meher DR. MDS Cognitive Performance Scale. J Gerontol 1994; 49: M174–82.PubMedCrossRefGoogle Scholar
  15. 15.
    Morris JN, Fries BE, Steel K, et al. Comprehensive clinical assessment in community setting: applicability of the MDS-HC. J Am Geriatr Soc 1997; 45: 1017–24.PubMedGoogle Scholar
  16. 16.
    Landi F, Russo A, Cesari M, et al. The ilSIRENTE study: a prospective cohort study on persons aged 80 years and older living in a mountain community of Central Italy. Aging Clin Exp Res 2005; 17: 486–93.PubMedGoogle Scholar
  17. 17.
    Landi F, Sgadari A, Cipriani L, et al. A simple program to train case managers in community elderly care. Aging Clin Exp Res 1996; 8: 211–8.Google Scholar
  18. 18.
    Morris JN, Fries BE, Bernabei R, Ikegami N, Gilgen R, Steel K. RAI — Home Care Assessment Manual. Washington, DC: Inter-RAI Coporation, 1996.Google Scholar
  19. 19.
    Hawes C, Morris JN, Phillips CD, Mor V, Fries BE, Nonemaker S. Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). Gerontologist 1995; 35: 172–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Landi F, Tua E, Onder G, et al. Minimum data set for home care: a valid instrument to assess frail older people living in the community. Med Care 2000; 38: 1184–90.PubMedCrossRefGoogle Scholar
  21. 21.
    Ferrucci L, Bandinelli S, Benvenuti E, Di Iorio A, Macchi C, Harris TB. Subsystems contributing to the decline in ability to walk: bridging the gap between epidemiology and geriatric practice in the InCHIANTI study. J Am Geriatr Soc 2000; 48: 1618–25.PubMedGoogle Scholar
  22. 22.
    Diagnostic and Statistical Manual of Mental Disorders — Fourth Edition (DSM-IV), American Psychiatric Association, Washington D.C., 1994.Google Scholar
  23. 23.
    Frederiksen K, Tariot P, DeJonghe E. Minimum Data Set Plus (MDS+) scores compared with scores from five rating scale. J Am Geriatr Soc 1996; 44: 305–9.PubMedGoogle Scholar
  24. 24.
    Hartmaier SL, Sloane PD, Guess HA. Validation of the Minimum Data Set Cognitive Performance Scale: agreement with the Mini-Mental State Examination. J Gerontol 1995; 50: M128–33.Google Scholar
  25. 25.
    Elosua R, Bartali B, Ordovas JM, Corsi AM, Lauretani F, Ferrucci L. Association between physical activity, physical performance, and inflammatory biomarkers in an elderly population: the InCHIANTI study. J Gerontol A Biol Sci Med Sci 2005; 60A: 760–7.CrossRefGoogle Scholar
  26. 26.
    Patel KV, Coppin AK, Manini TM, et al. Midlife physical activity and mobility in older age: The InCHIANTI study. Am J Prev Med 2006; 31: 217–24.PubMedCrossRefGoogle Scholar
  27. 27.
    Yoshitake T, Kiyohara Y, Kato I, et al. Incidence and risk factors of vascular dementia and Alzheimer’s disease in a defined elderly Japanese population: the Hisayama Study. Neurology 1995; 45: 1161–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Fabrigoule C, Letenneur L, Dartigues JF, Zarrouk M, Commenges D, Barberger-Gateau P. Social and leisure activities and risk of dementia: a prospective longitudinal study. J Am Geriatr Soc 1995; 43: 485–90.PubMedGoogle Scholar
  29. 29.
    Wang HX, Karp A, Winblad B, Fratiglioni L. Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. Am J Epidemiol 2002; 155: 1081–7.PubMedCrossRefGoogle Scholar
  30. 30.
    Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K. Physical activity and risk of cognitive impairment and dementia in elderly persons. Arch Neurol 2001; 58: 498–504.PubMedCrossRefGoogle Scholar
  31. 31.
    Hebert R, Lindsay J, Verreault R, Rockwood K, Hill G, Dubois MF. Vascular dementia: incidence and risk factors in the Canadian Study of Health and Aging. Stroke 2000; 31: 1487–93.PubMedCrossRefGoogle Scholar
  32. 32.
    Cotman CW, Berchtold NC. Exercise: a behavioral intervention to enhance brain health and plasticity. Trends Neurosci 2002; 25: 295–301.PubMedCrossRefGoogle Scholar
  33. 33.
    Molteni R, Ying Z, Gomez-Pinilla F. Differential effects of acute and chronic exercise on plasticity-related genes in the rat hippocampus revealed by microarray. Eur J Neurosci 2002; 16: 1107–16.PubMedCrossRefGoogle Scholar
  34. 34.
    Ide K, Secher NH. Cerebral blood flow and metabolism during exercise. Prog Neurobiol 2000; 61: 397–414.PubMedCrossRefGoogle Scholar
  35. 35.
    Black JE, Isaacs KR, Anderson BJ, Alcantara AA, Greenough WT. Learning causes synaptogenesis, whereas motor activity causes angiogenesis, in cerebellar cortex of adult rats. Proc Natl Acad Sci USA 1990; 87: 5568–72.PubMedCrossRefGoogle Scholar
  36. 36.
    Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273: 402–7.Google Scholar
  37. 37.
    Ritchie K, Artero S, Touchon J. Classification criteria for mild cognitive impairment: a population-based validation study. Neurology 2001; 56: 37–42.PubMedCrossRefGoogle Scholar
  38. 38.
    Schonknecht P, Pantel J, Kruse A, Schroder J. Prevalence and natural course of aging-associated cognitive decline in a population-based sample of young-old subjects. Am J Psychiatry 2005; 162: 2071–7.PubMedCrossRefGoogle Scholar
  39. 39.
    Landi F, Cesari M, Onder G, Lattanzio F, Gravina EM, Bernabei R. Physical activity and mortality in frail, community-living elderly patients. J Gerontol A Biol Sci Med Sci 2004; 59: 833–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Pluijm SM, Visser M, Puts MT, et al. Unhealthy lifestyles during the life course: association with physical decline in late life. Aging Clin Exp Res 2007; 19: 75–83.PubMedGoogle Scholar
  41. 41.
    Mangani I, Cesari M, Kritchevsky SB, et al. Physical exercise and comorbidity. Results from the Fitness and Arthritis in Seniors Trial (FAST). Aging Clin Exp Res 2006; 18: 374–80.PubMedGoogle Scholar
  42. 42.
    Vestergaard S, Kronborg Andersen C, Korsholm L, Puggaard L. Exercise intervention of 65+-year-old men and women: functional ability and health care costs. Aging Clin Exp Res 2006; 18: 227–34.PubMedGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2007

Authors and Affiliations

  • Francesco Landi
    • 1
  • Andrea Russo
    • 1
  • Christian Barillaro
    • 1
  • Matteo Cesari
    • 2
  • Marco Pahor
    • 2
  • Paola Danese
    • 1
  • Roberto Bernabei
    • 1
  • Graziano Onder
    • 1
  1. 1.Department of Gerontology and GeriatricsCatholic University of the Sacred HeartRomeItaly
  2. 2.Department of Aging and Geriatric ResearchUniversity of Florida, College of MedicineGainesvilleUSA

Personalised recommendations