To determine the association between physical activity (PA) and subjective cognitive complaints (SCCs), and the influential factors in this association.
Setting and Participants
Community-based data of the World Health Survey, which included 248,504 individuals from 47 low- and middle-income countries (LMICs), were analyzed [mean age = 38.6 (standard deviation 16.1) years; 50.7% female].
PA was assessed with the International Physical Activity Questionnaire. Participants were grouped into those who meet (high PA) the 150 minutes of moderate-to-vigorous intensity PA per week recommendation, and those who do not (low PA). Two questions on subjective memory and learning complaints in the past 30 days were used (scales ranged from 1 to 5, with higher scores representing more severe SCC). Multivariable ordinal logistic regression and mediation analyses were performed.
Overall, after adjusting for sociodemographic and a wide range of behavioral, psychological, and physical factors, low PA was associated with a higher risk for having more severe subjective memory complaints [odds ratio (OR) = 1.10, 95% confidence interval (CI) = 1.04-1.23] and learning complaints (OR = 1.18, 95% CI = 1.12-1.26). Significant associations were only observed among the middle-aged (45-64 years; learning complaints OR = 1.19, 95% CI = 1.06-1.33) and older populations (≥65 years; memory complaints OR = 1.31, 95% CI = 1.15-1.49, and learning complaints OR = 1.41, 95% CI = 1.24-1.60). Chronic physical conditions, sleep problems, depression, and anxiety explained between 7.7% and 29.4% of the PA-SCC association among those aged ≥45 years.
Conclusions and Implications
Low PA was associated with increased odds for more severe SCCs in middle-aged and older adults in LMICs. Given the particularly rapid increase in dementia in LMICs, more longitudinal research is warranted from this setting to understand the utility of PA promotion in the prevention of cognitive impairment.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of the American Medical Directors Association
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- World Population Prospects: The 2017 Revision, Key Findings and Advance Tables.2017 (ESA/P/WP/248)
- Alzheimer's Disease International. World Alzheimer Report 2015: The Global Impact of Dementia. Alzheimer's Disease International, London2015
- Research priorities to reduce the global burden of dementia by 2025.Lancet Neurol. 2016; 15: 1285-1294
- Fitness effects on the cognitive function of older adults: A meta-analytic study.Psychol Sci. 2003; 14: 125-130
- Exercise interventions for cognitive function in adults older than 50: A systematic review with meta-analysis.Br J Sports Med. 2018; 52: 154-160
- Physical activity and cognitive vitality.Annu Rev Psychol. 2015; 66: 769-797
- Physical activity and risk of cognitive decline: A meta-analysis of prospective studies.J Intern Med. 2011; 269: 107-117
- Does physical activity prevent cognitive decline and dementia? A systematic review and meta-analysis of longitudinal studies.BMC Public Health. 2014; 14: 510
- A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease.Alzheimer’s Dement. 2014; 10: 844-852
- Risk of dementia and mild cognitive impairment in older people with subjective memory complaints: Meta-analysis.Acta Psychiatr Scand. 2014; 130: 439-451
- From subjective cognitive complaints to dementia.Am J Alzheimers Dis Other Demen. 2016; 31: 105-114
- Are memory complaints predictive for dementia? A review of clinical and population-based studies.Int J Geriatr Psychiatry. 2000; 15: 983-991
- Subjective cognitive complaints and cognitive decline: Consequence or predictor? The epidemiology of vascular aging study.J Am Geriatr Soc. 2005; 53: 616-621
- Outcome over seven years of healthy adults with and without subjective cognitive impairment.Alzheimer’s Dement. 2010; 6: 11-24
- Physical activity across adulthood and subjective cognitive function in older men.Eur J Epidemiol. 2018; 33: 79-87
- The association of single and combined factors of sedentary behavior and physical activity with subjective cognitive complaints among community-dwelling older adults: Cross-sectional study.PLoS One. 2018; 13: 1-10
- Prediction of dementia in primary care patients.PLoS One. 2011; 6: e16852
- Lifestyle interventions to prevent cognitive impairment, dementia and Alzheimer disease.Nat Rev Neurol. 2018; 14: 653-666
- Prodromal Alzheimer’s disease: Successive emergence of the clinical symptoms.Ann Neurol. 2008; 64: 492-498
- The continuum of psychotic symptoms in the general population: A cross-national study.Schizophr Bull. 2012; 38: 475-485
- Memory and learning complaints in relation to depression among elderly people with multimorbidity.Geriatrics. 2017; 2: 15
- Psychotic experiences and subjective cognitive complaints among 224 842 people in 48 low- and middle-income countries.Epidemiol Psychiatr Sci. 2018; 29: e11
- Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): A systematic review.Int J Behav Nutr Phys Act. 2011; 8: 115
- Global recommendations on physical activity for health.World Health Organization, Geneva, Switzerland2010
- Subjective cognitive complaints across the adult life span: A 14-year analysis of trends and associations using the 1993, 2000 and 2007 English Psychiatric Morbidity Surveys.Psychol Med. 2014; 44: 1977-1987
- Mild cognitive impairment and physical activity in the general population: Findings from six low- and middle-income countries.Exp Gerontol. 2017; 100: 100-105
- Physical activity correlates in heavy episodic drinkers: Data from 46 low- and middle-income countries.Ment Health Phys Act. 2017; 13: 163-170
- The association between sleep problems and psychotic symptoms in the general population: A global perspective.Sleep. 2015; 38: 1875-1885
- The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI).Int J Methods Psychiatr Res. 2004; 13: 93-121
- Total, direct, and indirect effects in logit and probit models.Sociol Methods Res. 2013; 42: 164-191
- Measuring inconsistency in meta-analyses.BMJ. 2003; 327: 557-560
- Stress sensitivity and psychotic experiences in 39 low- and middle-income countries.Schizophr Bull. 2016; 42: 1353-1362
- Physical activity/exercise and diabetes: A position statement of the American Diabetes Association.Diabetes Care. 2016; 39: 2065-2079
- Risk of dementia in diabetes mellitus: A systematic review.Lancet Neurol. 2006; 5: 64-74
- Brain insulin resistance in type 2 diabetes and Alzheimer disease: Concepts and conundrums.Nat Rev Neurol. 2018; 14: 168-181
- The effects of physical activity on sleep: A meta-analytic review.J Behav Med. 2015; 38: 427-449
- Connections between sleep and cognition in older adults.Lancet Neurol. 2014; 13: 1017-1028
- Sleep-dependent memory consolidation.Nature. 2005; 437: 1272-1278
- Physical activity and incident depression: A meta-analysis of prospective cohort studies.Am J Psychiatry. 2018; 175: 631-648
- The impact of depression on the development of mild cognitive impairment over 3 years of follow-up: A population-based study.Dement Geriatr Cogn Disord. 2017; 43: 155-169
- Physical activity and muscle-brain crosstalk.Nat Rev Endocrinol. 2019; 15: 383-392
- Exercise: A behavioral intervention to enhance brain health and plasticity.Trends Neurosci. 2002; 25: 295-301
- Exercise builds brain health: Key roles of growth factor cascades and inflammation.Trends Neurosci. 2007; 30: 464-472
- Mediators of physical activity on neurocognitive function: A review at multiple levels of analysis.Front Hum Neurosci. 2016; 10: 626
- Equivalence of the mediation, confounding and suppression effect.Prev Sci. 2000; 1: 173-181
- World Alzheimer Report 2014: Dementia and Risk Reduction.Alzheimer's Disease International, London, UK2014
Published online: April 03, 2020
The authors declare no conflicts of interest.
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.