Active Voice: Lifelong Physical Activity and Cognitive Function in Midlife A Link Beginning in Childhood
By Juuso O. Hakala, M.D., and Suvi P. Rovio, Ph.D.

Juuso O. Hakala, M.D.Suvi P. Rovio, Ph.D.
With the aging of the population, the prevalence of cognitive deficits is increasing worldwide. This highlights the need for prompt and effective primordial prevention, i.e., lifestyle and behavioral factors that precede cognitive deficits. Lifestyle risk factors linked to cognitive decline (e.g., physical inactivity, smoking, poor diet) have become strikingly common and lead to simultaneously negative health consequences, such as decreased individual quality of life and increased public health care costs. For example, the number of children engaged in leisure time physical activity at a level that reaches the public health recommendations is less than 20 percent. Physical activity in midlife and old age has been suggested to protect against cognitive deficits. However, the independent influence of physical activity since childhood on the status of cognitive function in adulthood remains unknown.

Our study, as reported in the May 2019 issue of Medicine & Science in Sports & Exercise, focused on the associations between lifelong physical activity participation and cognitive function in midlife. The study is a part of the ongoing Cardiovascular Risk in Young Finns Study (YFS) where 3,596 children aged 3-18 years were recruited to participate in the baseline field study in 1980. Since then, researchers have followed up with the cohort into adulthood at intervals between three to nine years over the last 30-year period. Physical activity has been queried repeatedly in all YFS study phases. In 2011, cognitive function was assessed using a computerized neuropsychological test battery in 2,026 participants aged 34-49 years.

Our results indicated that a high level of physical activity in childhood, adolescence, young adulthood and adulthood may be associated with better reaction time in midlife. This association was independent of the physical activity levels reported in other age windows. Among men, high physical activity levels in young adulthood and adulthood were additionally found to be associated with better visual information processing and sustained attention in midlife. However, a higher level of adulthood physical activity was associated with better midlife spatial working memory.

Should the associations we observed be causal, our results suggest that a physically active lifestyle adopted in childhood, adolescence and young adulthood and continued into adulthood, may benefit cognitive function in middle age. Therefore, an active lifestyle from childhood could offer a possible strategy for primordial prevention or at least postponement of age-related cognitive deficits. Importantly, interventions targeted to promote lifelong physical activity would have potential for the risk factors associated with cognitive deficits. Improved physical activity behavior, in the long term, also could beneficially mitigate other risk factors linked to cognitive deficits, e.g., blood pressure or serum lipids.

Polarization between those persons who are physically active and those who are continuously physically inactive has already become a major issue affecting health from childhood to adulthood. Our novel insight on the lifelong benefits of physical activity on cognitive function is directly applicable to political decision-making and health recommendations aimed at promoting cognitive health across the lifespan. In conclusion, our findings provide novel insight into cost-effective and timely promotion of cognitive health.

About the authors:
Juuso O. Hakala, M.D., is a researcher in the Research Centre of Applied and Preventive Cardiovascular Medicine and the Centre for Population Health Research at the University of Turku and Turku University Hospital in Finland. He is pursuing a doctoral degree in cardiology and cardiovascular medicine. Currently, Dr. Hakala is a physician specializing in internal medicine in Satakunta Central Hospital, Pori, Finland. His research focuses on the cardiometabolic factors and cognitive performance. Dr. Hakala is an ACSM member.

Suvi P. Rovio, Ph.D., is an adjunct professor and senior researcher in the Research Centre of Applied and Preventive Cardiovascular Medicine and in the Centre for Population Health Research at the University of Turku and Turku University Hospital in Finland. Her research focuses on life-course and intergenerational determinants of cognitive function, leveraging the longitudinal data from two globally renowned studies, namely the Cardiovascular Risk in Young Finns Study and the Special Turku Coronary Risk Factor Intervention Project.