Cardiorespiratory fitness and cognitive function in midlife: neuroprotection or neuroselection?
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OBJECTIVE: A study was undertaken to determine whether better cognitive functioning at midlife among more physically fit individuals reflects neuroprotection, by which fitness protects against age-related cognitive decline, or neuroselection, by which children with higher cognitive functioning select more active lifestyles. METHODS: Children in the Dunedin Longitudinal Study (N = 1,037) completed the Wechsler Intelligence Scales and the Trail Making, Rey Delayed Recall, and Grooved Pegboard tasks as children and again at midlife (age = 38 years). Adult cardiorespiratory fitness was assessed using a submaximal exercise test to estimate maximum oxygen consumption adjusted for body weight in milliliters/minute/kilogram. We tested whether more fit individuals had better cognitive functioning than their less fit counterparts (which could be consistent with neuroprotection), and whether better childhood cognitive functioning predisposed to better adult cardiorespiratory fitness (neuroselection). Finally, we examined possible mechanisms of neuroselection. RESULTS: Participants with better cardiorespiratory fitness had higher cognitive test scores at midlife. However, fitness-associated advantages in cognitive functioning were already present in childhood. After accounting for childhood baseline performance on the same cognitive tests, there was no association between cardiorespiratory fitness and midlife cognitive functioning. Socioeconomic and health advantages in childhood and healthier lifestyles during young adulthood explained most of the association between childhood cognitive functioning and adult cardiorespiratory fitness. INTERPRETATION: We found no evidence for a neuroprotective effect of cardiorespiratory fitness as of midlife. Instead, children with better cognitive functioning are selecting healthier lives. Fitness interventions may enhance cognitive functioning. However, observational and experimental studies testing neuroprotective effects of physical fitness should consider confounding by neuroselection.
Published Version (Please cite this version)
Belsky, Daniel W, Avshalom Caspi, Salomon Israel, James A Blumenthal, Richie Poulton and Terrie E Moffitt (2015). Cardiorespiratory fitness and cognitive function in midlife: neuroprotection or neuroselection?. Ann Neurol, 77(4). pp. 607–617. 10.1002/ana.24356 Retrieved from https://hdl.handle.net/10161/9709.
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The goal of Dan’s work is to reduce social inequalities in aging outcomes in the US and elsewhere. Dan's research seeks to understand how genes and environments combine to shape health across the life course. His work uses tools from genome science and longitudinal data from population-based cohort studies. The aim is to identify targets for policy and clinical interventions to promote positive development in early life and extend healthspan.
Areas of interest: Aging, health disparities, epidemiology, life course, genetics, genomics, gene-environment interaction, health measurement
After finishing his Ph.D. at the UNC Gillings School of Public Health in 2012, Dan came to Duke for a postdoc at the Center for The Study of Aging and Human Development. Dan joined the faculty at Duke in 2014. He is Assistant Professor in the Department of Medicine, Division of Geriatrics at the Duke University School of Medicine and Social Science Research Institute. Dan is a Senior Fellow at the Aging Center and a Research Scholar at the Duke Population Research Institute.
Areas of expertise: Epidemiology and Health Measurement
Caspi’s research is concerned with three questions: (1) How do childhood experiences shape aging and the course of health inequalities across the life span? (2) How do genetic differences between people shape the way they respond to their environments? (3) How do mental health problems unfold across and shape the life course?
Psychosocial factors and coronary heart disease, including such factors as social support, Type A behavior and hostility, and depression, exercise training and depression in the elderly; behavioral approaches to the treatment of hypertension (e.g., weight loss and exercise); cardiac rehabilitation; neuropsychological outcomes following cardiac surgery; psychosocial aspects of heart and lung transplantation; exercise training and osteoarthritis and fibromyalgia; compliance.
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