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Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older
Larson EB, Wang L, Bowen JD, McCormick WC, Teri L, Crane P, Kukull W.. Annals of internal medicine, 2006-01-01
Topic: Risk, prevention and care in population studies
Background Alzheimer disease and other dementing disorders are major sources of morbidity and mortality in aging societies. Proven strategies to delay onset or reduce risk for dementing disorders would be greatly beneficial. Objective To determine whether regular exercise is associated with a reduced risk for dementia and Alzheimer disease. Design Prospective cohort study. Setting Group Health Cooperative, Seattle, Washington. Participants 1740 persons older than age 65 years without cognitive impairment who scored above the 25th percentile on the Cognitive Ability Screening Instrument (CASI) in the Adult Changes in Thought study and who were followed biennially to identify incident dementia. Measurements Baseline measurements, including exercise frequency, cognitive function, physical function, depression, health conditions, lifestyle characteristics, and other potential risk factors for dementia (for example, apolipoprotein E epsilon4); biennial assessment for dementia. Results During a mean follow-up of 6.2 years (SD, 2.0), 158 participants developed dementia (107 developed Alzheimer disease). The incidence rate of dementia was 13.0 per 1000 person-years for participants who exercised 3 or more times per week compared with 19.7 per 1000 person-years for those who exercised fewer than 3 times per week. The age- and sex-adjusted hazard ratio of dementia was 0.62 (95% CI, 0.44 to 0.86; P = 0.004). The interaction between exercise and performance-based physical function was statistically significant (P = 0.013). The risk reduction associated with exercise was greater in those with lower performance levels. Similar results were observed in analyses restricted to participants with incident Alzheimer disease. Limitations Exercise was measured by self-reported frequency. The study population had a relatively high proportion of regular exercisers at baseline. Conclusion These results suggest that regular exercise is associated with a delay in onset of dementia and Alzheimer disease, further supporting its value for elderly persons.
Key findings
- Objective To determine whether regular exercise is associated with a reduced risk for dementia and Alzheimer disease.
- Results During a mean follow-up of 6.2 years (SD, 2.0), 158 participants developed dementia (107 developed Alzheimer disease).
- The incidence rate of dementia was 13.0 per 1000 person-years for participants who exercised 3 or more times per week compared with 19.7 per 1000 person-years for those who exercised fewer than 3 times per week.
- The interaction between exercise and performance-based physical function was statistically significant (P = 0.013).
- The risk reduction associated with exercise was greater in those with lower performance levels.
Why it matters
Among 1,740 Seattle adults over 65 without cognitive impairment, followed for an average of 6.2 years, those who reported exercising 3 or more times a week developed dementia at 13.0 per 1,000 person-years, compared with 19.7 for those who exercised less (age- and sex-adjusted hazard ratio 0.62). The link was stronger in people with lower physical function. This is an observational study and exercise was self-reported, so it shows an association, not that exercise prevents dementia.
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Study details
- Study designcohort study
- Participants1,740
- Evidence strengthModerate
How this study scored 75/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of internal medicine) |
| Journal's citation record | 4 / 4 | Annals of Internal Medicine: journal h-index 648 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2006 — older than 20 years, still counted |
| Sample size | 3 / 4 | 1,740 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,468 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 66.7 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 6 / 6 | Cited 51.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 67 other studies in this library |
| Still being cited | 3 / 4 | Cited 96 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Walter A. Kukull: h-index 107 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 16418406) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 75 / 100 | — |
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Read the original
May need a subscription Unpaywall, Europe PMC and OpenAlex found no free copy of the full text (checked 10 Oct 2026), so the publisher may charge for it. The PubMed abstract is free.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Larson, E. B., Wang, L., Bowen, J. D., McCormick, W. C., Teri, L., Crane, P., et al. (2006). Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of internal medicine. https://doi.org/10.7326/0003-4819-144-2-200601170-00004
Vancouver
Larson EB, Wang L, Bowen JD, McCormick WC, Teri L, Crane P, et al. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of internal medicine. 2006. doi:10.7326/0003-4819-144-2-200601170-00004. PMID: 16418406.
BibTeX
@article{larson2006-16418406,
author = {Larson, E. B. and Wang, L. and Bowen, J. D. and McCormick, W. C. and Teri, L. and Crane, P. and Kukull, W.},
title = {{Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older}},
journal = {Annals of internal medicine},
year = {2006},
doi = {10.7326/0003-4819-144-2-200601170-00004},
pmid = {16418406},
url = {https://doi.org/10.7326/0003-4819-144-2-200601170-00004}
}
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