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  • 1.
    Kivimäki, Mika
    et al.
    UCL, Dept Epidemiol & Publ Hlth, London, England / Univ Helsinki, Clinicum, Finland / Univ Helsinki, Helsinki Inst Life Sci, Finland.
    Singh-Manoux, Archana
    UCL, Dept Epidemiol & Publ Hlth, England / INSERM, U1153, Epidemiol Ageing & Neurodegenerat Dis, Paris, France.
    Pentti, Jaana
    Univ Helsinki, Clinicum, Finland / Univ Turku, Dept Publ Hlth, Finland.
    Sabia, Séverine
    UCL, Dept Epidemiol & Publ Hlth, England / INSERM, U1153, Epidemiol Ageing & Neurodegenerat Dis, Paris, France.
    Nyberg, Solja T.
    Univ Helsinki, Clinicum, Finland.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden.
    Goldberg, Marcel
    INSERM, UMS 011, Populat Based Epidemiol Cohorts Unit, Villejuif, France.
    Knutsson, Anders
    Mid Sweden Univ, Dept Hlth Sci, Sundsvall, Sweden.
    Koskenvuo, Markku
    Univ Helsinki, Clinicum, Finland.
    Koskinen, Aki
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Kouvonen, Anne
    Univ Helsinki, Fac Social Sci, Finland / SWPS Univ Social Sci & Humanities Wroclaw, Poland / Queens Univ Belfast, Ctr Publ Hlth, Adm Data Res Ctr Northern Ireland, Belfast, Antrim, North Ireland.
    Nordin, Maria
    Stockholm Univ, Stress Res Inst, Sweden / Umea Univ, Dept Psychol, Sweden.
    Oksanen, Tuula
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Strandberg, Timo
    Univ Helsinki, Clinicum, Finland / Helsinki Univ Hosp, Finland / Univ Oulu, Ctr Life Course Hlth Res, Finland.
    Suominen, Sakari
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Univ Turku, Dept Publ Hlth, Finland.
    Theorell, Töres
    Stockholm Univ, Stress Res Inst, Sweden.
    Vahtera, Jussi
    Univ Turku, Dept Publ Hlth, Finland / Turku Univ Hosp, Finland.
    Väänanen, Ari
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Virtanen, Marianna
    Univ Eastern Finland, Sch Educ Sci & Psychol, Joensuu, Finland.
    Westerholm, Peter
    Uppsala Univ, Dept Med Sci, Sweden.
    Westerlund, Hugo
    Stockholm Univ, Stress Res Inst, Sweden.
    Zins, Marie
    INSERM, UMS 011, Populat Based Epidemiol Cohorts Unit, Villejuif, France.
    Seshadri, Sudha
    Univ Texas Hlth Sci Ctr San Antonio, Glenn Biggs Inst Alzheimers & Neurodegenerat Dis, San Antonio, TX 78229 USA / Framingham Heart Dis Epidemiol Study, Framingham, MA USA.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Sipilä, Pyry N.
    Univ Bristol, Bristol Med Sch, Populat Hlth Sci, Bristol, Avon, England.
    Shipley, Martin J.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Lindbohm, Joni V.
    Univ Helsinki, Clinicum, Finland.
    Ferrie, Jane E.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England / Univ Bristol, Bristol Med Sch, Populat Hlth Sci, Bristol, Avon, England.
    Jokela, Markus
    Univ Helsinki, Biomedicum, Fac Med, Finland.
    Physical inactivity, cardiometabolic disease, and risk of dementia: an individual-participant meta-analysis2019Inngår i: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 365, artikkel-id l1495Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE To examine whether physical inactivity is a risk factor for dementia, with attention to the role of cardiometabolic disease in this association and reverse causation bias that arises from changes in physical activity in the preclinical (prodromal) phase of dementia. DESIGN Meta-analysis of 19 prospective observational cohort studies. DATA SOURCES The Individual-Participant-Data Meta-analysis in Working Populations Consortium, the Inter-University Consortium for Political and Social Research, and the UK Data Service, including a total of 19 of a potential 9741 studies. REVIEW METHOD The search strategy was designed to retrieve individual-participant data from prospective cohort studies. Exposure was physical inactivity; primary outcomes were incident all-cause dementia and Alzheimer's disease; and the secondary outcome was incident cardiometabolic disease (that is, diabetes, coronary heart disease, and stroke). Summary estimates were obtained using random effects meta-analysis. RESULTS Study population included 404 840 people (mean age 45.5 years, 57.7% women) who were initially free of dementia, had a measurement of physical inactivity at study entry, and were linked to electronic health records. In 6.0 million person-years at risk, we recorded 2044 incident cases of all-cause dementia. In studies with data on dementia subtype, the number of incident cases of Alzheimer's disease was 1602 in 5.2 million person-years. When measured < 10 years before dementia diagnosis (that is, the preclinical stage of dementia), physical inactivity was associated with increased incidence of all-cause dementia (hazard ratio 1.40, 95% confidence interval 1.23 to 1.71) and Alzheimer's disease (1.36, 1.12 to 1.65). When reverse causation was minimised by assessing physical activity >= 10 years before dementia onset, no difference in dementia risk between physically active and inactive participants was observed (hazard ratios 1.01 (0.89 to 1.14) and 0.96 (0.85 to 1.08) for the two outcomes). Physical inactivity was consistently associated with increased risk of incident diabetes (hazard ratio 1.42, 1.25 to 1.61), coronary heart disease (1.24, 1.13 to 1.36), and stroke (1.16, 1.05 to 1.27). Among people in whom cardiometabolic disease preceded dementia, physical inactivity was non-significantly associated with dementia (hazard ratio for physical activity assessed > 10 before dementia onset 1.30, 0.79 to 2.14). CONCLUSIONS In analyses that addressed bias due to reverse causation, physical inactivity was not associated with all-cause dementia or Alzheimer's disease, although an indication of excess dementia risk was observed in a subgroup of physically inactive individuals who developed cardiometabolic disease.

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