Evidence map›Paper›PMID 40494735›Full record

ArticleThe journal of prevention of Alzheimer's disease2025

Trajectories of Cardiorespiratory Fitness Measured by Metabolic Equivalents and the Risk of Alzheimer's and Related Dementias.

Edward Zamrini, Yan Cheng, Peter Kokkinos, Charity J Morgan, Charles Faselis, Helen M Sheriff, Yijun Shao, Xuemei Sui, Ali Ahmed, Qing Zeng

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In one paragraph

Article in The journal of prevention of Alzheimer's disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Edward ZamriniWashington DC VA Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA; Irvine Clinical Research, Irvine, CA, USA.
Yan ChengWashington DC VA Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA.
Peter KokkinosWashington DC VA Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA.
Charity J MorganUniversity of Alabama at Birmingham, Birmingham, AL, USA.
Charles FaselisWashington DC VA Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA.
Helen M SheriffWashington DC VA Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA.
Yijun ShaoWashington DC VA Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA.
Xuemei SuiUniversity of South Carolina, Columbia, SC, USA.
Ali AhmedWashington DC VA Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA.
Qing ZengWashington DC VA Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA. Electronic address: zengq@gwu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigher fitness levels have been reported to protect against Alzheimer's Disease and Related Dementias (ADRD). However, the association between changes in fitness over time and ADRD risk remains unknown. This study aims to identify clusters of metabolic equivalents (METs) trajectories and examine their correlation with incident ADRD.

methodsA retrospective cohort study was conducted among Veterans with ≥3 standardized exercise treadmill tests (ETT) between 2000 and 2017. The exposure was change in fitness expressed in metabolic equivalents (METs). METs are based on treadmill speed, grade, and time. One MET is equivalent to 3.5 ml per kg of body weight per minute. The outcome was incident ADRD after the final ETT test, identified by diagnosis codes. Standardized METs scores were generated using mean and standard deviation for each age and sex stratum. Latent class growth analysis (LCGA) identified trajectory clusters. We assessed the association between clusters and ADRD using unadjusted Kaplan-Meier curves (overall and by age groups) and a multivariate Cox regression model adjusted for baseline characteristics at the first ETT.

resultsA total of 75,851 veterans were included. The average number of ETTs was 4.0 ± 1.8, with the average time gap of 6.5 ± 3.8 years between first and last test. We identified five trajectory clusters: Group 1 (n = 22,485), Group 2 (n = 22,694), Group 3 (n = 6691), Group 4 (n = 19,386), and Group 5 (n = 4595). All groups, except for Group 3, showed a stable and slight improvement or decline over time, differing only in their initial standardized METs scores: Group 5 had the highest initial score, Group 1 had the lowest initial score, while Group 3 started out with a score almost as high as Group 4 and dropped to as low as Group 1. Compared to Group 1, Group 3 had a 12 % reduced risk of developing ADRD (HR = 0.88; 95 % CI: 0.77 - 1.01; p = 0.0660), with a greater reduction than Group 2 (10 %) but less than Group 4 (17 %) or Group 5 (24 %). DISCUSSION: Our findings underscore the potential benefits of maintaining fitness to reduce the risk of ADRD with age. Although declining fitness levels are associated with an increased risk, the initial higher baseline fitness provides a degree of ongoing protection against ADRD.

Indexed as

Alzheimer DiseaseCardiorespiratory FitnessDementiaMetabolic EquivalentAgedExercise TestFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsVeteransAlzheimer's and related dementiasAnalysisCardiorespiratory fitnessClusterTrajectory

Identifiers

PMID40494735
PMCPMC12413720

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.