JAHA: Choose medium to high intensity exercise to prevent dementia more effectively! Especially men

In today's aging society is increasing, the incidence and prevalence of dementia in the world has been high, is still on the rise year by year.
the World Health Organization has said that for adults 60 years and older, dementia causes a higher disability-adjusted life expectancy (DALY) than stroke, cardiovascular disease, cancer, etc.
martin Prince research team at King's College London's Institute of Psychiatry, published in 2013 in Alzheimer's. According to a systematic review and meta-analysis in the journal Dementia, there were approximately 335.6 million people with dementia worldwide in 2010 and are expected to increase by 85% to 657 million in 2030, and may even rise to 115.4 million by 2050.
prevalence of dementia is relatively low in East Asian countries, future increases are likely to be higher than the world average.
chart below shows in more detail the prevalence of dementia in all regions of the world and the expected increase in 2030 and 2050.
evidence of pathophysiological changes prior to the onset of AD suggests that neuropathological changes have begun to occur in the human body decades before the onset of clinical symptoms of dementia.
In a forward-looking longitudinal clinical study published in the journal The New England Journal of Medicine, published in the journal The New England Journal, the team evaluated the cognitive function, brain imaging, cerebrospinal fluid, etc. of 128 subjects, and counted the age of the parents of 88 subjects with normal chromosomal Alzheimer's disease to infer the expected age of the subjects.
study found that in the 10-25 years before the onset of autosomal explicit genetic Alzheimer's disease, changes in indicators such as A beta42 (decrease) and tau protein (rise) in cerebrospinal fluid began to appear gradually, as well as pathological physiological changes such as atrophy of brain volume and a decrease in glucose metabolism in the pre-venom.
indicators of pathogenic gene carriers (red lines) and non-carriers (blue lines) are shown in the chart above over time.
3. More and more research evidence on common risk factors for dementia and cardiovascular disease confirms that sedentary, physical activity, lipid/glucose metabolic disorders, hypertension, etc. are both risk factors for cardiovascular disease and risk factors for cognitive decline and dementia.
For example, the Mayo Clinic D Knopman research team, previously published in Neurology, layered multiple risk factors for atherosclerotic cardiovascular disease, using word delay memory tests (DWRs), digital symbol replacement tests (DSS), and language fluency tests (WFs) to assess cognitive function among strated populations.
results found that high blood pressure, hyperlipidemia, diabetes and other risk factors for cognitive decline, the specific data can be found in the table below: Fourth, the prevention of delayed dementia, recommended exercise strategies to prevent dementia, or delay the onset of dementia, will effectively extend the life expectancy of patients, reduce disability rates, reduce health care costs, and improve the quality of life.
At this stage, there are limited drugs available to treat dementia and often only improve patient symptoms, and there is an urgent need to develop appropriate behavioural strategies to prevent delays in the onset of dementia or to delay the development of dementia.
to further explore this area, the National Institute for Aging released its Aging Research Guidance Strategy in 2016, highlighting behavioral, social, psychological, and economic factors that affect the healthy aging of middle-aged and older people.
increased moderate to high-intensity physical activity (MVPA) is considered an effective strategy that promises to reduce the risk of dementia and protect cognitive function.
In 2018, based on an analysis of existing literature, the U.S. Board of Physical Activity Guidelines recommended a strong correlation between MVPA and brain health, including the brain's speed of information processing, memory, cognitive function, executive function, and a reduced risk of dementia.
, however, in previous studies published in the journal American Journal of Health And Medicine, data from the National Health and Nutrition Survey (NHANS) were analyzed and found that only 8.2%, 9.6% and 44.6% of residents who met MVPA, M2VPA, or METPA exercise standards were below 50%.
further stratization, the study found that there were also significant differences in exercise among people of different genders, ages, races and levels of education.
The chart below provides detailed data on various types of stratification of the total population: the lower percentage of people who complete moderate to high-intensity physical activity (MVPA) strategies is more appropriate for a significant proportion of adult groups, especially for older adults with poor physical activity and a higher risk of cognitive decline, such as increased light-intensity physical activity (LPA) to reduce sedent.
, JAHA's latest study has been more analytical of moderate to high-intensity physical activity (MVPA), not yet combined with sedent sedentation behavior (SED), light-intensity physical activity (LPA) to further link cognitive function research.
The Kara M. Whitaker team at the University of Iowa assumed that replacing 30 minutes of sitting with LPA or MVPA per day would improve cognitive function in five to 10 years, and published the results in the journal Journal of the American Heart Association on January 20, 2021.
the study included 1970 eligible patients from the Young Coronary Arterial Risk Factors Study (CARDIA), who wore acceleration sensors that could determine movement between 2005 and 2006 and used digital symbol replacement tests (DSST), RavLT, and Stroop tests to assess patient function five years and/or 10 years later.
study found that in male patients: DSST assessment results: 30 minutes of MVPA per day instead of 30 minutes of LPA group, DSST score is better, and 30 minutes of LPA per day instead of 30 minutes of sedenttic group, DSST score is even worse.
RAVLT assessment results: 30 minutes of MVPA per day instead of 30 minutes of LPA, and 30 minutes of MVPA per day instead of 30 minutes of sedent, RAVLT score is better, while 30 minutes of LPA per day instead of 30 minutes of sedent, RAVLT score is even worse.
Stroop assessment results: 30 minutes of MVPA per day instead of 30 minutes of LPA, Stroop scored better, and 30 minutes of LPA per day instead of 30 minutes of sedent, Stroop scored worse.
the above poor evaluation results may be related to the system error caused by the lack of research design.
in female patients, the results were even worse when the Stroop assessment results were replaced with 30 minutes of MVPA per day for a 30-minute sedenttic group, and the rest of the cognitive evaluation results were not significantly different.
possible causes include a relatively high baseline of cognitive function in women compared to men, or a relatively low actual intensity of exercise in women.
, the study concluded that middle-age men should adhere to medium- to high-intensity exercise to reduce the risk of future cognitive decline.
should optimize research design in the future, while detecting patient imaging and other relevant indicators, and further observing and analyzing gender differences.