Longitudinal Associations Between Cardiorespiratory Fitness and Cognition in Older Adults: a 10-year-follow-up from the Generation 100 Study

Introduction: Cardiorespiratory fitness (CRF) is associated with better cognition in older adults. However, the long-term associations between CRF levels and cognitive outcomes remain unclear. This study aimed to investigate the association between baseline CRF, changes in CRF (from baseline to year 1 and year 3) and cognition in older adults. Methods: We included 770 cognitively healthy older adults (367 females; mean age 72.0±2 years at baseline) from the Generation 100 Study. All participants had complete data on CRF and important confounding factors (age, sex, educational attainment and self-rated memory at baseline). Cardiorespiratory fitness was measured directly as peak oxygen uptake using ergospirometry. Cognition was assessed using the Montreal Cognitive Assessment (MoCA) 3-, 5-, and 10 years after baseline. Linear mixed models were used to assess the relationship between CRF at baseline, changes in CRF, and MoCA score over time. Results: The mean MoCA score at year -3, -5, and -10 was 25.3, 25.0 and 24.8, respectively. Higher baseline CRF predicted 0.06 higher MoCA score at year 3 (95% CI 0.02 to 0.09) and 0.07 at year 5 (95 % CI 0.03 to 0.11) but was not associated with MoCA score at year 10 (β 0.02, 95 %CI -0.02 to 0.06). Neither 1-year nor 3-year changes in CRF were associated with MoCA scores at any time point. Conclusions: Changes in CRF over 1 and 3 years were not associated with cognition in healthy older adults. However, higher baseline CRF was linked to better cognition up to 5 years later, suggesting that achieving and maintaining an age-relative high CRF before entering the 7 th decade of life might benefit cognitive aging.