Helena Horder, PhD et al. Neurology® 2018;90:e1298-e1305. doi:10.1212/WNL.0000000000005290
Objective To investigate whether greater cardiovascular fitness in midlife is associated with decreased dementia risk in women followed up for 44 years.
Methods A population-based sample of 1,462 women 38 to 60 years of age was examined in 1968. Of these, 191 women completed a maximal cycling test to evaluate cardiovascular fitness. Subsequent examinations of dementia incidence were done in 1974, 1980, 1992, 2000, 2005, and 2009.
Dementia was diagnosed according to DSM-III-R criteria on the basis of information from neuropsychiatric examinations, informant interviews, hospital records, and registry data up to 2012.
Cox regressions were performed with adjustment for socioeconomic, lifestyle, and medical confounders.
Results Compared with medium fitness, the adjusted hazard ratio for all-cause dementia during the 44-year follow-up was 0.12 among those with high fitness and 1.41 among those with low fitness. High fitness delayed age at dementia onset by 9.5 years compared to low fitness and time to dementia onset by 5 years compared to medium fitness.
Conclusions Among Swedish women, a high cardiovascular fitness in midlife was associated with a decreased risk of subsequent dementia. Promotion of a high cardiovascular fitness may be included in strategies to mitigate or prevent dementia. Findings are not causal, and future research needs to focus on whether improved fitness could have positive effects on dementia risk and when during the life course a high cardiovascular fitness is most important.
My comment: Mr Motivator is right! Regular exercise is the best insurance you can ever take out. And you don’t have to run marathons to get fit. Don’t give up on fitness because of your job or because you have had kids. Get active. Spend that pension! Don’t give it away to the nursing home!
We are getting demented later in life than we used to! Good news?
An analysis of seven population based cohort studies in the USA and Europe found that over the last 25 years the incidence of dementia has fallen by 13% per calendar decade. The reduction tended to be greater in men compared to women.
In a large longitudinal study, moderate alcohol consumption seemed to have a beneficial effect. The Health and Retirement Study followed 20,000 middle aged and older people for nine years. When compared to those who never drank alcohol, participants who drank low to moderate quantities had higher scores for mental status, word recall and vocabulary, and lower rates of decline in all of these domains.
Although aspirin has proven benefit in the secondary prevention of cardiovascular disease, they have not been shown to reduce the incidence of dementia or cognitive decline.
20,000 older people were randomised to have either 100mg aspirin a day or placebo. Around 600 developed dementia over the five years of follow up. There was no difference between the treatment group and the placebo group however.
My comment: Although GPs and hospital doctors have been treating diabetes, hypertension and cardiovascular risk factors very aggressively over the last few decades, it is rare to get conclusive feedback that we have actually been achieving useful end points such as this, so I was delighted to see this report.
Diabetes Diet 