Minimal amount of exercise prevents incident dementia in cognitively normal older adults with osteoarthritis: a retrospective longitudinal follow-up study

Abstract

Robust evidence suggests that regular exercise, including walking more than 6000 steps, is effective for preventing dementia; however, such activity is less feasible in older people with osteoarthritis (OA) or other motor disabilities. Therefore, we aimed to test whether the minimal amount of exercise (MAE) could help prevent dementia in older adults with OA. A retrospective longitudinal study was performed and a non-demented cohort (≥ 50-years-old) of 242 people (155 [64.0%] non-converters and 87 [36.0%] converters) from three centers in Taiwan was analyzed with a mean follow-up of 3.1 (range 0.3-5.9) and 2.9 (range 0.5-6.0) years, respectively. MAE was defined as walking for approximately 15-30 min or 1500-3000 steps. Rate of MAE (0, 1-2, or ≥ 3) within one week were defined as MAE-no, MAE-weekly, or MAE-daily, respectively. The incidence rates of dementia were compared between groups. Multivariate logistic regression and Cox proportional hazards analyses were used to study the influence of MAE on dementia occurrence. Age, education, sex, activities of daily living, neuropsychiatric symptoms, cognition, multiple vascular risk factors, and related medications were adjusted. Compared to the MAE-no group, the odds ratios for the incidents of dementia were 0.48 and 0.19 in the MAE-weekly and MAE-daily groups, respectively. In addition, older age, poorer cognition, poorer ADL performance, and congestive heart failure increased the incidence of dementia. Daily and weekly MAE prevented dementia in older adults with OA. As such, an informative public health policy may help promote adequate exercise in at-risk groups.

Figure 1

Flow chart for selecting the study participants.

Figure 2

Percentage frequency of conversion according to the MAE frequency. Multiple logistic regression analysis was adopted to investigate the contribution of frequency in the non-dementia participants to conversion to dementia. OR were adjusted for age, sex, education, follow-up years, CASI, HAIADL, NPI, diabetes, hypertension, dyslipidemia, coronary artery diseases, arrythmia, congestive heart failure, and medications. Compared to MAE-No group, OR were 0.48 and 0.19 in the MAE-weekly group and MAE-daily group, respectively.

Figure 3

Cox proportional hazards regression was adopted for investigating the contribution of the MAE frequency among non-dementia participants to the dementia conversion group. HR were compared with MAE-No group and were adjusted for age, sex, education, CASI, HAIADL, NPI, diabetes, hypertension, dyslipidemia, coronary artery diseases, arrythmia, congestive heart failure, and all medications.