• Cardiorespiratory fitness is associated with improved cognitive function in older adults.
• Researchers found that individuals with better cardiorespiratory fitness scored higher across five cognitive health domains.
• The findings illustrate that lifestyle choices, such as exercise, can significantly decrease dementia risk.

Cardiorespiratory fitness among older adults is associated with better outcomes related to cognitive ability, including memory and executive functioning.

According to new research, those benefits also appear to remain robust despite the presence of key risk factors for cognitive decline, such as old age and carrying the APOE4 gene, a predictor of Alzheimer’s disease. The findings were published December 10 in The British Journal of Sports Medicine.

“We found that cardiorespiratory fitness — a measure of aerobic capacity that we can modify by engaging in regular aerobic exercise — was positively related to better cognitive performance across multiple domains,” first study author Lauren Oberlin, PhD, associate investigator at Advent Health and clinical assistant professor of psychiatry at Weill Cornell Medical College, told Healthline.

“In addition, higher fitness levels were linked to better thinking and memory skills even among older adults at higher risk for cognitive decline,” she noted.

The findings support recommendations for individuals of all ages, even older adults, to get more active.

Benefits across five cognitive domains

For their research, Oberlin and her colleagues recruited 648 older adults for a physical test and a battery of cognitive assessments.

Participants were between 65 and 80 years of age, and predominantly (71%) female.

Participants who engaged in less than 20 minutes per day of moderate-to-vigorous exercise three days per week or more over the past six months were excluded from the study. Those with severe mental health conditions or certain neurological conditions were also excluded, as were people with a recent history of cardiovascular events or type 1 diabetes.

Enrolled participants took part in a VO2 max test on a treadmill to assess cardiorespiratory fitness. The test measures the maximum rate of oxygen that an individual’s body can utilize while exercising at maximum intensity. The higher the VO2 max score, the higher the level of cardiorespiratory fitness.

Participants had an average VO2 max of 21.68 ml/kg/min, below what is considered a good VO2 max score for both men (30-40 ml/kg/min) and women (25-35 ml/kg/min).

Following the VO2 max test, participants then took cognitive tests across five domains of brain function:

• Working memory: Short-term memory, like remembering a phone number while dialing.
• Episodic memory: The ability to recall specific events and details.
• Processing speed: How fast the brain can respond to new information.
• Executive function/attention control: The domain associated with decision making and planning.
• Visuospatial function: The ability to perceive and interpret spatial relationships, used for activities like driving and puzzle solving.

Higher cardiorespiratory fitness, as indicated by the VO2 test, was associated with better performance across all five of these domains, regardless of age and the presence of the APOE4 gene.

“This is a ray of hope,” James Powers, MD, professor of geriatric medicine at Vanderbilt University and director of the Middle Tennessee Geriatric Workforce Enhancement Program, told Healthline. Powers wasn’t affiliated with the research.

“We’re finding that there indeed is a very real effect, a correlation between cardiovascular fitness, exercise, and cognitive status. This study is very important to us as we try to educate the community, and try to encourage our patients in lifestyle choices throughout their lifespan,” Powers said.

“What we’re learning from studies like this, and there are others, is that we indeed can take some personal effort that can have a meaningful impact in our lives in terms of forestalling or preventing a risk of dementia,” he noted.

In addition, the association was more prominent in women and participants taking beta-blockers. However, as an observational study, there is no recognized causation between taking those drugs and the cognitive benefits.

“Beta-blockers can impact an individual’s ability to reach fitness-related thresholds,” Oberlin said.

“It may be that maintaining higher fitness in the setting of chronic conditions treated by beta-blockers may be important for preserving executive functioning. However, since this is a cross-sectional study, we can only speculate on the nature of these relationships,” she added.

Improving cardiorespiratory fitness at any age

The Centers for Disease Control and Prevention (CDC) recommends 150 minutes per week of moderate-intensity physical activity, such as 30 minutes per day, five days per week.

These guidelines include activities you might not think of as “exercise”, such as gardening and walking.

It is especially important for older adults to maintain physical activity and cardiorespiratory fitness while minimizing the risk of injury.

A workout plan for older adults may include activities such as:

• balance and flexibility exercise
• regular walks
• swimming or water aerobics
• strength training
• aerobics classes like Zumba

The bottom line is that staying physically fit is not just about your body; it’s about your brain.

“Every additional step you take is an investment in your brain health,” Lydia Bazzano, MD, PhD, director of the Tulane Center for Lifespan Epidemiology Research at Tulane University, told Healthline. Bazzano was not affiliated with the research.

“Even if you’re just parking farther away and walking a little bit more toward your destination. Every extra bit of physical activity that you can get is a potential benefit to your brain,” she said.

Takeaway

Better cardiorespiratory fitness translates to better cognitive health outcomes in older adults, according to new research.

The study’s findings, based on a VO2 max test, showed that individuals who were more fit performed better across five domains of cognitive ability, including memory and executive functioning.

The study indicates that staying physically fit, even into older adulthood, is important for brain health.

Lifestyle choices, including exercise, can meaningfully impact risk of dementia and cognitive decline.