Midlife Physical Activity, Psychological Distress, and Dementia Risk: The HUNT Study

Article type: Research Article

Authors: Zotcheva, Ekaterina^a | Bergh, Sverre^{b; c} | Selbæk, Geir^{b; c; d} | Krokstad, Steinar^{e; f} | Håberg, Asta Kristine^{g; h} | Strand, Bjørn Heine^{c; d; i} | Ernstsen, Linda^{a; *}

Affiliations: [a] Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway | [b] Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway | [c] Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, T—nsberg, Norway | [d] Faculty of Medicine, University of Oslo, Oslo, Norway | [e] Department of Public Health and Nursing, HUNT Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway | [f] Levanger Hospital, Nord-Tr–ndelag Hospital Trust, Norway | [g] Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway | [h] Department of Radiology and Nuclear Medicine, Norwegian National Advisory Unit on Functional MRI, St. Olav’s Hospital, Trondheim, Norway | [i] Norwegian Institute of Public Health, Oslo, Norway

Correspondence: [*] Correspondence to: Linda Ernstsen, NTNU, Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Post box 8905, N-7491 Trondheim, Norway. Tel.: +47 73413036; E-mail: linda.ernstsen@ntnu.no.

Abstract: Background: Physical activity (PA) is associated with a decreased dementia risk, whereas psychological distress (distress) is linked to an increased dementia risk. Objective: We investigated independent and joint associations of midlife moderate-to-vigorous PA (MVPA) and distress with incident dementia. Methods: Our study comprised 28,916 participants aged 30–60 years from the Nord-Trøndelag Health Study (HUNT1, 1984–1986). Data on MVPA and distress from HUNT1 was linked to the Health and Memory Study in Nord-Trøndelag for dementia case identification. Participants were followed from 1995 until 2011. We used adjusted Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI). Results: In fully adjusted analyses, MVPA was associated with a reduced dementia risk (HR 0.81, 95% CI 0.62–1.06), compared to no MVPA. Distress was associated with an increased dementia risk (HR 1.30, 95% CI 0.99–1.70). Compared to distressed participants not taking part in MVPA, non-distressed no-MVPA participants had a reduced dementia risk (HR 0.72, 95% CI 0.54–0.96). The same applied to distressed MVPA participants (HR 0.50, 95% CI 0.22–1.14), and non-distressed MVPA participants (HR 0.63, 95% CI 0.44–0.90). Our results indicated an additive interaction between MVPA and distress on dementia risk. Conclusion: Our results suggest that midlife MVPA reduces risk of incident dementia among both distressed and non-distressed individuals.

Keywords: Anxiety, cognition, dementia, depression, exercise, psychological stress

DOI: 10.3233/JAD-180768

Journal: Journal of Alzheimer's Disease, vol. 66, no. 2, pp. 825-833, 2018