by Ying Sun, Chi Chen, Yuetian Yu, Haojie Zhang, Xiao Tan, Jihui Zhang, Lu Qi, Yingli Lu and Ningjian Wang
Abstract:
BACKGROUND: Whether or not there is targeted pharmacotherapy for dementia, an active and healthy lifestyle that includes physical activity (PA) may be a better option than medication for preventing dementia. We examined the association between leisure-time sedentary behavior (SB) and the risk of dementia incidence and mortality. We further quantified the effect on dementia risk of replacing sedentary time with an equal amount of time spent on different physical activities. METHODS: In the UK Biobank, 484,169 participants (mean age = 56.5 years; 45.2% men) free of dementia were followed from baseline (2006-2010) through July 30, 2021. A standard questionnaire measured individual leisure-time SB (watching TV, computer use, and driving) and PA (walking for pleasure, light and heavy do-it-yourself activity, strenuous sports, and other exercise) frequency and duration in the 4 weeks prior to evaluation. Apolipoprotein E (APOE) genotype data were available for a subset of 397,519 (82.1%) individuals. A Cox proportional hazard model and an isotemporal substitution model were used in this study. RESULTS: During a median 12.4 years of follow-up, 6904 all-cause dementia cases and 2115 deaths from dementia were recorded. In comparison to participants with leisure-time SB <5 h/day, the hazard ratio ((HR), 95% confidence interval (95%CI)) of dementia incidence was 1.07 (1.02-1.13) for 5-8 h/day and 1.25 (1.13-1.38) for >8 h/day, and the HR of dementia mortality was 1.35 (1.12-1.61) for >8 h/day. A 1 standard deviation increment of sedentary time (2.33 h/day) was strongly associated with a higher incidence of dementia and mortality (HR = 1.06, 95%CI: 1.03-1.08 and HR = 1.07, 95%CI: 1.03-1.12, respectively). The association between sedentary time and the risk of developing dementia was more profound in subjects <60 years than in those ≥60 years (HR = 1.26, 95%CI: 1.00-1.58 vs. HR = 1.21, 95%CI: 1.08-1.35 in >8 h/day, p for interaction = 0.013). Replacing 30 min/day of leisure sedentary time with an equal time spent in total PA was associated with a 6% decreased risk and 9% decreased mortality from dementia, with exercise (e.g., swimming, cycling, aerobics, bowling) showing the strongest benefit (HR = 0.82, 95%CI: 0.78-0.86 and HR = 0.79, 95%CI: 0.72-0.86). Compared with APOE ε4 noncarriers, APOE ε4 carriers are more likely to see a decrease in Alzheimer's disease incidence and mortality when PA is substituted for SB. CONCLUSION: Leisure-time SB was positively associated with the risk of dementia incidence and mortality. Replacing sedentary time with equal time spent doing PA may be associated with a significant reduction in dementia incidence and mortality risk.
Reference:
Replacement of leisure-time sedentary behavior with various physical activities and the risk of dementia incidence and mortality: A prospective cohort study. (Ying Sun, Chi Chen, Yuetian Yu, Haojie Zhang, Xiao Tan, Jihui Zhang, Lu Qi, Yingli Lu and Ningjian Wang), In J Sport Health Sci, volume 12, 2023.
Bibtex Entry:
@article{Sun:2023aa,
abstract = {BACKGROUND: Whether or not there is targeted pharmacotherapy for dementia, an active and healthy lifestyle that includes physical activity (PA) may be a better option than medication for preventing dementia. We examined the association between leisure-time sedentary behavior (SB) and the risk of dementia incidence and mortality. We further quantified the effect on dementia risk of replacing sedentary time with an equal amount of time spent on different physical activities. METHODS: In the UK Biobank, 484,169 participants (mean age = 56.5 years; 45.2% men) free of dementia were followed from baseline (2006-2010) through July 30, 2021. A standard questionnaire measured individual leisure-time SB (watching TV, computer use, and driving) and PA (walking for pleasure, light and heavy do-it-yourself activity, strenuous sports, and other exercise) frequency and duration in the 4 weeks prior to evaluation. Apolipoprotein E (APOE) genotype data were available for a subset of 397,519 (82.1%) individuals. A Cox proportional hazard model and an isotemporal substitution model were used in this study. RESULTS: During a median 12.4 years of follow-up, 6904 all-cause dementia cases and 2115 deaths from dementia were recorded. In comparison to participants with leisure-time SB <5 h/day, the hazard ratio ((HR), 95% confidence interval (95%CI)) of dementia incidence was 1.07 (1.02-1.13) for 5-8 h/day and 1.25 (1.13-1.38) for >8 h/day, and the HR of dementia mortality was 1.35 (1.12-1.61) for >8 h/day. A 1 standard deviation increment of sedentary time (2.33 h/day) was strongly associated with a higher incidence of dementia and mortality (HR = 1.06, 95%CI: 1.03-1.08 and HR = 1.07, 95%CI: 1.03-1.12, respectively). The association between sedentary time and the risk of developing dementia was more profound in subjects <60 years than in those ≥60 years (HR = 1.26, 95%CI: 1.00-1.58 vs. HR = 1.21, 95%CI: 1.08-1.35 in >8 h/day, p for interaction = 0.013). Replacing 30 min/day of leisure sedentary time with an equal time spent in total PA was associated with a 6% decreased risk and 9% decreased mortality from dementia, with exercise (e.g., swimming, cycling, aerobics, bowling) showing the strongest benefit (HR = 0.82, 95%CI: 0.78-0.86 and HR = 0.79, 95%CI: 0.72-0.86). Compared with APOE ε4 noncarriers, APOE ε4 carriers are more likely to see a decrease in Alzheimer's disease incidence and mortality when PA is substituted for SB. CONCLUSION: Leisure-time SB was positively associated with the risk of dementia incidence and mortality. Replacing sedentary time with equal time spent doing PA may be associated with a significant reduction in dementia incidence and mortality risk.},
address = {Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.; Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.; Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.; Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.; Department of Medical Sciences, Uppsala University, Uppsala 751 85, Sweden; School of Public Health, Zhejiang University, Hangzhou 310058, China.; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510180, China.; Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.; Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China. Electronic address: luyingli2008@126.com.; Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China. Electronic address: wnj486@126.com.},
author = {Sun, Ying and Chen, Chi and Yu, Yuetian and Zhang, Haojie and Tan, Xiao and Zhang, Jihui and Qi, Lu and Lu, Yingli and Wang, Ningjian},
cois = {The authors declare that they have no competing interests.},
copyright = {Copyright {\copyright}2023. Production and hosting by Elsevier B.V.},
crdt = {2022/11/15 19:26},
date = {2023 May},
date-added = {2023-06-19 19:41:17 +0100},
date-modified = {2023-06-19 19:52:53 +0100},
dcom = {20230517},
dep = {20221113},
doi = {10.1016/j.jshs.2022.11.005},
edat = {2022/11/16 06:00},
gr = {MC{\_}PC{\_}17228/MRC{\_}/Medical Research Council/United Kingdom; MC{\_}QA137853/MRC{\_}/Medical Research Council/United Kingdom},
issn = {2213-2961 (Electronic); 2095-2546 (Print); 2213-2961 (Linking)},
jid = {101606001},
journal = {J Sport Health Sci},
jt = {Journal of sport and health science},
keywords = {Alzheimer's Disease; Physical activity; Sedentary behavior; Exercise},
language = {eng},
lid = {S2095-2546(22)00112-0 {$[$}pii{$]$}; 10.1016/j.jshs.2022.11.005 {$[$}doi{$]$}},
lr = {20230531},
mh = {Male; Humans; Middle Aged; Female; *Sedentary Behavior; Prospective Studies; Incidence; Apolipoprotein E4; Exercise; Leisure Activities; *Dementia/epidemiology},
mhda = {2023/05/17 06:42},
month = {May},
number = {3},
oto = {NOTNLM},
own = {NLM},
pages = {287--294},
phst = {2022/05/12 00:00 {$[$}received{$]$}; 2022/08/17 00:00 {$[$}revised{$]$}; 2022/10/12 00:00 {$[$}accepted{$]$}; 2023/05/17 06:42 {$[$}medline{$]$}; 2022/11/16 06:00 {$[$}pubmed{$]$}; 2022/11/15 19:26 {$[$}entrez{$]$}},
pii = {S2095-2546(22)00112-0},
pl = {China},
pmc = {PMC10199132},
pmid = {36379419},
pst = {ppublish},
pt = {Journal Article; Research Support, Non-U.S. Gov't},
rn = {0 (Apolipoprotein E4)},
sb = {IM},
status = {MEDLINE},
title = {Replacement of leisure-time sedentary behavior with various physical activities and the risk of dementia incidence and mortality: A prospective cohort study.},
volume = {12},
year = {2023},
bdsk-url-1 = {https://doi.org/10.1016/j.jshs.2022.11.005}}