A1 Journal article (refereed)
Physical Activity and Cognitive Decline Among Older Adults : A Systematic Review and Meta-Analysis (2024)
Iso-Markku, P., Aaltonen, S., Kujala, U. M., Halme, H.-L., Phipps, D., Knittle, K., Vuoksimaa, E., & Waller, K. (2024). Physical Activity and Cognitive Decline Among Older Adults : A Systematic Review and Meta-Analysis. JAMA Network Open, 7(2), Article e2354285. https://doi.org/10.1001/jamanetworkopen.2023.54285
JYU authors or editors
Publication details
All authors or editors: Iso-Markku, Paula; Aaltonen, Sari; Kujala, Urho M.; Halme, Hanna-Leena; Phipps, Daniel; Knittle, Keegan; Vuoksimaa, Eero; Waller, Katja
Journal or series: JAMA Network Open
eISSN: 2574-3805
Publication year: 2024
Publication date: 01/02/2024
Volume: 7
Issue number: 2
Article number: e2354285
Publisher: American Medical Association (AMA)
Publication country: United States
Publication language: English
DOI: https://doi.org/10.1001/jamanetworkopen.2023.54285
Publication open access: Openly available
Publication channel open access: Open Access channel
Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/93369
Abstract
Physical activity is associated with the risk for cognitive decline, but much of the evidence in this domain comes from studies with short follow-ups, which is prone to reverse causation bias.
Objective
To examine how length of follow-up, baseline age, physical activity amount, and study quality modify the longitudinal associations of physical activity with cognition.
Data Sources
Observational studies of adults with a prospective follow-up of at least 1 year, a valid baseline cognitive measure or midlife cohort, and an estimate of the association of baseline physical activity and follow-up cognition were sought from PsycInfo, Scopus, CINAHL, Web of Science, SPORTDiscus, and PubMed, with the final search conducted on November 2, 2022.
Study Selection
Two independent researchers screened titles with abstracts and full-text reports.
Data Extraction and Synthesis
Two reviewers independently assessed study quality and extracted data. Pooled estimates of association were calculated with random-effects meta-analyses. An extensive set of moderators, funnel plots, and scatter plots of physical activity amount were examined. This study is reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.
Main Outcomes and Measures
Pooled estimates of the associations between physical activity and global cognition, as well as specific cognitive domains, were examined.
Results
A total of 104 studies with 341 471 participants were assessed. Analysis of binary outcomes included 45 studies with 102 452 individuals, analysis of follow-up global cognition included 14 studies with 41 045 individuals, and analysis of change in global cognition included 25 studies with 67 463 individuals. Physical activity was associated with a decreased incidence of cognitive impairment or decline after correction for funnel plot asymmetry (pooled risk ratio, 0.97; 95% CI, 0.97-0.99), but there was no significant association in follow-ups longer than 10 years. Physical activity was associated with follow-up global cognition (standardized regression coefficient, 0.03; 95% CI, 0.02-0.03) and change in global cognition (standardized regression coefficient, 0.01; 95% CI, 0.01 to 0.02) from trim-and-fill analyses, with no clear dose-response or moderation by follow-up length, baseline age, study quality or adjustment for baseline cognition. The specific cognitive domains associated with physical activity were episodic memory (standardized regression coefficient, 0.03; 95% CI, 0.02-0.04) and verbal fluency (standardized regression coefficient, 0.05; 95% CI, 0.03-0.08).
Conclusions and Relevance
In this meta-analysis of the association of physical activity with cognitive decline, physical activity was associated with better late-life cognition, but the association was weak. However, even a weak association is important from a population health perspective.
Keywords: physical activity; performance (capacity); older people; ageing; cognitive development
Contributing organizations
Ministry reporting: Yes
VIRTA submission year: 2024
Preliminary JUFO rating: 1
