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Regular Physical Activity After Dementia Diagnosis May Lower Mortality Risk

Regular physical activity (PA) following dementia diagnosis could lower the risk of all-cause mortality, according to results from a retrospective cohort study published in the British Journal of Sports Medicine.

“Considering lifestyle factors, health examination data and severity of dementia, our results emphasize the maintenance and initiation of PA after dementia diagnosis, regardless of intensity, to reduce mortality risk,” authors noted. “Light PA might be as beneficial as moderate to vigorous PA for reduction of mortality risk.”

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Researchers used data from the Korean National Health Insurance Service Database, including 60,252 individuals diagnosed with dementia between 2010 and 2016 who underwent health examinations both before and after diagnosis. PA was assessed using the International Physical Activity Questionnaire–Short Form. Multivariable Cox proportional hazards regression models were used to analyze the associations between PA and mortality risk.

During a mean follow-up of 3.7 years, 16,431 (27.3%) deaths occurred. Higher PA levels after dementia diagnosis were associated with a dose-dependent decrease in mortality risk (p for trend <0.001). Maintaining regular PA, when compared with inactivity, was associated with the lowest mortality risk (HR=0.71, 95% CI 0.65 to 0.79). Sustained engagement in PA of any intensity was associated with decreased mortality risk: light (HR=0.70, 95% CI 0.67 to 0.75), moderate (HR=0.74, 95% CI 0.64 to 0.86), and vigorous PA (HR=0.70, 95% CI 0.61 to 0.79). Initiating any PA intensity after dementia diagnosis was associated with at least 20% reduced mortality risk. These associations remained consistent in Alzheimer disease.

“Future studies are warranted to elucidate the causal association between PA and mortality risk in individuals with dementia,” authors concluded. 

Researchers noted that due to the study's retrospective cohort design, they could not eliminate the potential for reverse causality, as individuals with milder dementia and fewer limitations may be more physically active. While administrative data used to detect dementia may differ from actual diagnoses, stringent criteria for claims mitigate this concern. Other study limitations included a lack of data on the type of PA and reliance on the IPAQ–SF questionnaire, which might underestimate shorter bouts of PA, though its criteria align with established guidelines. Self-reported PA data among individuals with dementia could introduce recall bias, but caregiver assistance in completing health check-up questionnaires may reduce this issue. Lastly, the ethnic homogeneity of the sample limits the generalizability of the findings.

 

Reference
Park KY, Huh Y, Nam GE, et al. Changes in physical activity and all-cause mortality among individuals with dementia: a cohort study using the National Health Insurance Service Database in Korea. Br J Sports Med. 2024;58(21):1258-1266. DOI: 10.1136/bjsports-2024-108264