April 3, 2014Open Access
Cardiorespiratory fitness and cognitive function in middle age
Key Result
Greater baseline cardiorespiratory fitness was associated with better verbal memory (0.12 words higher per minute of CRF, p<0.0001), psychomotor speed, and executive function 25 years later.
Study Design
Type
Cohort (n=2,747)
Multicenter
Yes
Structured PICO
Does greater cardiorespiratory fitness in young adulthood improve cognitive function 25 years later?
P
Population
2,747 black and white men and women aged 18 to 30 years at baseline, followed for 25 years to assess the association between cardiorespiratory fitness and cognitive function.
E
Exposure
Higher cardiorespiratory fitness (CRF) measured by symptom-limited maximal treadmill test duration
C
Comparator
Lower cardiorespiratory fitness (CRF)
O
Outcome
Cognitive function at year 25 measured by verbal memory (Rey Auditory Verbal Learning Test [RAVLT]), psychomotor speed (Digit Symbol Substitution Test [DSST]), and executive function (Stroop Test)surrogate
Greater cardiorespiratory fitness in young adulthood is significantly associated with better verbal memory and psychomotor speed 25 years later in middle age.
Main Result
Mean Difference: 0.12
p-value: p=<0.0001
Abstract
OBJECTIVE: To investigate whether greater cardiorespiratory fitness (CRF) is associated with better cognitive function 25 years later. METHODS: We studied 2,747 participants in the community-based Coronary Artery Risk Development in Young Adults Study of black and white men and women aged 18 to 30 years at recruitment in 1985-1986 (baseline year 0). Symptom-limited maximal treadmill test durations at years 0 and 20 provided measures of CRF. Cognitive tests at year 25 measured verbal memory (Rey Auditory Verbal Learning Test RAVLT), psychomotor speed (Digit Symbol Substitution Test DSST), and executive function (Stroop Test). RESULTS: Per minute of baseline CRF, the RAVLT was 0.12 words recalled higher (standard error SE = 0.03, p < 0.0001), the DSST was 0.92 digits higher (SE = 0.13, p < 0.0001), and the Stroop Test score was 0.52 lower (better performance, SE = 0.11, p < 0.0001), after accounting for race, sex, age, education, and clinical center. Compared with the lowest quartile of CRF, each cognitive test was 21% to 34% of an SD better in the highest CRF quartile. Further adjustment for lifestyle and clinical measures attenuated coefficients for RAVLT and DSST slightly, while the coefficient predicting the Stroop Test lost more than half its value (p = 0.07). Analysis in the subset of 1,957 participants who also completed the year-20 treadmill test showed that 20-year change in CRF was positively associated only with DSST (p < 0.001). CONCLUSIONS: Better verbal memory and faster psychomotor speed at ages 43 to 55 years were clearly associated with better CRF 25 years earlier.