Changes in Cognition and Mortality in Relation to Exercise in Late Life: A Population Based Study
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{"title"=>"Changes in cognition and mortality in relation to exercise in late life: A population based study", "type"=>"journal", "authors"=>[{"first_name"=>"Laura E.", "last_name"=>"Middleton", "scopus_author_id"=>"16203486700"}, {"first_name"=>"Arnold", "last_name"=>"Mitnitski", "scopus_author_id"=>"6701482641"}, {"first_name"=>"Nader", "last_name"=>"Fallah", "scopus_author_id"=>"20734097200"}, {"first_name"=>"Susan A.", "last_name"=>"Kirkland", "scopus_author_id"=>"7005787049"}, {"first_name"=>"Kenneth", "last_name"=>"Rockwood", "scopus_author_id"=>"7103175498"}], "year"=>2008, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"52349120531", "pmid"=>"18769616", "isbn"=>"1932-6203 (Electronic)", "pui"=>"352399760", "issn"=>"19326203", "scopus"=>"2-s2.0-52349120531", "doi"=>"10.1371/journal.pone.0003124"}, "id"=>"f3a13651-9dc7-3d90-a6ea-d773103ca03c", "abstract"=>"BACKGROUND: On average, cognition declines with age but this average hides considerable variability, including the chance of improvement. Here, we investigate how exercise is associated with cognitive change and mortality in older people and, particularly, whether exercise might paradoxically increase the risk of dementia by allowing people to live longer.\\n\\nMETHODS AND PRINCIPAL FINDINGS: In the Canadian Study of Health and Aging (CSHA), of 8403 people who had baseline cognition measured and exercise reported at CSHA-1, 2219 had died and 5376 were re-examined at CSHA-2. We used a parametric Markov chain model to estimate the probabilities of cognitive improvement, decline, and death, adjusted for age and education, from any cognitive state as measured by the Modified Mini-Mental State Examination. High exercisers (at least three times per week, at least as intense as walking, n = 3264) had more frequent stable or improved cognition (42.3%, 95% confidence interval: 40.6-44.0) over 5 years than did low/no exercisers (all other exercisers and non exercisers, n = 4331) (27.8% (95% CI 26.4-29.2)). The difference widened as baseline cognition worsened. The proportion whose cognition declined was higher amongst the high exercisers but was more similar between exercise groups (39.4% (95% CI 37.7-41.1) for high exercisers versus 34.8% (95% CI 33.4-36.2) otherwise). People who did not exercise were also more likely to die (37.5% (95% CI 36.0-39.0) versus 18.3% (95% CI 16.9-19.7)). Even so, exercise conferred its greatest mortality benefit to people with the highest baseline cognition.\\n\\nCONCLUSIONS: Exercise is strongly associated with improving cognition. As the majority of mortality benefit of exercise is at the highest level of cognition, and declines as cognition declines, the net effect of exercise should be to improve cognition at the population level, even with more people living longer.", "link"=>"http://www.mendeley.com/research/changes-cognition-mortality-relation-exercise-late-life-population-based-study", "reader_count"=>72, "reader_count_by_academic_status"=>{"Unspecified"=>5, "Professor > Associate Professor"=>3, "Researcher"=>21, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>3, "Student > Master"=>8, "Other"=>2, "Student > Bachelor"=>10, "Professor"=>4}, "reader_count_by_user_role"=>{"Unspecified"=>5, "Professor > Associate Professor"=>3, "Researcher"=>21, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>11, "Student > Postgraduate"=>3, "Student > Master"=>8, "Other"=>2, "Student > Bachelor"=>10, "Professor"=>4}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Agricultural and Biological Sciences"=>11, "Computer Science"=>1, "Earth and Planetary Sciences"=>1, "Engineering"=>1, "Nursing and Health Professions"=>3, "Biochemistry, Genetics and Molecular Biology"=>1, "Mathematics"=>3, "Medicine and Dentistry"=>21, "Neuroscience"=>2, "Sports and Recreations"=>8, "Psychology"=>13, "Social Sciences"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>21}, "Social Sciences"=>{"Social Sciences"=>1}, "Sports and Recreations"=>{"Sports and Recreations"=>8}, "Psychology"=>{"Psychology"=>13}, "Mathematics"=>{"Mathematics"=>3}, "Unspecified"=>{"Unspecified"=>5}, "Engineering"=>{"Engineering"=>1}, "Neuroscience"=>{"Neuroscience"=>2}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>11}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}}, "reader_count_by_country"=>{"Canada"=>2, "Egypt"=>1, "Denmark"=>1, "Portugal"=>1}, "group_count"=>2}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/921753"], "description"=>"<p>Selection of the study sample from the total CSHA-1 population, including those participants from CSHA-1 who completed the 3MS, reported exercise levels, and either completed the CSHA-2 3MS or died before follow up.</p>", "links"=>[], "tags"=>["csha-1", "completed", "csha-2", "3ms", "died"], "article_id"=>592194, "categories"=>["Medicine", "Mathematics", "Neuroscience"], "users"=>["Laura E. Middleton", "Arnold Mitnitski", "Nader Fallah", "Susan A. Kirkland", "Kenneth Rockwood"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0003124.g001", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Selection_of_the_study_sample_from_the_total_CSHA_1_population_including_those_participants_from_CSHA_1_who_completed_the_3MS_reported_exercise_levels_and_either_completed_the_CSHA_2_3MS_or_died_before_follow_up_/592194", "title"=>"Selection of the study sample from the total CSHA-1 population, including those participants from CSHA-1 who completed the 3MS, reported exercise levels, and either completed the CSHA-2 3MS or died before follow up.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-09-01 00:36:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/922008"], "description"=>"<p>Changes in cognition in relation to cognitive status at baseline by age and exercise level for people with higher levels of education.</p>", "links"=>[], "tags"=>["cognition", "baseline", "higher"], "article_id"=>592457, "categories"=>["Medicine", "Mathematics", "Neuroscience"], "users"=>["Laura E. Middleton", "Arnold Mitnitski", "Nader Fallah", "Susan A. Kirkland", "Kenneth Rockwood"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0003124.g004", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Changes_in_cognition_in_relation_to_cognitive_status_at_baseline_by_age_and_exercise_level_for_people_with_higher_levels_of_education_/592457", "title"=>"Changes in cognition in relation to cognitive status at baseline by age and exercise level for people with higher levels of education.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-09-01 00:40:57"}
  • {"files"=>["https://ndownloader.figshare.com/files/922237"], "description"=>"<p>Older people are those whose age is at least 76 years old. Higher education means 10 years or more.</p>*<p>Significant difference between exercise groups.</p>", "links"=>[], "tags"=>["probabilities", "getting", "maintaining"], "article_id"=>592683, "categories"=>["Medicine", "Mathematics", "Neuroscience"], "users"=>["Laura E. Middleton", "Arnold Mitnitski", "Nader Fallah", "Susan A. Kirkland", "Kenneth Rockwood"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0003124.t002", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Average_probabilities_and_standard_deviation_of_getting_better_or_maintaining_the_same_cognitive_performance_cognitive_decline_or_dying_and_their_standard_deviations_/592683", "title"=>"Average probabilities (and standard deviation) of getting better or maintaining the same cognitive performance, cognitive decline or dying and their standard deviations.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2008-09-01 00:44:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/921828"], "description"=>"<p>Changes in cognition in relation to baseline cognitive status at baseline by exercise level in unadjusted analyses.</p>", "links"=>[], "tags"=>["cognition", "baseline", "unadjusted"], "article_id"=>592274, "categories"=>["Medicine", "Mathematics", "Neuroscience"], "users"=>["Laura E. Middleton", "Arnold Mitnitski", "Nader Fallah", "Susan A. Kirkland", "Kenneth Rockwood"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0003124.g002", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Changes_in_cognition_in_relation_to_baseline_cognitive_status_at_baseline_by_exercise_level_in_unadjusted_analyses_/592274", "title"=>"Changes in cognition in relation to baseline cognitive status at baseline by exercise level in unadjusted analyses.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-09-01 00:37:54"}
  • {"files"=>["https://ndownloader.figshare.com/files/922273"], "description"=>"*<p> = significantly different between the high exercise and low exercise groups.</p>†<p> = significantly different between participants with cognitive impairment and those with no cognitive impairment.</p>§<p> = significantly different between respondents and non-respondents.</p>", "links"=>[], "tags"=>["groups", "respondents"], "article_id"=>592720, "categories"=>["Medicine", "Mathematics", "Neuroscience"], "users"=>["Laura E. Middleton", "Arnold Mitnitski", "Nader Fallah", "Susan A. Kirkland", "Kenneth Rockwood"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0003124.t001", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Descriptive_traits_of_high_versus_low_no_exercise_groups_and_respondents_versus_non_respondents_/592720", "title"=>"Descriptive traits of high versus low/no exercise groups and respondents versus non-respondents.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2008-09-01 00:45:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/921919"], "description"=>"<p>Changes in cognition in relation to baseline cognitive status at baseline by age and exercise level for people with lower levels of education.</p>", "links"=>[], "tags"=>["cognition", "baseline"], "article_id"=>592370, "categories"=>["Medicine", "Mathematics", "Neuroscience"], "users"=>["Laura E. Middleton", "Arnold Mitnitski", "Nader Fallah", "Susan A. Kirkland", "Kenneth Rockwood"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0003124.g003", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Changes_in_cognition_in_relation_to_baseline_cognitive_status_at_baseline_by_age_and_exercise_level_for_people_with_lower_levels_of_education_/592370", "title"=>"Changes in cognition in relation to baseline cognitive status at baseline by age and exercise level for people with lower levels of education.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-09-01 00:39:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/455490", "https://ndownloader.figshare.com/files/455585", "https://ndownloader.figshare.com/files/455605", "https://ndownloader.figshare.com/files/455629", "https://ndownloader.figshare.com/files/455653"], "description"=>"<div><h3>Background</h3><p>On average, cognition declines with age but this average hides considerable variability, including the chance of improvement. Here, we investigate how exercise is associated with cognitive change and mortality in older people and, particularly, whether exercise might paradoxically increase the risk of dementia by allowing people to live longer.</p><h3>Methods and Principal Findings</h3><p>In the Canadian Study of Health and Aging (CSHA), of 8403 people who had baseline cognition measured and exercise reported at CSHA-1, 2219 had died and 5376 were re-examined at CSHA-2. We used a parametric Markov chain model to estimate the probabilities of cognitive improvement, decline, and death, adjusted for age and education, from any cognitive state as measured by the Modified Mini-Mental State Examination. High exercisers (at least three times per week, at least as intense as walking, n = 3264) had more frequent stable or improved cognition (42.3%, 95% confidence interval: 40.6–44.0) over 5 years than did low/no exercisers (all other exercisers and non exercisers, n = 4331) (27.8% (95% CI 26.4–29.2)). The difference widened as baseline cognition worsened. The proportion whose cognition declined was higher amongst the high exercisers but was more similar between exercise groups (39.4% (95% CI 37.7–41.1) for high exercisers versus 34.8% (95% CI 33.4–36.2) otherwise). People who did not exercise were also more likely to die (37.5% (95% CI 36.0–39.0) versus 18.3% (95% CI 16.9–19.7)). Even so, exercise conferred its greatest mortality benefit to people with the highest baseline cognition.</p><h3>Conclusions</h3><p>Exercise is strongly associated with improving cognition. As the majority of mortality benefit of exercise is at the highest level of cognition, and declines as cognition declines, the net effect of exercise should be to improve cognition at the population level, even with more people living longer.</p></div>", "links"=>[], "tags"=>["changes", "cognition", "based"], "article_id"=>149723, "categories"=>["Medicine", "Mathematics", "Neuroscience"], "users"=>["Laura E. Middleton", "Arnold Mitnitski", "Nader Fallah", "Susan A. Kirkland", "Kenneth Rockwood"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0003124.s001", "https://dx.doi.org/10.1371/journal.pone.0003124.s002", "https://dx.doi.org/10.1371/journal.pone.0003124.s003", "https://dx.doi.org/10.1371/journal.pone.0003124.s004", "https://dx.doi.org/10.1371/journal.pone.0003124.s005"], "stats"=>{"downloads"=>5, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Changes_in_Cognition_and_Mortality_in_Relation_to_Exercise_in_Late_Life_A_Population_Based_Study/149723", "title"=>"Changes in Cognition and Mortality in Relation to Exercise in Late Life: A Population Based Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2008-09-01 02:42:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/922155"], "description"=>"<p>Relative risks of death for the low exercise group relative to the high exercise group by baseline cognitive state.</p>", "links"=>[], "tags"=>["risks", "baseline"], "article_id"=>592604, "categories"=>["Medicine", "Mathematics", "Neuroscience"], "users"=>["Laura E. Middleton", "Arnold Mitnitski", "Nader Fallah", "Susan A. Kirkland", "Kenneth Rockwood"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0003124.g005", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Relative_risks_of_death_for_the_low_exercise_group_relative_to_the_high_exercise_group_by_baseline_cognitive_state_/592604", "title"=>"Relative risks of death for the low exercise group relative to the high exercise group by baseline cognitive state.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-09-01 00:43:24"}

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  • {"unique-ip"=>"8", "full-text"=>"9", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"8", "full-text"=>"6", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"12", "full-text"=>"13", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"5", "full-text"=>"7", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2016", "month"=>"12"}
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  • {"unique-ip"=>"5", "full-text"=>"6", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
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  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"11", "full-text"=>"10", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"8", "full-text"=>"7", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"9", "full-text"=>"9", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
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  • {"unique-ip"=>"12", "full-text"=>"11", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"11", "full-text"=>"11", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"28", "full-text"=>"28", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"12", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"11", "full-text"=>"14", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
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Relative Metric

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