Effect of Physical Activity on the Progression of Alzheimer’s Disease: The Clinical Research Center for Dementia of South Korea Study

Article type: Research Article

Authors: Minn, Yang-Ki^a | Choi, Seong Hye^{b; *} | Suh, Young Ju^c | Jeong, Jee Hyang^d | Kim, Eun-Joo^e | Kim, Jong Hun^f | Park, Kyung Won^g | Park, Moon Ho^h | Youn, Young Chulⁱ | Yoon, Bora^j | Choi, Seok-Jin^b | Oh, Youn Kyung^k | Yoon, Soo Jin^l

Affiliations: [a] Department of Neurology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea | [b] Department of Neurology, Inha University School of Medicine, Incheon, South Korea | [c] Department of Biomedical Sciences, Inha University School of Medicine, Incheon, South Korea | [d] Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea | [e] Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea | [f] Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea | [g] Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, South Korea | [h] Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea | [i] Department of Neurology, College of Medicine, Chung-Ang University, Seoul, South Korea | [j] Department of Neurology, College of Medicine, Konyang University, Daejeon, South Korea | [k] Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea | [l] Department of Neurology, Eulji University School of Medicine, Daejeon, South Korea

Correspondence: [*] Correspondence to: Seong Hye Choi, MD, PhD, Department of Neurology, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon 22332, South Korea. Tel.: +82 32 890 3860; Fax: +82 32 890 1140; E-mail: [email protected].

Abstract: Background:There is a lack of research on the effects of physical activity (PA) on the progression of Alzheimer’s disease (AD). Objectives:We investigated whether PA is associated with progression of dementia and mortality in AD. Methods:In the present study, 934 patients with mild-to-moderate AD were included. PA was evaluated using a questionnaire written by the caregiver. The outcome measures were the Clinical Dementia Rating-Sum of Boxes (CDR-SB), Seoul-Instrumental Activities of Daily Living (S-IADL), Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI), a global composite score of neuropsychological subtests, and mortality. They were evaluated annually and received a maximum of three follow-up examinations. Results:Between-group differences compared with the no PA group in the change of CDR-SB scores were –0.431 (95% CI = –0.824∼–0.039; p = 0.031) for the moderate PA group (150–750 minutes per week of moderate intensity PA), and –1.148 (–1.656∼–0.639; p < 0.001) for the high PA group (>750 minutes per week). As PA increased, there was a significant trend to slow the rate of increase in the CDR-SB, S-IADL, and CGA-NPI scores. The patients with ≥150 minutes per week for each of non-recreational and recreational PAs had a lower risk of mortality compared to those with <150 minutes per week for each of the PAs (hazard ratio 0.22, 95% CI = 0.05∼0.88; p = 0.033). Conclusion:More PA is associated with slower progression of dementia severity, functional decline, and abnormal behavior, and with a lower risk of mortality in AD.

Keywords: Alzheimer’s disease, dementia, physical activity, progression, mortality

DOI: 10.3233/JAD-180333

Journal: Journal of Alzheimer's Disease, vol. 66, no. 1, pp. 249-261, 2018