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. 2023 Oct;19(10):4325-4334.
doi: 10.1002/alz.12998. Epub 2023 Mar 22.

Cardiorespiratory fitness and risk of Alzheimer's disease and related dementias among American veterans

Yan Cheng  1   2 , Edward Zamrini  1   2   3   4 , Charles Faselis  1   2   5 , Douglas Redd  1   2 , Yijun Shao  1   2 , Charity J Morgan  6 , Helen M Sheriff  1   2 , Ali Ahmed  1   2   7 , Peter Kokkinos  1   2   8 , Qing Zeng-Treitler  1   2
Affiliations

Cardiorespiratory fitness and risk of Alzheimer's disease and related dementias among American veterans

Yan Cheng et al. Alzheimers Dement. 2023 Oct.

Abstract

Introduction: Cardiorespiratory fitness (CRF) is associated with improved health and survival. Less is known about its association with Alzheimer's disease and related dementias (ADRD).

Methods: We identified 649,605 US veterans 30 to 95 years of age and free of ADRD who completed a standardized exercise tolerance test between 2000 and 2017 with no evidence of ischemia. We examined the association between five age- and sex-specific CRF categories and ADRD incidence using multivariate Cox regression models.

Results: During up to 20 (median 8.3) years of follow-up, incident ADRD occurred in 44,105 (6.8%) participants, with an incidence rate of 7.7/1000 person-years. Compared to the least-fit, multivariable-adjusted hazard ratios (95% confidence intervals) for incident ADRD were: 0.87 (0.85-0.90), 0.80 (0.78-0.83), 0.74 (0.72-0.76), and 0.67 (0.65-0.70), for low-fit, moderate-fit, fit, and high-fit individuals, respectively.

Disscussion: These findings demonstrate an independent, inverse, and graded association between CRF and incident ADRD. Future studies may determine the amount and duration of physical activity needed to optimize ADRD risk reduction.

Keywords: Alzheimer's disease; dementia; fitness; risk factors.

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Conflict of interest statement

Conflicts of Interest: All authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Cohort assembly
Figure 2a
Figure 2a
Kaplan Meier plots of unadjusted associations of CRF with AD/ADRD in the overall cohort
Figure 2b
Figure 2b
Kaplan Meier plots of multivariable-adjusted associations of CRF with AD/ADRD in the overall cohort
Figure 3
Figure 3
Multivariable-adjusted association between CRF and risk of AD/ADRD in subgroups of patients using least-fit as the reference group
See this image and copyright information in PMC

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