Effect of a 24-Month Physical Activity Intervention vs Health Education on Cognitive Outcomes in Sedentary Older Adults: The LIFE Randomized Trial
Open accessAbstract
IMPORTANCE: Epidemiological evidence suggests that physical activity benefits cognition, but results from randomized trials are limited and mixed. OBJECTIVE: To determine whether a 24-month physical activity program results in better cognitive function, lower risk of mild cognitive impairment (MCI) or dementia, or both, compared with a health education program. DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial, the Lifestyle Interventions and Independence for Elders (LIFE) study, enrolled 1635 community-living participants at 8 US centers from February 2010 until December 2011. Participants were sedentary adults aged 70 to 89 years who were at risk for mobility disability but able to walk 400 m. INTERVENTIONS: A structured, moderate-intensity physical activity program (n = 818) that included walking, resistance training, and flexibility exercises or a health education program (n = 817) of educational workshops and upper-extremity stretching. MAIN OUTCOMES AND MEASURES: Prespecified secondary outcomes of the LIFE study included cognitive function measured by the Digit Symbol Coding (DSC) task subtest of the Wechsler Adult Intelligence Scale (score range: 0-133; higher scores indicate better function) and the revised Hopkins Verbal Learning Test (HVLT-R; 12-item word list recall task) assessed in 1476 participants (90.3%). Tertiary outcomes included global and executive cognitive function and incident MCI or dementia at 24 months. RESULTS: At 24 months, DSC task and HVLT-R scores (adjusted for clinic site, sex, and baseline values) were not different between groups. The mean DSC task scores were 46.26 points for the physical activity group vs 46.28 for the health education group (mean difference, -0.01 points [95% CI, -0.80 to 0.77 points], P = .97). The mean HVLT-R delayed recall scores were 7.22 for the physical activity group vs 7.25 for the health education group (mean difference, -0.03 words [95% CI, -0.29 to 0.24 words], P = .84). No differences for any other cognitive or composite measures were observed. Participants in the physical activity group who were 80 years or older (n = 307) and those with poorer baseline physical performance (n = 328) had better changes in executive function composite scores compared with the health education group (P = .01 for interaction for both comparisons). Incident MCI or dementia occurred in 98 participants (13.2%) in the physical activity group and 91 participants (12.1%) in the health education group (odds ratio, 1.08 [95% CI, 0.80 to 1.46]). CONCLUSIONS AND RELEVANCE: Among sedentary older adults, a 24-month moderate-intensity physical activity program compared with a health education program did not result in improvements in global or domain-specific cognitive function. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01072500.
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Interventional studies have often, but not always, found beneficial effects of aerobic exercise on cognition.
“Other interventional studies have often, but not always, found beneficial effects of aerobic exercise on cognition.96–99”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [99]
Some studies have shown larger benefits on executive tasks than on other cognitive domains.
“Some studies have shown larger benefits on executive tasks than other cognitive domains.97,99,102,103”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [99]
Some but not all randomized trials targeting these conditions have shown encouraging results.
“Encouraging results have been observed in some, but not all,99 RCTs targeting some of these conditions.”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [99]
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- Authors
- Sink, K. M., Espeland, M. A., Castro, C. M., Church, T., Cohen, R., Dodson, J. A., Guralnik, J., Hendrie, H. C., Jennings, J., Katula, J., Lopez, O. L., McDermott, M. M., Pahor, M., Reid, K. F., Rushing, J., Verghese, J., Rapp, S., & Williamson, J. D.
- Affiliations
- Wake Forest University Health Sciences (US)
- Stanford Medicine (US)
- Pennington Biomedical Research Center (US)
- University of Florida (US)
- New York University (US)
- University of Maryland, Baltimore (US)
- Indiana University Indianapolis (US)
- Wake Forest University (US)
- Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, North Carolina
- Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
- Northwestern University (US)
- Tufts University (US)
- Albert Einstein College of Medicine (US)
- Corresponding author
- Sink, Kaycee M.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2015-08-25
- Volume
- 314
- Issue
- 8
- Pages
- 781
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC4698980
- OpenAlex
- W2110665915
- Cited by
- 402
- References
- 44
- Citations by year
- 2026: 26 · 2025: 23 · 2024: 32 · 2023: 34 · 2022: 44 · 2021: 38 · 2020: 44 · 2019: 45 · 2018: 42 · 2017: 38 · 2016: 30 · 2015: 5 · 2014: 1
- FWCI
- 31.15
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- JAMA (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Agriculture (58-1950-7-707)
- National Institutes of Health (5p30ag031679-15)
- National Institute on Aging (1-P30-AG21332, U01AG022376, 1 P30 AG031679, 3U01AG022376-05A2S, UO1 AG22376, P30-AG031679, P30AG024827, P30AG028740, P30AG021332, P30AG021342)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- physical activity interventions, health education, cognitive function, older adults, sedentary lifestyle, mild cognitive impairment, dementia, walking, resistance training, flexibility training, executive function, verbal learning, life studies, community-dwelling older adults, cognitive aging, memory retrieval, attention and processing speed, walking speed
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Dementia, Exercise Therapy, Female, Health Education, Health Promotion, Humans, Male, Walking, Treatment Outcome, Upper Extremity, Muscle Stretching Exercises, Resistance Training, Executive Function, Sedentary Behavior, Cognitive Dysfunction
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