Potentially modifiable risk factors for dementia in six low-income and middle-income countries: A multinational, population-based survey.

OBJECTIVES: We aimed to determine the proportion of dementia cases potentially preventable in six low-income and middle-income countries. STUDY DESIGN: We analyzed data from 19,278 adults aged 50 years or more from China, South Africa, Ghana, India, Russia, and Mexico included in the WHO's Study on global AGEing and adult health. MAIN OUTCOME MEASURES: We calculated the population attributable fraction for ten potentially modifiable risk factors: less education, hearing loss, hypertension, diabetes, depression, heavy drinking, obesity, smoking, physical inactivity, and social isolation. Weighted attributable fraction was calculated considering communality among risk factors. RESULTS: We estimated that 37.6 % of the burden of dementia might be attributable to these risk factors. The highest and lowest overall weighted attributable fractions were 38.3 % and 22.9 % in China and Ghana, respectively. Less education (8.3 %), smoking (6.3 %), and physical inactivity (5.7 %) showed the highest attributable fraction for dementia. The overall attributable fraction was higher in the poorest (38.1 %) than in the richest (30.9 %) income quintile. The burden of obesity, diabetes, and hypertension was 61 % higher in the wealthiest than in the poorest population. A total of 7.2 million cases of dementia in these six low- and middle-income countries are potentially caused by these ten potentially modifiable risk factors. CONCLUSIONS: Overall, 38 % of cases of dementia in China, South Africa, Ghana, India, Russia, and Mexico can be attributable to ten potentially modifiable risk factors. Cardiometabolic risk factors account for a more significant burden of dementia in the wealthiest population. Less education had the highest population attributable fraction independent of living area and income.

The association of aerobic and muscular fitness with cognitive impairment: Findings from a nationally representative survey.

This study aimed to characterize the combined association between cardiorespiratory fitness (CRF), muscular strength, and cognitive outcomes in middle-aged and older adults from low and middle-income countries (LMICs). We analyzed cross-sectional, population-based data from adults aged 50 years or older from six LMICs. Mild cognitive impairment (MCI) was defined according to the National Institute on Aging-Alzheimer's Association criteria. Estimated CRF (eCRF) was calculated using previously validated, sex-specific equations. Handgrip strength (HS) was used as an indicator of muscular strength. We used linear and robust Poisson regression models to examine the associations between eCRF, HS, and MCI. Data from 28,339 adults (63.1 [9.5] years) were analyzed. Participants with low eCRF (PR: 1.45; 95%CI: 1.11, 1.90) and HS (PR: 1.92; 95%CI: 1.79, 2.04) were more prone to have MCI. Participants with low HS showed higher likelihood of MCI than those with preserved HS through the CRF range; however, this difference was not seen among highly fit individuals (10 METs or higher). Each 1-MET (PR: 0.77; 95%CI: 0.67, 0.86) and 5-kgf (PR: 0.63; 95%CI: 0.48, 0.79) increase was associated with a reduction in the likelihood of MCI. eCRF and HS were strongly and independently associated with MCI in middle-aged and older adults.

High-velocity resistance training improves executive function in mobility-limited older adults.

OBJECTIVES: To examine the effect of high-velocity resistance training (HVRT) on the executive function of middle-aged and older adults with and without mobility limitations. METHODS: Participants (n = 41, female: 48.9%) completed a supervised 12-week HVRT intervention (2 sessions/week; at 40-60% of one-repetition maximum). The sample included 17 middle-aged adults (40-55 years); 16 older adults (>60 years) and 8 mobility-limited older adults (LIM). Executive function was assessed before and after the intervention period and was reported as z-scores. Maximal dynamic strength, peak power, quadriceps muscle thickness, maximal isometric voluntary contraction (MVIC), and functional performance were also measured pre and post intervention. Training-related adaptations in cognitive measures were calculated using a Generalized Estimating Equation model. RESULTS: HVRT improved executive function in LIM (adjusted marginal mean differences [AMMD]: 0.21; 95%CI: 0.04, 0.38; p = 0.040) although no effect on middle-aged (AMMD: 0.04; 95%CI: -0.09; 0.17; p = 0.533) and older (AMMD: -0.11; 95%CI: -0.25; 0.02; p = 0.107) participants was observed. Improvements in maximal dynamic strength, peak power, MVIC, quadriceps muscle thickness, and functional performance were all associated with changes in executive function, and changes in the first four also seem to mediate the association between changes in functional performance and executive function. CONCLUSIONS: HVRT-induced improvement in executive function of mobility-limited older adults were mediated by changes in lower-body muscle strength, power, and muscle thickness. Our findings reinforce the relevance of muscle-strengthening exercises to preserve cognition and mobility in older adults.

Care seek behavior for low back pain in southern Brazil during the COVID-19 pandemic: a panel data analysis.

BACKGROUND: During the COVID-19 pandemic, people with low back pain (LBP) might have avoided seeking care for their pain. We aimed to investigate how the COVID-19 pandemic has affected LBP care seeking behavior among adults. METHODS: Data from four assessments of the PAMPA cohort were analyzed. Participants who reported experiencing LBP during wave one both before and during social restrictions (n = 1,753 and n = 1,712, respectively), wave two (n = 2,009), and wave three (n = 2,482) were included. We asked participants about sociodemographic, behavioral, and health factors and outcomes related to LBP. Poisson regression analyses were conducted, and data are presented as prevalence ratios (PR) and respective 95% confidence interval (95%CI). RESULTS: Overall, care seeking behavior decreased by half in the first months of restrictions, from 51.5% to 25.2%. Although there was an increase in care seeking behavior observed in the other two assessments (nearly 10 and 16 months after restrictions), it was insufficient to reach pre-pandemic levels. In the first months of restrictions, a similar scenario was observed for specific care, such as general practitioner and exercise professional care, with proportions of pre-pandemic levels reached after 10 and 16 months. Women were more likely to seek care for LBP 10 and 16 months after restrictions (PR 1.30 95%CI 1.11; 1.52, PR 1.22 95%CI 1.06; 1.39, respectively). Also, those participants who worked, were physically active, and reported pain-related disability and high pain levels were more likely to seek care at all time points assessed. CONCLUSION: Overall, care-seeking behavior for LBP significantly decreased in the first months of restrictions and increased in the following months; however, this behavior remained lower than pre-pandemic levels.

Short-term impact of COVID-19 pandemic on low back pain: data from the PAMPA Cohort, Brazil.

BACKGROUND: To evaluate the short-term impact of COVID-19 pandemic on low back pain (LBP) outcomes in southern Brazil. METHODS: Data from the PAMPA Cohort were analyzed. Adults were recruited between June and July 2020 in the Rio Grande do Sul state using online-based strategies. Participants responded a self-reported, online questionnaire on LBP with two timepoints: before (retrospectively) and during COVID-19 pandemic. We assessed LBP experience, LBP-related activity limitation (no/yes), and LBP intensity (0 to 10 [strongest pain]). RESULTS: From a total sample of 2,321 respondents (mean age: 37.6 ± 13.5; 75.4% women), the prevalence of LBP did not change significantly from before (74.7% [95%CI 72.3; 76.9]) to the first months of pandemic (74.2% [95%CI 71.9; 76.3]). However, an increased pain levels (ß: 0.40; 95%CI 0.22; 0.58) and a higher likelihood for activity limitation due to LBP was observed (PR 1.14; 95%CI 1.01; 1.29). Longitudinal analyzes showed that age, gender, BMI, chronic diseases, physical activity, and anxiety and depression symptoms, were associated with LBP in the first pandemic months. CONCLUSION: Although the prevalence of LBP did not change at the first months of COVID-19 pandemic, LBP-induced impairment in daily activities and pain intensity was higher when compared to before the pandemic.

Effects of exercise training on inflammatory, neurotrophic and immunological markers and neurotransmitters in people with depression: A systematic review and meta-analysis.

BACKGROUND: Major depressive disorder is the most common type of mental disorder. The biological pathway by which exercise promotes its antidepressant effects remains uncleared. This study aimed to systematically review the chronic effect of exercise on blood biomarkers and its association with changes in depressive symptoms in adults with major depressive disorder. METHODS: Randomized controlled trials (RCT) published until February 2020 were screened in seven databases. Studies were systematically reviewed by two independent reviewers. Random effect meta-analysis was performed and reported as standardized mean differences (SMD) and 95 % confidence interval (CI). The meta- analysis protocol was registered with PROSPERO (CRD42021221177). RESULTS: From 3865 records, 12 studies (N = 757 participants, mean age [SD]: 43.0 [11.0], 66.2 % women) were included in this review. Exercise training resulted in superior increase in circulating BDNF (SMD: 0.44, 95%CI: 0.15, 0.73) and kynurenine (SMD: 0.29, 95%CI: 0.04, 0.54), and decrease depressive symptoms (SMD: -0.72, 95%CI: -1.08, -0.37) in adults with major depression disorder compared to control groups. Multivariate meta-regression analysis showed that improvements in circulating levels of BDNF, kynurenine and interleukyn-6 were associated with decreases in depressive symptoms. LIMITATIONS: Results were not stratified by the type of medication used by participants due to the lack of reporting of the included studies. Few studies provided data on other biomarkers (e.g., TNF-α and IL-10) besides BNDF and kynurenine. CONCLUSIONS: Antidepressant effect of exercise may be triggered by improved circulating levels of BNDF, kynurenine, and interleukine-6 in adults with major depressive disorder.

Chronic low back pain prevalence in Federal Highway Police Officers: A cross-sectional study.

BACKGROUND: Police officers are exposed to specific occupational tasks, which require lifting, trunk flexion and rotation, carrying weight, and frequent standing periods, which may be associated with an increased risk of experiencing low back pain (LBP). OBJECTIVE: To describe the prevalence and intensity of chronic LBP (CLBP) in Brazilian Federal Highway Police officers (FHPO) from the Rio Grande do Sul state and evaluate its associated factors. METHODS: A total of 208 FHPOs participated in this study. The participants answered an electronic questionnaire containing sociodemographic, behavioral, and occupational questions, and CLBP history. Data analysis comprises descriptive statistics and Poisson regression models. RESULTS: Most of the FHPO were male, aged 41 or more, lived with a partner and were physically active. Sixty-seven percent of FHPO had CLBP, and the median pain intensity was 3.0 (IQR = 0- 5). Participants who lived with a partner were less likely to report CLBP (PR = 0.80; 95% CI = 0.64; 0.99). On the other hand, those who worked as FHPO for more than 11 years were more likely to report CLPB (PR = 1.32; 95% CI = 1.06; 1.63), and high pain intensity (ß= 0.95; 95% CI = 0.19; 1.71). CONCLUSIONS: The high CLBP prevalence among FHPO from Rio Grande do Sul state indicates a need to highlight the importance for police organizations to promote CLBP prevention and implement workplace management programs.

Physical activity and the incidence of depression during the COVID-19 pandemic in Brazil: Findings from the PAMPA cohort.

We examined the longitudinal association between physical activity (PA) and the incidence of self-reported diagnosed depression in adults in southern Brazil during the COVID-19 pandemic. Data from the PAMPA (Prospective Study About Mental and Physical Health) cohort was used. Data collection for baseline was carried out on June-July 2020, with two follow-up assessments taking place six months apart. An online, self-reported questionnaire assessed depression and PA. Depression was assessed by asking participants whether they were ever diagnosed with depression. We included 441 participants (women: 75.9%; mean age [SD]: 38.0 [13.5]) in southern Brazil. Over the follow-up, 21.8% (95% confidence interval [CI]: 18.1%-25.9%) were diagnosed with depression. Insufficiently active (<150 min per week of physical activity) (Incidence rate [IR]: 61.9; 95%CI: 39.5-102.4; p = 0.047) and active (≥150 min per week of physical activity) (IR: 50.4; 95%CI: 31.9-84.0; p = 0.015) participants had reduced IR of depression per 1000 persons-year at risk compared to inactive ones (0 min per week of physical activity) (IR: 99.9; 95%CI: 79.7-126.8). In the adjusted analyses, participants in the insufficient active (hazard ratio [HR]: 0.58; 95%CI: 0.34-0.98) and active (HR: 0.53; 95%CI: 0.31-0.93) group had a lower risk of developing depression than the inactive group. PA both at and out of home reduced the risk of incident depression (HR: 0.49; 95%CI: 0.25-0.98) compared to no physical activity. Endurance (HR: 0.52; 95%CI: 0.28-0.97) and endurance plus strengthening (HR: 0.40; 95%CI: 0.17-0.95) PA reduced the risk of incident depression compared to none. Being physically active during pandemic, regardless of the amount of PA practiced, reduced the incidence of depression in adults in southern Brazil.

Effects of intradialytic exercise on functional capacity in patients with end-stage chronic kidney disease: a systematic review and meta-analysis.

The study aimed to investigate the effect of intradialytic exercise training programmes on the submaximal functional capacity of patients with kidney failure. We searched for randomized clinical trials that assessed submaximal functional capacity using the 6-min walk test (6 MWT) in adult patients on maintenance haemodialysis submitted to intradialytic physical training. The search was performed on 15 October 2021, in different databases. Random-effect, multivariate meta-regression adjusted for multiplicity were performed to examine the relationship between exercise effect and covariates. Intradialytic physical exercise induced greater changes in 6MWT distance (k = 18; n = 1,458; WMD: 37.0; 95% CI 29.3; 50.6 metres) than control groups, with substantial heterogeneity (I2 = 78.3%). Aerobic, strength, and combined exercise promoted an average increase of 48.7 (95%CI 30.9; 66.4 metres), 16.9 (95%CI 7.6; 26.3 metres), and 75.8 (95%CI 55.1; 96.6 metres) metres, respectively. Strength training resulted in inferior gains in 6MWT distance compared to aerobic training (WMD: -25.0; 95%CI: -49.1; -0.9). Intervention length shorter than 11 weeks (WMD: 37.0; 95%CI: -5.4; 79.3 metres) did not induce greater changes in 6MWT compared to control groups. There was a positive response in submaximal functional capacity to intradialytic training in kidney failure patients on maintenance haemodialysis.

Physical activity trajectory in the first 10 months of the COVID-19 pandemic in Southern Brazil: a follow-up study.

BACKGROUND: A continuous tracking of the PA level during the COVID-19 pandemic is important to understand how people's behaviour has varied along time. The aim of this study was to evaluate the physical activity (PA) trajectory over the first 10 months of the COVID-19 pandemic in the south of Brazil. METHODS: Data from three timepoints of the PAMPA Cohort were used, as follows: (1) pre-COVID-19 (retrospective); (2) Jun/Jul 2020; (3) Dec 2020/Jan 2021. Self-reported PA practice, frequency, duration, as well as place where activities were performed (at or out of home) were assessed. RESULTS: A reduction in any (from 68.7 to 47.7%), sufficient (from 41.5 to 22.1%) and out of home PA (from 59.4 to 30.1%) was observed from the first (pre-COVID-19) to the second (Jun/Jul 2020) timepoint, followed by an increase in the third timepoint (Dec 2020/Jan 2021) (60.1%, 37.9%, and 54.3% for any, sufficient, and out of home PA, respectively). The PA trajectory was similar, regardless of sex, educational level or income. Only any (p = 0.0007) and sufficient (p = 0.0012) PA showed significant interaction with time by sex. Female participants were less likely to engage in any (OR 0.45 95% CI 0.26; 0.77) and sufficient PA (OR 0.40 95% CI 0.24; 0.66). CONCLUSION: During the first 10 months of COVID-19 pandemic there was a marked fluctuation on PA pattern in adults from southern Brazil. An ongoing tracking of PA behaviour during COVID-19 pandemic is important to understand how this behaviour varies. Public policies should focus on increasing PA in a higher standard than pre-COVID levels.

Physical Inactivity From Childhood to Adolescence and Incident Depression.

INTRODUCTION: The long-term impact of physical activity during early life on the risk of depression in later stages of adulthood remains unclear. This study examines the association between physical activity during childhood and adolescence and the incidence of depressive symptoms in early, middle, and late adulthood. METHODS: Data from a birth cohort (the 1958 National Child Development Survey), including births (N=17,415) in England, Wales, and Scotland, were used. After birth, 11 more follow-ups were carried out between ages 7 and 62 years (2020). Leisure-time physical activity was assessed through a self-reported questionnaire. Psychological measures were assessed with the teacher-rated Bristol Social Adjustment Guide, the teacher-rated Rutter scale, and the self-rated Malaise Inventory. Leisure-time physical activity and psychological symptoms were examined in all the 11 follow-up assessments included in this study. Best-fit model was used to obtain hazard ratios and 95% CIs of depression symptoms by physical activity status in different ages, including demographic, behavioral, and health-related variables as potential confounders. RESULTS: After multivariate analysis, being physically active at age 16 years reduced the risk of incident elevated depressive symptoms (hazard ratio=0.73, 95% CI=0.62, 0.85) throughout adulthood. The long-term impacts of physical activity practiced at age 16 years persisted throughout adulthood up to age 62 years. CONCLUSIONS: Adolescence is a critical early-life period to promote physical activity for reducing the incidence of elevated depressive symptoms throughout adulthood. Public health policies should promote healthy lifestyles during the lifespan to reduce both the burden of physical inactivity and depressive symptoms at the population level.

Are gender differences in physical inactivity associated with the burden of dementia in low- and lower-middle income countries?

We explore the association between gender differences in physical inactivity and dementia in low and lower-middle-income countries (LLMIC). Data were extracted from the Repository of the Global Health Observatory and the United Nations Development Program with 2016 as reference year. Sample was composed using countries with a Human Development Index lower than 0.700. We calculated the population attributable fraction for physical inactivity in dementia. Absolute and relative gender differences in physical inactivity were calculated by subtracting and dividing the prevalence of physical inactivity among men from women's prevalence, respectively. Physical inactivity accounts for 12.25% cases of dementia in LLMIC. Women account for 58% of deaths and 56% of DALY's due to dementia in LLMIC. Adjusted prevalence of dementia was associated with prevalence and absolute gender difference in physical inactivity. DALYs and deaths due to dementia were associated with absolute and relative gender differences in physical inactivity. A reduction of 10% in physical inactivity only among women might reproduce a similar decline in the burden of dementia compared to the same 10% decrease in physical inactivity in the whole LLMIC population. Decreasing gender gap in physical inactivity may be an alternative approach to reduce the burden of dementia in LLMIC.

Determinants of increased frequency of depressive and anxiety symptoms in exercise professionals during the COVID-19 pandemic.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has affected workers in different health services including exercise professionals (EP). The urgent need to adapt in-person to online activities might have led to increased frequency of anxiety and depressive symptoms. OBJECTIVE: We aimed to identify the determinants of aggravated depressive and anxiety symptoms in EP in southern Brazil during social distancing from the COVID-19. METHODS: A cross-sectional study was conducted with EP who worked at fitness centers, sports clubs, private schools, or at a public exercise program offered by the municipal council. We used an online-based, self-administered, adapted version of the Hospital Anxiety and Depression scale to compare symptoms of depression and anxiety pre- and during social distancing. RESULTS: Participants (n = 201) had a mean age of 32.7±8.0 years, with more than half being male, white, and having an university degree. We observed that 81%and 71%of respondents reported higher frequency in anxiety and depression symptoms, respectively, during social distancing than in the period before it. Physical education teachers, women, non-white professionals, and those with chronic disease were more likely to worsen anxiety symptoms. Women had higher odds to increased frequency in depressive symptoms. Physical activity and previous experience with internet-based tools for working activities reduced the risk of increased depressive symptoms. CONCLUSIONS: Sex, ethnicity, chronic diseases, educational level, physical activity, and experience with online tools were determinants for increased frequency of depression and anxiety symptoms in EP.

How has COVID-19 social distancing impacted physical activity patterns? Data from the PAMPA cohort, Brazil.

OBJECTIVE: This study aimed to evaluate how social distancing measures affected physical activity (PA) patterns in adults from Rio Grande do Sul, Brazil. METHODS: Participants were recruited from social and local media campaigns, contacts with private and public universities, as well as research personal contacts across the state. PA was assessed before (retrospectively) and during social distancing. Frequency (days per week) and time (minutes per day) were asked to those participants who practiced PA. Two PA variables were built to each time-frame (before and during social distancing): 1) any PA (yes/no question), and 2) sufficient PA (based on the 150 min/week cut-off point). RESULTS: Overall, 2321 participants answered the questionnaire. Any and sufficient PA decreased from before to during social distancing (22.3% and 17.0%, respectively). A linear increase of activity during social distancing was observed in participants who practiced up to 400 min or less of PA per week before social distancing. Regarding associated factors, female, overweight/obese and diagnosed chronic disease participants were less likely to practice any or sufficient PA during social distancing when compared to the period before. CONCLUSION: PA practice (both any and sufficient) decreased in Southern Brazil in the first months of social distancing. Women, overweight/obese and chronic diseased participants showed a higher decrease in PA compared to other groups. Finally, those participants who practiced PA before social distancing were more likely to continue practicing during COVID-19 pandemic.

Physical activity attenuates the risk for dementia associated with aging in older adults with mild cognitive impairment. Findings from a population-based cohort study.

From 2016 to 2040 the number of people with dementia in the United Kingdom is expected to increase by 57%, while 70% percent of it is due to a higher life expectancy. Thus, we analyzed the overall and age-stratified effect of physical activity on risk of dementia in participants with mild cognitive impairment (MCI) of the English Longitudinal Study of Ageing (ELSA). Participants of the ELSA, aged over 50 with MCI, were followed-up nine times between 2002 and 2019. Physical activity was assessed using a self-reported, validated questionnaire and participants were classified as inactive, low, or moderate-to-high active. Medical diagnosis of dementia was self-reported or determined using the Informant Questionnaire on Cognitive Decline in the Elderly. Data from 521 participants with MCI were analyzed (56% women; mean [SD] age, 68.7 [10.6]). Over 17-year follow-up, 20.5 (95%CI: 17.3 to 24.2)% were diagnosed with dementia. The risk of incident dementia was reduced in participants engaging in low (HR: 0.34; 95%CI: 0.22 to 0.54) or moderate-to-high (HR: 0.16; 95%CI: 0.08 to 0.33) levels of physical activity. Risk of dementia in adults aged 80 or more engaging in low or moderate-to-high levels of physical activity was not different from inactive adults aged between 50 and 69 years. Results were sustained after competing risk regression model and sensitivity analyses to reduce the impact of reverse causality. Physical activity appears to minimize the risk associated with aging in older adults with MCI.

Two-minute exercise testing is sufficient to estimate maximal cardiorespiratory fitness in people with epilepsy.

We aimed to examine the agreement between submaximal cardiopulmonary exercise testing (CPET) measures and peak oxygen consumption (VO2peak) in adults with epilepsy. Data from a randomized controlled trial with adults with epilepsy (N = 21) were analyzed. VO2peak was assessed using indirect calorimetry during a treadmill graded maximal CPET. Oxygen uptake efficiency slope (OUES) was calculated from the relationship between oxygen uptake and minute ventilation during the entire test (OUESpeak) and the first 2 (OUES2min), 3 (OUES3min), and 4 (OUES4min) minutes of the CPET. The strength of the association between measures was tested by Pearson correlation. Linear regression models were used to predict VO2peak based on OUES from the different testing durations. Agreement between measured and predicted maximal values was tested using intraclass correlation coefficient (ICC) and Bland-Altman plots. OUES2min, OUES3min, and OUES4min were highly associated with absolute (r = 0.84, r = 0.76, r = 0.75, respectively) and relative (r = 0.84, r = 0.78, r = 0.78, respectively) VO2peak. Agreement (ICC = 0.83) between CPET-measured and OUES-predicted VO2peak values was stronger with OUES2min than the other time-based OUES markers. Bland-Altman plot showed satisfactory agreement between predicted and measured CPET measures with the narrowest limits of agreement observed with the OUES2min. No potential bias was identified between these two measurements (p = 0.33). Changes in absolute (r = 0.77) and relative (r = 0.88) VO2peak were highly associated with the change in OUES2min. OUES2min can be used as a surrogate for maximal cardiorespiratory fitness in adults with epilepsy. Studies with larger samples size are encouraged to confirm our findings in a more heterogeneous population.

Multimorbidity and leisure-time physical activity over the life course: a population-based birth cohort study.

BACKGROUND: We aimed to test which life course model best described the association between leisure-time physical activity (LTPA) and multimorbidity at age 55. We analyzed data from birth to age 55 using the database from the 1958 National Child Development Survey. METHODS: Multimorbidity was considered as the presence of more than one chronic condition. LTPA was measured through questionnaires from 1965 (age 7) to 2013 (age 55), which were applied in eight different occasions. We compared the fit of a series of nested adjusted logistic regression models (representing either the critical, accumulation or sensitive period models) with a fully saturated model. Data were reported as odds ratio (OR) and 95% confidence interval (CI). RESULTS: From an eligible sample of 15,613 cohort members, 9137 were interviewed in the latest sweep (58.5%). Men were more physically active than women at ages 11, 16, and 23 (p < 0.001). LTPA every day in the week was more frequent in women than men in ages 33, 42, and 50 (p < 0.001). The prevalence of multimorbidity at age 55 was 33.0% (n = 2778). The sensitive analysis revealed that LTPA during adolescence (OR: 0.83; 95% CI: 0.70, 0.98) and mid adult life (age 50 and 55; OR: 0.82; 95%CI: 0.69, 0.98) have a stronger effect on the risk for multimorbidity at age 55 considering all other life stages in the model. Also, adolescence showed a critical independent effect on the risk for multimorbidity (OR: 0.82; 95%CI: 0.70, 0.97). No difference was found between those models. CONCLUSIONS: These data support the notion of a protective physical activity "legacy" at early ages of childhood against multimorbidity at older ages. We highlight the need for LTPA promotion through intervention tailored especially on schooling and older ages in order to reduce the burden of multimorbidity.

Association between physical activity and subjective memory decline triggered by the COVID-19 pandemic: Findings from the PAMPA cohort.

Implementation of social distancing reduced the incidence of coronavirus disease (COVID-19) cases. Nevertheless, this strategy has other undesirable effects such as physical inactivity and psychological distress, which are associated with cognitive impairment. We aimed to examine whether physical activity during social distancing restrictions could reduce the risk of subjective memory decline in adults. Participants (n=2321) completed the baseline assessment of PAMPA cohort (Prospective Study About Mental and Physical Health), a ambispective cohort study conducted in southern Brazil. An online-based, self-administered questionnaire assessed physical activity and self-rated memory in two different periods: before and during social distancing. Data collection was executed from June 22nd to July 23rd 2020. Adjusted Poisson regression models were performed and values reported in prevalence ratio (PR) with 95% confidence interval (CI). Participants presented with a mean age of 38.2 (95%CI: 37.5, 38.9) years. Most were women (76.6%), had at least a university degree (66.7%), and were overweight or obese (53.3%). Subjective memory decline was reported by 30.0% (95%CI: 27.7%, 32.4%) of respondents. Most individuals with subjective memory decline reported being physically inactive during the pandemic of COVID-19. Participants were less likely to experience subjective memory decline if they either became (PR: 0.56; 95%CI: 0.36, 0.89) or remained (PR: 0.68; 95%CI: 0.49, 0.93) physically active compared to inactive respondents. Physical activity participation during social distancing reduced the likelihood of subjective memory decline in adults. Physical activity should be highlighted as a potential alternative to reduce the burden of the COVID-19 pandemic on cognitive function and mental health.

Physical activity in later life and risk of dementia: Findings from a population-based cohort study.

BACKGROUND: Dementia is the second leading cause of death in the United Kingdom, affecting 7.1% of older adults. One in five dementia cases in Europe can be attributable to physical inactivity. We examined the association between physical activity at age 50 or older and risk of dementia over 15 years. METHODS: The English Longitudinal Study of Ageing (ELSA) comprises a national population-based cohort that began in 2002-03 (baseline) with 9275 individuals aged ≥50 years. Dementia diagnosis was followed over 15 years. Physical activity in daily life and at work was measured at baseline and at two yearly intervals and participants were categorized as inactive, low, or moderate-to-high active. Cumulative incidence of dementia during follow-up was calculated; hazard ratios and 95% confidence intervals (CI) were estimated using survival analysis. RESULTS: At baseline, 69% of the sample were categorized as moderate-to-high active. The inactive, low, and moderate-to-high active groups had a cumulative incidence of dementia of 4.8% (95%CI: 4.4 to 5.4), 0.9% (95%CI:0.8 to 1.1), and 0.2% (95%CI: 0.1 to 0.5), respectively. In adjusted analyses, participants in the low and moderate-to-high active groups had, respectively, 60% and 78% lower risk of developing dementia than the inactive group. Survival analyses showed large between-group differences in the cumulative incidence of dementia over 15 years based on the physical activity categories. CONCLUSION: In people aged 50 or more, there is an inverse dose-response association between physical activity and incidence of dementia over 15 years. Even low levels of physical activity have beneficial effects.