Physical Activity and Trajectory of Cognitive Change in Older Persons: Mayo Clinic Study of Aging

Janina Krell-Roesch, Jeremy A. Syrjanen, Jelena Bezold, Sandra Trautwein, Bettina Barisch-Fritz, Klaus Boes, Alexander Woll, Erica Forzani, Walter K. Kremers, Mary M. MacHulda, Michelle M. Mielke, David S. Knopman, Ronald C. Petersen, Maria Vassilaki, Yonas E. Geda

Research output: Contribution to journalArticlepeer-review


Background: Little is known about the association between physical activity (PA) and cognitive trajectories in older adults. Objective: To examine the association between PA and change in memory, language, attention, visuospatial skills, and global cognition, and a potential impact of sex or Apolipoprotein E (APOE) ϵ4 status. Methods: Longitudinal study derived from the population-based Mayo Clinic Study of Aging, including 2,060 cognitively unimpaired males and females aged ≥70 years. Engagement in midlife (ages 50-65) and late-life (last year) PA was assessed using a questionnaire. Neuropsychological testing was done every 15 months (mean follow-up 5.8 years). We ran linear mixed-effect models to examine whether mid-or late-life PA at three intensities (mild, moderate, vigorous) was associated with cognitive z-scores. Results: Light intensity midlife PA was associated with less decline in memory function compared to the no-PA reference group (time x light PA; estimate [standard error] 0.047 [0.016], p = 0.004). Vigorous late-life PA was associated with less decline in language (0.033 [0.015], p = 0.030), attention (0.032 [0.017], p = 0.050), and global cognition (0.039 [0.016], p = 0.012). Females who were physically inactive in midlife experienced more pronounced cognitive decline than females physically active in midlife and males regardless of PA (p-values for time interaction terms with midlife PA levels and sex were all p < 0.05 for global cognition). APOE ϵ4 carriership did not moderate the association between PA and cognition. Conclusion: Engaging in PA, particularly of vigorous intensity in late-life, was associated with less pronounced decline in global and domain-specific cognition. This association may differ by sex.

Original languageEnglish (US)
Pages (from-to)377-388
Number of pages12
JournalJournal of Alzheimer's Disease
Issue number1
StatePublished - 2021


  • Cognitive trajectories
  • community-dwelling persons
  • late-life
  • midlife
  • physical activity

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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