Physical activity and mortality in postmenopausal women. Physical Activity and the Risk of Dementia in Oldest Old Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Leisure activities and cognitive function in elderly community-dwelling individuals in Japan: a 5-year prospective cohort study. Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women's Health Initiative Cohort Study. Integrative Exercise and Lifestyle Intervention Increases Leisure-Time Activity in Breast Cancer Patients Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. Physical activity and risk of cognitive impairment among oldest-old women. Improving cognition by adherence to physical or mental exercise: A moderated mediation analysis Twelve-week physical and leisure activity programme improved cognitive function in community-dwelling elderly subjects: a randomized controlled trial. A prospective study of physical activity and cognitive decline in elderly women: women who walk. The 'Women's Lifestyle Study', 2-year randomized controlled trial of physical activity counselling in primary health care: rationale and study design A complex multimodal activity intervention to reduce the risk of dementia in mild cognitive impairment–ThinkingFit: pilot and feasibility study for a randomized controlled trial Physical activity recommendations and decreased risk of mortality.
OBJECTIVE To evaluate the association between physical activity and all case mortality  in postmenopausal women . DESIGN Prospect i ve cohort study with 7 years of follow-up through December 31 , 1992 . SETTING AND PARTICIPANTS Subjects were 40417 postmenopausal Iowa women , aged 55 to 69 years at baseline in 1986 .  Physical activity was assessed by mailed question naire . MAIN OUTCOME MEASURE  All-cause mortality ( n=2260 ) . RESULTS After adjustment for potential confounders and excluding women who reported having cancer or heart disease and those who died in the first 3 years of follow-up , women who reported regular physical activity were at significantly reduced risk of death during follow-up compared with women who did not ( relative risk [ RR ] , 0.77 ; 95 % confidence interval [ CI ] , 0.66 - 0.90 ) . Increasing frequency of moderate physical activity was associated with reduced risk of death during follow-up ( from rarely or never engaging in activity to activity at least 4 times per week , RRs , 1.0 [ referent ] , 0.76 , 0.70 , and 0.62 ; P value for trend<.001 ) . A similar pattern was seen for vigorous physical activity ( corresponding RRs , 1.0 , 0.89 , 0.74 , and 0.57 ; Pvalue for trend=.06 ) . Reduced risks of death with increased physical activity were evident for cardiovascular diseases ( n=729 ) and respiratory illnesses ( n=147 ) . Women who engaged only in moderate but not vigorous physical activity also benefited , with moderate activity as infrequently as once per week demonstrating a reduced mortality risk of 0.78 ( 95 % CI , 0.64 - 0.96 ) . CONCLUSIONS These results demonstrate a grade d , inverse association between physical activity and all-cause mortality  in postmenopausal women . These findings strengthen the confidence that population recommendations to engage in regular physical activity are applicable to postmenopausal women Objective : This study evaluated the protective role of physical activity ( PA ) against  cognitive impairment ( CI ) in the oldest old ( age ≥ 85 ) . Method : Prospect i ve data on 66 optimally healthy , oldest old adults ( mean age 88.5 ) were analyzed using survival analysis . Results : In all , 12 men and 11 women reported exercising > 4 hours per week , and 38 participants developed CI ( mean onset age 93 ; mean follow-up 4.7 years ) . The effect of exercise was modified by gender . In more active women ( > 4 hours/week ) , the risk of CI was reduced by 88 % ( 95 % confidence interval 0.03 , 0.41 ) compared to those less active . Less active women had 2 times the incidence rate of CI compared to less active men and almost 5 times the rate compared to active women . Discussion : This study demonstrates the beneficial effects of exercise  on healthy brain aging even in the oldest old and emphasizes the importance of increasing PA in older women Context Some studies suggest that people with high levels of physical activity are less likely to develop dementia . Content All 1740 participants in this cohort study were 65 years of age or older and were cognitively intact at baseline . Over 6.2 years , the rate of dementia was 13.0 per 1000 person-years in those who exercised 3 or more times per week and 19.7 per 1000 person-years in those who exercised less than 3 times per week . Limitations The only measure of exercise intensity was self-reported frequency . The cohort was largely white and well-educated . Implication s This study adds to the evidence that regular exercise is associated with a lower risk for dementia . However , the existing evidence does not prove that regular exercise is associated with a lower dementia risk . The Editors Alzheimer disease and other dementing illnesses are major sources of morbidity and mortality ( 1 - 3 ) that affect millions of persons in the increasingly aging society of the United States . Research design ed to discover strategies to delay onset and progression of these potentially devastating illnesses is ongoing worldwide . Effective prevention strategies would result in substantial benefits through improved quality of life , prolonged independent life expectancy , and reduced economic cost and social burdens .  Regular physical exercise is an important element in overall health promotion ( 4 ) and might also be an effective strategy to delay onset of dementia ( 5 ) . A biological basis for how physical exercise might preserve brain function includes improved cerebral blood flow and oxygen delivery ( 6 ) and inducing fibroblast growth factor in the hippocampus ( 7 ) . More recent evidence suggests that reduced loss of hippocampal brain tissue in the aging brain is related to level of physical fitness ( 8) . Evidence from some longitudinal studies and r and omized trials suggests that physical exercise enhances cognitive function in older adults ( 9 - 15 ) , whereas other studies have failed to observe the benefits of physical exercise in preserving cognitive function ( 16 - 19 ) . Many people regard Alzheimer disease as one of the most dreaded consequences of aging . If regular physical exercise were shown to be effective in reducing the risk or delaying the onset of dementing illnesses , it would be another compelling reason to promote physical exercise . Few population -based longitudinal studies have examined the role of physical exercise on the risk for dementia in elderly persons . One recent longitudinal study showed that physical exercise was associated with decreased risk for decline in cognitive function ( odds ratio [ OR ] , 0.58 ) , Alzheimer disease ( OR , 0.50 ) , and any dementia ( OR , 0.63 ) ( 11 ) , whereas another longitudinal study showed no association between physical exercise and dementia ( 16 ) . More recent studies showed that walking was associated with a reduced risk for dementia and Alzheimer disease in a cohort of Japanese-American men ( 20 ) and that engaging in more diverse physical activities was associated with a reduced risk for dementia in the Cardiovascular Health Study ( 21 ) . The purpose of this study was 2-fold : 1 ) to determine whether regular exercise is associated with a reduced risk for incidence of dementia ( in particular , Alzheimer disease ) in a cohort followed biennially over 6 years and 2 ) to examine whether the association of physical exercise with incident dementia is modulated by other potential risk factors , such as depression , cardiovascular and cerebrovascular disease , diabetes , apolipoprotein E 4 allele , cognitive function , physical function , self-rated health , and lifestyle characteristics . Methods Study Sample The Adult Changes in Thought ( ACT ) study is a population -based , longitudinal study of aging and dementia . The ACT study was design ed to determine the incidence of Alzheimer disease , other types of dementia , and cognitive impairment as well as to determine risk factors for these conditions . The details of the ACT study have been described elsewhere ( 22 , 23 ) . Briefly , a r and om sample of 6782 individuals was drawn from Seattle-area members of Group Health Cooperative ( GHC ) , a consumer-governed health maintenance organization . The participants were 65 years of age and older when the study began in 1994 to 1996 . Those who had an existing diagnosis of dementia , were current residents of a nursing home , or were participating in other studies were ineligible ( n= 1360 ) . Of 5422 eligible persons , 2581 participated and 2841 declined participation . Age , sex , and ethnicity of the remaining 2581 participants did not differ significantly from those who were excluded . Nonresponse has been described elsewhere ( 22 ) . Declining to participate was more common among the oldest age group ( > 85 years ) , women , and African-American and minority groups ( 22 ) . Additional details regarding the incident rates of dementia and Alzheimer disease from the ACT study have been published elsewhere and are consistent with rates reported in U.S. and European cohort studies ( 22 ) . The institutional review boards of the University of Washington and Group Health Cooperative approved the ACT study . Participants received the  Cognitive Ability Screening Instrument ( CASI ) ( 24 ) as initial screening for cognitive function and were interviewed with structured question naires to obtain data , including demographic characteristics , medical history , memory and general functioning , and potential epidemiologic risk factors . Persons scoring 86 or higher on the CASI were entered directly into the ACT cohort as being cognitively intact . ( The CASI scores range from 0 to 100 ; a score of 86 corresponds to a Mini-Mental State Examination score of 25 to 26 . ) Persons with a score lower than 86 had additional medical record review and st and ardized clinical and neuropsychological evaluation for dementia . Persons who did not meet established criteria for dementia ( 25 ) were included in the ACT cohort . The current study sample was selected from the 2581 ACT participants to examine the temporal relationship of physical exercise preceding development of dementia . By design , we selected the 1895 persons whose CASI scores were above the 25th percentileCASI scores 91 to 100 . We excluded 686 persons whose CASI scores were in the lowest quartileCASI scores 62 to 90because the lowest quartile group might include persons who had mild cognitive impairment or impending dementia ( 26 ) . We did not collect information about the history of exercise before the participants entered the study . Therefore , in the group with low CASI scores , we could not be certain whether a reported low level of physical exercise preceded the development of dementia or was a consequence of the development of cognitive impairment or dementia . Of 1895 participants selected , 155 withdrew after the baseline visit and did not have a follow-up examination and were thus excluded from the analyses , leaving the analytic sample of 1740 persons . Incident Dementia We conducted biennial examinations to identify cases of incident dementia , when participants were rescreened with the CASI . Those who scored 86 or higher on the CASI remained in the ACT cohort . Scores on the CASI that were less than 86 at follow-up prompted a full st and ardized clinical examination . The results of rescreening by the CASI and by the clinical and neuropsychological examinations were review ed at a consensus diagnosis conference that included at least the examining physician , a neuropsychologist , another study physician , and the study nurse . Persons who did not meet the criteria for dementia were considered as not having dementia and were followed in the ACT cohort ( 22 , 23 ) . Persons who met the Diagnostic and Statistical Manual of Mental Disorders , fourth edition ( DSM-IV ) , criteria ( 25 ) for dementia were considered to have incident dementia . Dementia type was determined by the National Institute of Neurological and Communicative Diseases and Stroke-Alzheimer 's Disease and Related Disorders Association ( NINCDS-ADRDA ) criteria ( 27 ) for Alzheimer disease and by the DSM-IV criteria ( 25 ) for other types of dementia . Level of physical activity was not considered at the consensus conference . Physical Exercise Physical exercise was assessed at baseline by asking participants the number of days per week they did each of the following activities for at least 15 minutes at a time during the past year : walking , hiking , bicycling , aerobics or calisthenics , swimming , water aerobics , weight training or stretching , or other exercise . The frequency of exercise was calculated by the times per week that participants engaged in any of these forms of exercise . In this study , persons who exercised at least 3 times a week , above the lowest quartile , were classified as exercising regularly . Baseline Variables as Potential Confounders Numerous factors may influence the relationship between exercise and risk for dementia , including physical functioning , cognitive function , depression , health conditions , and lifestyle characteristics . Physical function was assessed by a performance-based physical function ( PPF ) test ( 23 ) , which consisted of 4 performance tests : 10-foot timed walk , time to st and from a seated position in a chair to a st and ing position 5 times , balance test , and grip strength in the dominant h and . Each test was scored from 0 to 4 points . The final PPF score was the sum of the scores for the 4 performance tests and ranged from 0 to 16 ; higher scores indicated better physical function . Details of the PPF test have been reported elsewhere ( 23 ) . Cognitive function was assessed by using the CASI , which provides quantitative assessment of attention , concentration , orientation , short-term memory , long-term memory , language ability , visual construction , list-generating fluency , abstract ion , and judgment ( 24 ) . At baseline , depression was measured by using the 11-item Center for Epidemiologic Studies Depression ( CES-D ) scale ( 28 ) . The CES-D scores ranged from 0 to 33 , with higher scores BACKGROUND Physical activity is associated with low mortality in men , but little is known about the association in women , different age groups , and everyday activity . OBJECTIVE To evaluate the relationship between levels of physical activity during work , leisure time , cycling to work , and sports participation and all-cause mortality . DESIGN Prospect i ve study to assess different types of physical activity associated with risk of mortality during follow-up after the subsequent examination . Mean follow-up from examination was 14.5 years . SETTING Copenhagen University Hospital , Copenhagen , Denmark . PARTICIPANTS Participants were 13,375 women and 17,265 men , 20 to 93 years of age , who were r and omly selected .  Physical activity was assessed by self-report , and health status , including  blood pressure , total cholesterol level , triglyceride levels , body mass index , smoking , and educational level  , was evaluated . MAIN OUTCOME MEASURE All-cause mortality . RESULTS A total of 2,881 women and 5,668 men died . Compared with the sedentary , age- and sex-adjusted mortality rates in leisure time physical activity groups 2 to 4 were 0.68 ( 95 % confidence interval , 0.64 - 0.71 ) , 0.61 ( 95 % confidence interval , 0.57 - 0.66 ) , and 0.53 ( 95 % confidence interval , 0.41 - 0.68 ) , respectively , with no difference between sexes and age groups . Within the moderately and highly active persons , sports participants experienced only half the mortality of non participants . Bicycling to work decreased risk of mortality in approximately 40 % after multivariate adjustment , including leisure time physical activity . CONCLUSIONS Leisure time physical activity was inversely associated with  all-cause mortality in both men and women in all age groups . Benefit was found from moderate leisure time physical activity , with further benefit from sports activity and bicycling as transportation OBJECTIVE This study aim ed to clarify the longitudinal relationship between leisure activities and cognitive decline  among Japanese community-dwelling older adults , using a 5-year prospect i ve cohort study design . METHODS A total of 567 men and women , aged 70years and over , participated in the study . The  Mini-Mental State Examination was used in baseline and follow-up surveys to assess cognitive function . The change in cognitive function from baseline to follow-up was determined , and cognitive decline over 5years was used as the outcome variable .  Leisure activities ( hobby , social activity , and physical activity )  were assessed at baseline and used as independent variables . Age , gender , number of years of education , presence of chronic diseases , instrumental activities of daily living , depressive symptoms , smoking , hearing deficits , and level of cognitive function at baseline were used as covariates . RESULTS Multivariate logistic regression analysis , adjusted for potential confounders , showed that non-participation in a hobby  was significantly and independently associated with cognitive decline ( odds ratio : 1.87 , 95 % confidence interval : 1.16 - 3.02 , p<0.01 ) . There were no significant relationships between social activity , physical activity and cognitive decline . CONCLUSIONS Our study found a longitudinal inverse relationship between hobby participation and cognitive decline among elderly Japanese community-dwelling individuals , suggesting that engaging in a hobby in later life can contribute to preserving cognitive function CONTEXT Women who are  physically active  have a decreased risk for breast cancer , but the types , amounts , and timing of activity needed are unknown . OBJECTIVE To prospect ively examine the association between current and past recreational physical activity and incidence of  breast cancer in postmenopausal women . DESIGN , SETTING , AND PATIENTS Prospect i ve cohort study in 74 171 women aged 50 to 79 years who were recruited by 40 US clinical centers from 1993 through 1998 . MAIN OUTCOME MEASURE Incident invasive and in situ breast cancer . RESULTS We documented 1780 newly diagnosed cases of breast cancer over a mean follow-up of 4.7 years . Compared with less active women , women who engaged in regular strenuous physical activity at age 35 years had a 14 % decreased risk of breast cancer ( relative risk [ RR ] , 0.86 ; 95 % confidence interval [ CI ] , 0.78 - 0.95 ) . Similar but attenuated findings were observed for strenuous physical activity at ages 18 years and 50 years . An increasing total current physical activity score was associated with a reduced risk for breast cancer ( P = .03 for trend ) . Women who engaged in the equivalent of 1.25 to 2.5 hours per week of brisk walking had an 18 % decreased risk of breast cancer ( RR , 0.82 ; 95 % CI , 0.68 - 0.97 ) compared with inactive women . Slightly greater reduction in risk was observed for women who engaged in the equivalent of 10 hours or more per week of brisk walking . The effect of exercise  was most pronounced in women in the lowest tertile of body mass index ( BMI ) ( < 24.1 ) , but also was observed for women in the middle tertile of BMI ( 24.1 - 28.4 ) . CONCLUSIONS These data suggest that increased physical activity is associated with reduced risk for breast cancer in postmenopausal women , longer duration provides most benefit , and that such activity need not be strenuous Background . Physical activity has been demonstrated to increase survival in breast cancer patients , but few breast cancer patients meet the general recommendations for physical activity . The aim of this pilot study was to investigate if a supervised integrated counseling and group-based exercise program could increase leisure-time activity in women with breast cancer . Methods . This pilot project , design ed as a single-arm study with pre-post testing , consisted of 24 classes of combined aerobic and strength exercise training as well as classes on dietary and health behavior . A total of 48 women with breast cancer who were undergoing or had recently completed anticancer treatment completed the study .  Leisure-time physical activity , grip strength , functional capacity , quality of life ( QoL ) , and depression were assessed at baseline , after intervention , and at the 12-week follow-up after intervention . Results . The breast cancer patients increased their leisure-time physical activity ( P = .004 ) , global strength ( P = .004 ) , functional capacity ( P = .001 ) , and QoL ( P = .009 ) , and their depression score ( P = .004 ) significantly decreased . These improvements were independent of whether the patients were in ongoing therapy or had completed their treatment . Conclusion . This integrated intervention may produce lifestyle changes in breast cancer patients and survivors using the teachable moment to increase their leisure-time physical activity and , thereby , their CONTEXT Many observational studies have shown that physical activity reduces the risk of cognitive decline ; however , evidence from r and omized trials is lacking . OBJECTIVE To determine whether physical activity reduces the rate of cognitive decline among older adults at risk . DESIGN AND SETTING R and omized controlled trial of a 24-week physical activity intervention conducted between 2004 and 2007 in metropolitan Perth , Western Australia . Assessors of cognitive function were blinded to group membership . PARTICIPANTS We recruited volunteers who reported memory problems but did not meet criteria for dementia . Three hundred eleven individuals aged 50 years or older were screened for eligibility , 89 were not eligible , and 52 refused to participate . A total of 170 participants were r and omized and 138 participants completed the 18-month assessment . INTERVENTION Participants were r and omly allocated to an education and usual care group or to a 24-week home-based program of physical activity . MAIN OUTCOME MEASURE Change in Alzheimer Disease Assessment Scale-Cognitive Subscale ( ADAS-Cog ) scores ( possible range , 0 - 70 ) over 18 months . RESULTS In an intent-to-treat analysis , participants in the intervention group improved 0.26 points ( 95 % confidence interval , -0.89 to 0.54 ) and those in the usual care group deteriorated 1.04 points ( 95 % confidence interval , 0.32 to 1.82 ) on the ADAS-Cog at the end of the intervention . The absolute difference of the outcome measure between the intervention and control groups was -1.3 points ( 95 % confidence interval,-2.38 to -0.22 ) at the end of the intervention . At 18 months , participants in the intervention group improved 0.73 points ( 95 % confidence interval , -1.27 to 0.03 ) on the ADAS-Cog , and those in the usual care group improved 0.04 points ( 95 % confidence interval , -0.46 to 0.88 ) . Word list delayed recall and Clinical Dementia Rating sum of boxes improved modestly as well , whereas word list total immediate recall , digit symbol coding , verbal fluency , Beck depression score , and Medical Outcomes 36-Item Short-Form physical and mental component summaries did not change significantly . CONCLUSIONS In this study of adults with subjective memory impairment , a 6-month program of physical activity provided a modest improvement in cognition over an 18-month follow-up period . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000136606 BACKGROUND The health benefits of leisure-time physical activity are well known , but whether less exercise than the recommended 150 min a week can have life expectancy benefits is unclear . We assessed the health benefits of a range of volumes of physical activity in a Taiwanese population . METHODS In this prospect i ve cohort study , 416,175 individuals ( 199,265 men and 216,910 women ) participated in a st and ard medical screening programme in Taiwan between 1996 and 2008 , with an average follow-up of 8·05 years ( SD 4·21 ) . On the basis of the amount of weekly exercise indicated in a self-administered question naire , participants were placed into one of five categories of exercise volumes : inactive , or low , medium , high , or very high activity . We calculated hazard ratios ( HR ) for mortality risks for every group compared with the inactive group , and calculated life expectancy for every group . FINDINGS Compared with individuals in the inactive group , those in the low-volume activity group , who exercised for an average of 92 min per week ( 95 % CI 71 - 112 ) or 15 min a day ( SD 1·8 ) , had a 14 % reduced risk of all-cause mortality ( 0·86 , 0·81 - 0·91 ) , and had a 3 year longer life expectancy . Every additional 15 min of daily exercise beyond the minimum amount of 15 min a day further reduced all-cause mortality by 4 % ( 95 % CI 2·5 - 7·0 ) and all-cancer mortality by 1 % ( 0·3 - 4·5 ) . These benefits were applicable to all age groups and both sexes , and to those with cardiovascular disease risks . Individuals who were inactive had a 17 % ( HR 1·17 , 95 % CI 1·10 - 1·24 ) increased risk of mortality compared with individuals in the low-volume group . INTERPRETATION 15 min a day or 90 min a week of moderate-intensity exercise might be of benefit , even for individuals at risk of cardiovascular disease . FUNDING Taiwan Department of Health Clinical Trial and Research Center of Excellence and National Health Research Institutes IMPORTANCE The 2008 Physical Activity Guidelines for Americans recommended a minimum of 75 vigorous-intensity or 150 moderate-intensity minutes per week ( 7.5 metabolic-equivalent hours per week ) of aerobic activity for substantial health benefit and suggested additional benefits by doing more than double this amount . However , the upper limit of longevity benefit or possible harm with more physical activity is unclear . OBJECTIVE To quantify the dose-response association between leisure time physical activity and mortality and define the upper limit of benefit or harm associated with increased levels of physical activity . DESIGN , SETTING , AND PARTICIPANTS We pooled data from 6 studies in the National Cancer Institute Cohort Consortium ( baseline 1992 - 2003 ) . Population -based prospect i ve cohorts in the United States and Europe with self-reported physical activity were analyzed in 2014 . A total of 661,137 men and women ( median age , 62 years ; range , 21 - 98 years ) and 116,686 deaths were included . We used Cox proportional hazards regression with cohort stratification to generate multivariable-adjusted hazard ratios ( HRs ) and 95 % CIs . Median follow-up time was 14.2 years . EXPOSURES Leisure time moderate- to vigorous-intensity physical activity . MAIN OUTCOMES AND MEASURES The upper limit of mortality benefit from high levels of leisure time physical activity . RESULTS Compared with individuals reporting no leisure time physical activity , we observed a 20 % lower mortality risk among those performing less than the recommended minimum of 7.5 metabolic-equivalent hours per week ( HR , 0.80 [ 95 % CI , 0.78 - 0.82 ] ) , a 31 % lower risk at 1 to 2 times the recommended minimum ( HR , 0.69 [ 95 % CI , 0.67 - 0.70 ] ) , and a 37 % lower risk at 2 to 3 times the minimum ( HR , 0.63 [ 95 % CI , 0.62 - 0.65 ] ) . An upper threshold for mortality benefit occurred at 3 to 5 times the physical activity recommendation ( HR , 0.61 [ 95 % CI , 0.59 - 0.62 ] ) ; however , compared with the recommended minimum , the additional benefit was modest ( 31 % vs 39 % ) . There was no evidence of harm at 10 or more times the recommended minimum ( HR , 0.69 [ 95 % CI , 0.59 - 0.78 ] ) . A similar dose-response relationship was observed for mortality due to cardiovascular disease and to cancer . CONCLUSIONS AND RELEVANCE Meeting the 2008 Physical Activity Guidelines for Americans minimum by either moderate- or vigorous-intensity activities was associated with nearly the maximum longevity benefit . We observed a benefit threshold at approximately 3 to 5 times the recommended leisure time physical activity minimum and no excess risk at 10 or more times the minimum . In regard to mortality , health care professionals should encourage inactive adults to perform leisure time physical activity and do not need to discourage adults who already participate in high-activity levels OBJECTIVES Physical activity may reduce the risk of cognitive decline in the elderly , but its effects among the oldest-old ( i.e. , those aged 85 years and older ) are not well known . Our study assessed the association between very late-life physical activity and 5-year risk of  mild cognitive impairment ( MCI ) or dementia and neuropsychological test performance among oldest-old women . METHODS This prospect i ve study was conducted at three sites . Participants included 1,249 women ( mean [ st and ard deviation ] age : 83.3 [ 2.8 ] years ) .  Baseline physical activity  was measured by self-reported blocks walked per week and analyzed according to tertile . Five years later , surviving participants who were 85 years and older ( oldest-old ) completed neuropsychological testing and underwent adjudication of clinical cognitive status ( normal , MCI , or dementia ) . All analyses were adjusted for baseline age , education , cognition , depression , body mass index , hypertension , smoking , and coronary artery disease . RESULTS Compared with women in the lowest tertile , women in the highest tertile were less likely to develop dementia ( 13.0 % versus 23.2 % ; multivariate adjusted odds ratio : 0.54 [ 95 % confidence interval : 0.36 - 0.82 ] ) . However , risk of MCI was not associated with physical activity . Physical activity was also associated with higher performance 5 years later on tests of global cognition , category fluency , and executive function but not phonemic fluency , memory , or attention . CONCLUSIONS Higher level of very late-life physical activity was associated with a lower risk of subsequent dementia  in oldest-old women . These findings support future studies for late-life physical activity interventions for the prevention of dementia among oldest-old women Background : The role of adherence to an intervention is examined to further underst and the relationship between performing new challenging activities ( either mental or physical ones ) and their putative cognitive benefits . Method : Healthy older women ( N = 229 , age range : 70–93 years ) took part in a six-month r and omised controlled trial , covering either a physical or mental activity ( three × weekly ) . They completed five tests , measuring episodic and working memory pre- and post-intervention . A moderated mediation model was specified to test the strength of the indirect effect of the activity mode ( i.e. physical vs. mental ) through adherence ( i.e. time spent on course attendance ) on levels of baseline cognitive performance . Results : Both physical and mental activity groups performed better over time than the control group ( p < 0.001 ) . Adherence predicted cognitive performance ( p = 0.011 ) . The indirect effect of the activity mode on cognitive performance through adherence was especially seen when levels of baseline composite scores were low ( p = 0.023 ) . Conclusion : Older healthy women can improve episodic and working memory through spending time on a challenging physical or mental activity . Results are most promising for cognitively less fit women . Time spent on course attendance can be interpreted as an adherence indicator that makes a difference for various cognitive outcomes of the intervention BACKGROUND Japan is one of the most rapidly ageing societies in the world . A number of municipalities have started services for the prevention of cognitive decline for community-dwelling elderly individuals , but the effectiveness of these services is currently insufficient . Our study explored the efficacy of a comprehensive intervention programme consisting of physical and leisure activities to prevent cognitive decline in community-dwelling elderly subjects . METHOD We administered a 12-week intervention programme consisting of physical and leisure activities aim ed at enhancing participants ' motivation to participate and support one another by providing a pleasant atmosphere , empathetic communication , praise , and errorless support . This programme for the prevention of cognitive decline was conducted as a service by the city of Maebashi . All participants underwent the Five-Cog test , which evaluated the cognitive domains of attention , memory , visuospatial function , language , and reasoning . Executive function was evaluated by the Wechsler Digit Symbol Substitution Test and Yamaguchi Kanji-Symbol Substitution Test . Subjective health status , level of social support , functional capacity , subjective quality of life , and depressive symptoms were assessed with a question naire . Grip strength test , timed up- and -go test , 5-m maximum walking times test , and functional reach test were performed to evaluate physical function . Fifty-two participants were r and omly allocated to  intervention ( n = 26 ) and control ( n = 26 ) groups . Twenty-six participants , aged between 65 - 87 years , received intervention once a week at a community centre . The programme was conducted by health-care professionals , with the help of senior citizen volunteers . RESULTS The intervention group ( n = 19 ) showed significant improvement on the analogy task of the Five-Cog test ( F(1,38 ) = 4.242 , P = 0.046 ) and improved quality of life ( F(1,38 ) = 4.773 , P = 0.035 ) as compared to the control group ( n = 24 ) . CONCLUSION A community-based 12-week intervention programme that aim ed to enhance motivation to participate in activities result ed in improvements in some aspects of cognitive function and quality of life .  Senior citizens who volunteered in the present intervention enabled the smooth implementation of the programme and alleviated the burden on professional staff BACKGROUND Several studies have suggested that physical activity is positively associated with cognitive function in elderly persons . Evidence about this association has been limited by the cross-sectional design of most studies and by the frequent lack of adjustment for potential confounding variables . We determined whether physical activity is associated with cognitive decline in a prospect i ve study of older women . METHODS We studied 5925 predominantly white community-dwelling women ( aged > or = 65 years ) who were recruited at 4 clinical centers and were without baseline cognitive impairment or physical limitations . We measured cognitive performance using a modified  Mini-Mental State Examination  at baseline and 6 to 8 years later .  Physical activity  was measured by self-reported blocks ( 1 block approximately 160 m ) walked per week and by total kilocalories ( energy ) expended per week in recreation , blocks walked , and stairs climbed . Cognitive decline was defined as a 3-point decline or greater on repeated modified Mini-Mental State Examination . RESULTS Women with a greater physical activity level at baseline were less likely to experience cognitive decline during the 6 to 8 years of follow-up : cognitive decline occurred in 17 % , 18 % , 22 % , and 24 % of those in the highest , third , second , and lowest quartile of blocks walked per week ( P < .001 for trend ) . Almost identical results were obtained by quartile of total kilocalories expended per week . After adjustment for age , educational level , comorbid conditions , smoking status , estrogen use , and functional limitation , women in the highest quartile remained less likely than women in the lowest quartile to develop cognitive decline ( for blocks walked : odds ratio , 0.66 [ 95 % confidence interval , 0.54 - 0.82 ] ; for total kilocalories : odds ratio , 0.74 [ 95 % confidence interval , 0.60 - 0.90 ] ) . CONCLUSIONS Women with higher levels of baseline physical activity were less likely to develop cognitive decline . This association was not explained by differences in baseline function or health status . This finding supports the hypothesis that physical activity prevents cognitive decline in older community-dwelling women Background Physical inactivity is an independent risk factor for diabetes and heart disease . There is evidence that increasing physical activity can reduce the risk of developing these chronic diseases , but less evidence about effective ways to increase adherence to physical activity . Interventions are therefore needed that produce sustained increases in adherence to physical activity , are cost-effective and improve clinical endpoints . Methods The Women 's Lifestyle Study is a two year r and omized controlled trial involving a nurse-led intervention to increase physical activity in 40–74 year old physically inactive women recruited from primary care . Baseline measures were assessed in a face-to-face interview with a primary care nurse . The intervention involved delivery of a ' Lifestyle script ' by a primary care nurse followed by telephone counselling for nine months and a face-to-face nurse visit at six months . Outcome measurements are assessed at 12 and 24 months . The primary outcome is physical activity measured using a vali date d physical activity question naire . Secondary outcomes include blood pressure , weight , waist circumference , physical fitness ( step test ) , serum HbA1c , fasting glucose , lipids , insulin , and quality of life ( SF36 ) . Costs were measured prospect ively to allow a subsequent cost-effectiveness evaluation if the trial is positive . Discussion Due to report in 2008 , the Women 's Lifestyle Study tests the effectiveness of an enhanced low-cost , evidence -based intervention in increasing physical activity , and improving cardiovascular and diabetes risk indicators over two years . If successful in demonstrating improvements in health outcomes , this r and omized controlled trial will be the first to demonstrate long-term cardiovascular and diabetes risk health benefit , in addition to improvements in physical activity , from a sustainable physical activity intervention based in primary care . Trial Registration Australian Clinical Trials Registry ( ACTR ) , ACTRN012605000490673 Background Dementia affects 35 million people worldwide and is currently incurable . Many cases may be preventable because regular participation in physical , mental and social leisure activities during middle age is associated with up to 47 % dementia risk reduction . However , the majority of middle-aged adults are not active enough . MCI is therefore a clear target for activity interventions aim ed at reducing dementia risk . An active lifestyle during middle age reduces dementia risk but it remains to be determined if increased activity reduces dementia risk when MCI is already evident . Before this can be investigated conclusively , complex multimodal activity programmes are required that ( 1 ) combine multiple health promoting activities , ( 2 ) engage people with MCI , and ( 3 ) result in sufficient adherence rates . Methods We design ed the ThinkingFit programme to engage  people with MCI  in a complex intervention comprised of three activity components : physical activity , group-based cognitive stimulation ( GCST ) and individual cognitive stimulation ( ICST ) . Engagement and adherence was promoted by applying specific psychological techniques to enhance behavioural flexibility in an early pre-phase and during the course of the intervention . To pilot the intervention , participants served as their own controls during a 6- to 12-week run-in period , which was followed by 12 weeks of activity intervention . Results Out of 212 MCI patients screened , 163 were eligible , 70 consented and 67 completed the intervention ( mean age 74 years ) .  Activity adherence rates were high : physical activity = 71 % ; GCST = 83 % ; ICST = 67 % . Significant treatment effects ( p < .05 ) were evident on physical health outcomes ( decreased BMI and systolic blood pressure , [ pre/post values of 26.3/25.9 kg/m2 and 145/136 mmHg respectively ] ) , fitness ( decreased resting and recovery heart rate [ 68/65 bpm and 75/69 bpm ] ) , and cognition ( improved working memory [ 5.3/6.3 items ] ) . Conclusions We found satisfactory recruitment , retention and engagement rates , coupled with significant treatment effects in elderly MCI patients . It appears feasible to conduct r and omized controlled trials of the dementia prevention potential of complex multimodal activity programmes like ThinkingFit . Trial registration Clinical Trials.gov registration nr : NCT01603862 ; date : 17/5/2012 BACKGROUND Whether national physical activity recommendations are related to mortality benefit is incompletely understood . METHODS We prospect ively examined physical activity guidelines in relation to mortality  among 252,925 women and men aged 50 to 71 years in the National Institutes of Health-American Association of Retired Persons ( NIH-AARP ) Diet and Health Study .  Physical activity was assessed using 2 self-administered baseline question naires . RESULTS During 1,265,347 person-years of follow-up , 7,900 participants died . Compared with being inactive , achievement of activity levels that approximate the recommendations for moderate activity ( at least 30 minutes on most days of the week ) or vigorous exercise ( at least 20 minutes 3 times per week ) was associated with a 27 % ( relative risk [ RR ] , 0.73 ; 95 % confidence interval [ CI ] , 0.68 - 0.78 ) and 32 % ( RR , 0.68 ; 95 % CI , 0.64 - 0.73 ) decreased mortality risk , respectively . Physical activity reflective of meeting both recommendations was related to substantially decreased mortality risk overall ( RR , 0.50 ; 95 % CI , 0.46 - 0.54 ) and in subgroups , including smokers ( RR , 0.48 ; 95 % CI , 0.44 - 0.53 ) and nonsmokers ( RR , 0.54 ; 95 % CI , 0.45 - 0.64 ) , normal weight ( RR , 0.45 ; 95 % CI , 0.39 - 0.52 ) and overweight or obese individuals ( RR , 0.48 ; 95 % CI , 0.44 - 0.54 ) , and those with 2 h/d ( RR , 0.53 ; 95 % CI , 0.44 - 0.63 ) and more than 2 h/d of television or video watching ( RR , 0.50 ; 95 % CI , 0.45 - 0.55 ) . Engaging in physical activity at less than recommended levels was also related to reduced mortality risk ( RR , 0.81 ; 95 % CI , 0.76 - 0.86 ) . CONCLUSIONS Following physical activity guidelines is associated with lower risk of death . Mortality benefit may also be achieved by engaging in less than recommended activity levels
In this review we found that exercise interventions ( or lifestyle activities ) that improved cardiorespiratory exercise capacity showed the most positive impact on physical health .
CONCLUSIONS Findings suggest that programs should facilitate and support women to participate in regular exercise by embedding physical activity programs in public health initiatives , by developing home-based exercise programs that require few re sources and by creating interventions that can incorporate physical activity within a healthy lifestyle .
The review also suggests that clinicians should consider prescribing exercise in a tailored manner for older women to ensure that it is of a high enough intensity to obtain the positive sustained effects of exercise
BACKGROUND Participation in regular physical activity is among the most promising and cost effective strategies to reduce physical and cognitive decline and premature death .
However , confusion remains about the amount , frequency , and duration of physical activity that is likely to provide maximum benefit as well as the way in which interventions should be delivered .
AIMS This paper aim ed to review research on the impact of leisure-time and general physical activity levels on physical and cognitive decline in postmenopausal women .