Relation of Physical Fitness to Brain Aging and Cognition in Older Adults

Level of physical fitness may be an important factor influencing the effects of brain aging and age-related cognitive decline. Multiple measures of aerobic fitness were used in a cohort of healthy older adults 50-89 years of age to identify how individual differences in fitness relate to brain aging and age-associated cognitive decline. Healthy adults (n=123; 65 F and 58 M; mean ± sd age = 67.9 ± 10.0; Mini-Mental State Exam = 29.1 ± 1.2) were screened to exclude neurological, psychiatric, and medical illnesses that could affect cognitive function, including hypertension. The Scaled Subprofile Model (SSM) with voxel-based morphometry and Statistical Parametric Mapping version 8 (VBM; SPM8 Dartel) were performed on T1-weighted 3T volumetric magnetic resonance imaging (MRI) scans to identify a gray matter pattern associated with brain aging. Performance on aerobic fitness measures, assessed during a graded exercise treadmill test (GXT), was evaluated in relation to the age-associated MRI gray matter network pattern and indices of neuropsychological function. Multivariate SSM VBM network analysis identified a linear combination of patterns that predicted age (R² = 0.48, p = 8.71e-19). This combined pattern was characterized by reductions in bilateral lateral and medial frontal, parietal, lateral temporal, and cerebellar regions with relative preservations in thalamic, occipital, and medial temporal regions including the hippocampus. Higher expression of the age-related network pattern was associated with poorer performance on multiple fitness indices. The best combination of fitness measures in predicting brain aging included overall treadmill exercise time, ventilatory efficiency, and the difference between basal and maximal respiratory rate (p = 6.67e-7). A higher combined fitness index score related to brain aging was associated with better performance on measures of memory, executive function, and processing speed in this cohort (6.08e-9≤ p≤ 0.05). Those individuals with higher levels of aerobic fitness had lower expression of the gray matter brain aging pattern and better performance on measures of memory, executive function, and processing speed. Identifying those fitness indices that are the best predictors of brain aging and cognitive performance may aid efforts in developing and evaluating exercise based interventions for age-related cognitive decline