Physical Activity Over the Life Course and Its Association with Cognitive Performance and Impairment in Old Age

OBJECTIVE: To determine how physical activity at various ages over the life course is associated with cognitive impairment in late life. DESIGN: Cross-sectional study. SETTING: Four U.S. sites. PARTICIPANTS: Nine thousand three hundred forty-four women aged 65 and older (mean 71.6) who self-reported teenage, age 30, age 50, and late-life physical activity. MEASUREMENTS: Logistic regression was used to determine the association between physical activity status at each age and likelihood of cognitive impairment (modified Mini-Mental State Examination (mMMSE) score >1.5 standard deviations below the mean, mMMSE score <= 22). Models were adjusted for age, education, marital status, diabetes mellitus, hypertension, depressive symptoms, smoking, and body mass index. RESULTS: Women who reported being physically active had a lower prevalence of cognitive impairment in late life than women who were inactive at each time (teenage: 8.5% vs 16.7%, adjusted odds ratio (AOR) = 0.65, 95% confidence interval (CI) = 0.53-0.80; age 30: 8.9% vs 12.0%, AOR = 0.80, 95% CI = 0.67-0.96); age 50: 8.5% vs 13.1%, AOR = 0.71, 95% CI = 0.59-0.85; old age: 8.2% vs 15.9%, AOR = 0.74, 95% CI = 0.61-0.91). When the four times were analyzed together, teenage physical activity was most strongly associated with lower odds of late-life cognitive impairment (OR = 0.73, 95% CI = 0.58-0.92). However, women who were physically inactive as teenagers and became active in later life had lower risk than those who remained inactive. CONCLUSIONS: Women who reported being physically active at any point over the life course, especially as teenagers, had a lower likelihood of cognitive impairment in late life. Interventions should promote physical activity early in life and throughout the life course. J Am Geriatr Soc 58: 1322-1326, 2010.