Higher cardiorespiratory fitness is associated with improved cognitive performance across five key domains, including memory and executive function, in older adults, according to a recent study.
Lauren Oberlin, PhD, of Weill Cornell Medicine, and colleagues investigated how cardiorespiratory fitness relates to cognitive function in older adults, publishing their findings in the British Journal of Sports Medicine. Using baseline data from the IGNITE trial, they examined CRF's impact across cognitive domains while considering demographic and clinical factors as potential moderators.
The study included 648 cognitively healthy participants aged 65 to 80 years (mean age 69.88 ± 3.75 years; 71.1% women). Participants had an average education of 16.32 ± 2.21 years, with 27.2% identified as APOE4 carriers. CRF was assessed using VO2max during a graded treadmill exercise test, following American College of Sports Medicine guidelines. The test included criteria for maximal effort, such as achieving a respiratory exchange ratio ≥1.10 or a rating of perceived exertion ≥17.
Cognitive performance was assessed using a comprehensive neuropsychological battery. Tests included the Letter Comparison Test (processing speed), the Hopkins Verbal Learning Test (episodic memory), and the Flanker Task (executive function/attentional control). Confirmatory factor analysis was employed to create latent factors representing episodic memory, processing speed, working memory, executive function/attentional control, and visuospatial function.
Results demonstrated that higher CRF was significantly associated with better performance across all cognitive domains (p < 0.01) after adjusting for age, sex, education, APOE4 carriage, and body mass index. Age and APOE4 carriage did not significantly moderate these associations. However, CRF-related cognitive benefits were more pronounced among women and participants with fewer years of education. For example, in processing speed, the interaction effects for sex (β = −0.447, p = 0.015) and education (β = −0.863, p = 0.018) were significant. Similarly, beta-blocker use amplified the positive association between CRF and executive function/attentional control (β = 0.305, p = 0.047).
A key limitation of the study is its cross-sectional design, which prevents establishing causal relationships. The study also noted variability in achieving maximal exertion during the VO2max test, as over 50% of participants did not meet the respiratory exchange ratio threshold, though 78% satisfied at least three of four maximal effort criteria.
The study investigators concluded that higher CRF provides multidomain cognitive benefits, particularly in areas susceptible to age-related decline. Future research could explore causal pathways and mechanisms to guide personalized interventions targeting fitness and cognitive health in older adults.
Full disclosures can be found in the published study.