Exercise Reduces Silent Brain Infarcts

Allison Gandey

June 10, 2011

June 10, 2011 — Older people who exercise regularly may be less likely to develop silent brain infarcts, considered hallmarks of subclinical cerebrovascular disease.

"Encouraging older people to take part in moderate to intense exercise may be an important strategy for keeping their brains healthy," lead investigator Joshua Willey, MD, from Columbia University in New York, said in a news release.

His team's new study was published online June 8 in Neurology.

"These silent strokes are more significant than the name implies because they have been associated with an increased risk of falls and impaired mobility, memory problems, and even dementia as well as stroke," Dr. Willey said.

The analysis included more than 1200 people from the Northern Manhattan Study who had never had a stroke. The population-based prospective cohort is evaluating risk factors for incident vascular disease.

Participants completed a questionnaire about how often and how intensely they exercised at the beginning of the study and then had magnetic resonance imaging on average 6 years later, when most were about 70 years old.

The primary outcomes for this study were silent brain infarcts and white-matter hyperintensity volume.

In all, 43% of people reported they had no regular exercise; 36% engaged in regular light exercise, such as golf, walking, bowling, or dancing; and 21% participated in regular moderate to intense exercise, such as hiking, tennis, swimming, biking, jogging, or racquetball.

Silent Infarcts

Sixteen percent of participants had silent brain infarcts.

In fully adjusted models, compared with participants who did not engage in physical activity, those in the upper quartile of metabolic equivalent scores for activity were almost half as likely to have silent brain infarcts (adjusted odds ratio 0.6; 95% confidence interval, 0.4 - 0.9).

The results were consistent after the researchers took into account other vascular risk factors, such as high blood pressure, high cholesterol, and smoking. There was no difference between those who engaged in light exercise and those who did not exercise.

"Of course, light exercise has many other beneficial effects, and these results should not discourage people from doing light exercise," Dr. Willey said.

Physical activity was also not associated with white-matter hyperintensity volume.

The study also showed that the benefit of moderate to intense exercise on brain health was not apparent for people on Medicaid or with no health insurance.

People who exercised regularly at a moderate to intense level who had Medicaid or no health insurance were no less likely to have silent infarcts than people who did no regular exercise. Dr. Willey explained, "It may be that the overall life difficulties for people with no insurance or on Medicaid lessens the protective effect of regular exercise."

This study was funded by the National Institute of Neurological Disorders and Stroke. Dr. Joshua Willey has received research support from the National Institutes of Health.

Neurology. Published online June 8, 2011.

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