1. Physical activity was significantly associated with a decreased incidence of all-cause dementia and Alzheimer’s disease, irrespective of follow-up length, baseline age and study quality.

2. Physical activity was found to be a protective factor for all-cause dementia and Alzheimer’s disease, even in follow-ups longer than 20 years.

Evidence Rating Level: 1 (Excellent)

Physical activity (PA) is an important modifiable risk factor in the prevention and incidence of dementia. Although many meta-analyses have previously investigated this relationship, they have often lacked rigorous quality assessments or have short follow-up times. As a result, the present systematic review and meta-analysis examines the influence of mid-life PA as a protective factor of all-cause dementia, Alzheimer’s disease and vascular dementia.

From 16,324 identified articles, 58 articles were included (n=257 983) from database inception to October 2021. Studies were included if they had a baseline measure of PA and a follow-up longer than 1 year. Studies were excluded if participants had a specific disease at baseline or had established mild cognitive impairment/dementia at baseline. Quality assessment was performed using a tool that authors developed specifically for the present study. Statistical analyses were performed using pooled effect sizes, dose-response analysis and funnel plots.

Results demonstrated that physical activity was significantly associated with a decreased incidence of all-cause dementia and Alzheimer’s disease, irrespective of follow-up length, baseline age, and study quality. Furthermore, physical activity was found to be a protective factor for all-cause dementia and Alzheimer’s disease, even in follow-ups longer than 20 years. However. the study was limited by the lack of high-quality studies and the limited reports of vascular dementia as an outcome. Nonetheless, the present study provides a unique contribution to the literature by demonstrating a significant association between PA and dementia during longer follow-ups than earlier analyses.

Click to read the study in British Journal of Sports Medicine

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