Clinically, Crizzle and colleagues  reviewed exercise and PD and concluded that ‘patients with PD improve their physical performance and activities selleck inhibitor of daily living through exercise’. But that review did not address cognitive improvement. Lastly, there is good evidence that exercise may be protective against stroke and VaD [27,28]. 2. Epidemiological studies on exercise show protective effects on cognition 2A. Exercise may preserve cognition and slow cognitive decline Yaffe and colleagues  followed 5,925 women (more than 65 years old) for 6 to 8 years with baseline selfreport exercise measures. Women with a greater physical activity level at baseline experienced less cognitive decline during the 6 to 8 years of follow-up: cognitive decline occurred in 17%, 18%, 22%, and 24% of those in the highest, third, second, and lowest quartiles of blocks walked per week, respectively (P < 0.
001 for trend). Weuve and colleagues  used baseline energy expenditure measures from a survey of 18,766 nurses. The authors found, on a global cognitive score, that women in the second through fifth quintiles of energy expenditure scored an average of, respectively, 0.06, 0.06, 0.09, and 0.10 standard units higher than women in the lowest quintile (P for trend <0.001). The authors also observed less cognitive decline among women who were more active, especially those in the two highest quintiles of energy expenditure. A recent report by Middleton and colleagues  noted that women who gave a history of being physically active at any time in life, especially as teenagers, had a lower chance of cognitive decline in late life.
Nine thousand three hundred forty-four women (65 years old or older, mean 71.6 years) self-reported teenage, age 30, age 50, and late-life physical activity. Women who reported being physically Cilengitide selleck active had a lower prevalence of cognitive impairment in late life than women who were inactive at each stage. 2B. Exercise is associated with decreased incident dementia Abbott and colleagues , in a study of 2,257 men, reported that men who walked the least (< 0.25 miles/day) experienced a 1.8-fold excess risk of dementia in comparison with those who walked more than 2 miles/day (17.8 versus 10.3/1,000 person-years; relative hazard 1.77, 95% confidence interval [CI] 1.04 to 3.01). Larson and colleagues  followed 1,740 persons (older than 65 years) for an average of 6.2 years with respect to incident dementia. The incidence rate was 13.0 per 1,000 person-years for participants who exercised three or more times per week in comparison with 19.7 per 1,000 person-years for those who exercised less. The age- and sex-adjusted hazard ratio of dementia was 0.62 (95% CI 0.44 to 0.86; P = 0.004).