Physical activity and amyloid beta in middle-aged and older adults: A systematic review and meta-analysis

María Rodriguez-Ayllon; Patricio Solis-Urra; Cristina Arroyo-Ávila; Miriam Álvarez-Ortega; Pablo Molina-García; Cristina Molina-Hidalgo; Manuel Gómez-Río; Belinda Brown; Kirk I Erickson; Irene Esteban-Cornejo

doi:10.1016/j.jshs.2023.08.001

Physical activity and amyloid beta in middle-aged and older adults: A systematic review and meta-analysis

J Sport Health Sci. 2024 Mar;13(2):133-144. doi: 10.1016/j.jshs.2023.08.001. Epub 2023 Aug 7.

Affiliations

¹ Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, GD 3015, the Netherlands.
² Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18071, Spain; Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar 2531015, Chile; Department of Nuclear Medicine, Virgen de las Nieves University Hospital, Institute of Biosanitary Research of Granada (IBS), Granada 18014, Spain.
³ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18071, Spain.
⁴ Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Institute of Biosanitary Research of Granada (IBS), Granada 18014, Spain.
⁵ Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
⁶ Department of Nuclear Medicine, Virgen de las Nieves University Hospital, Institute of Biosanitary Research of Granada (IBS), Granada 18014, Spain.
⁷ Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA 6150, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
⁸ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18071, Spain; Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA 6150, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; Advent Health Research Institute, Neuroscience Institute Orlando, Orlando, FL 32803, USA.
⁹ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18071, Spain; Physiopathology of Obesity and Nutrition Research Center (CIBERobn), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain. Electronic address: ireneesteban@ugr.es.

Abstract

Background: One of the pathological hallmarks distinguishing Alzheimer's disease from other dementias is the accumulation of amyloid beta (Aβ). Higher physical activity is associated with decreased dementia risk, and one potential path could be through Aβ levels modulation. We aimed to explore the relationship between physical activity and Aβ in middle-aged and older adults.

Methods: A systematic search of PubMed, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trials, and SPORTDiscus was performed from inception to April 28, 2022. Studies were eligible if they included physical activity and Aβ data in adults aged 45 years or older. Multi-level meta-analyses of intervention and observational studies were performed to examine the role of physical activity in modulating Aβ levels.

Results: In total, 37 articles were included (8 randomized controlled trials, 3 non-randomized controlled trials, 4 prospective longitudinal studies, and 22 cross-sectional studies). The overall effect size of physical activity interventions on changes in blood Aβ was medium (pooled standardized mean difference = -0.69, 95% confidence interval (95%CI): -1.41 to 0.03; I² = 74.6%). However, these results were not statistically significant, and there were not enough studies to explore the effects of physical activity on cerebrospinal fluid (CSF) and brain Aβ. Data from observational studies were examined based on measurements of Aβ in the brain using positron emission tomography scans, CSF, and blood. Higher physical activity was positively associated with Aβ only in the CSF (Estimate r = 0.12; 95%CI: 0.05-0.18; I² = 38.00%).

Conclusion: Physical activity might moderately reduce blood Aβ in middle-aged and older adults. However, results were only near statistical significance and might be interpreted with caution given the methodological limitations observed in some of the included studies. In observational studies, higher levels of physical activity were positively associated with Aβ only in CSF. Therefore, further research is needed to understand the modulating role of physical activity in the brain, CSF, and blood Aβ, as well as its implication for cognitive health.

Keywords: Aging; Cognitive impairment; Dementia; Exercise; PET.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Aged
Alzheimer Disease*
Amyloid beta-Peptides* / metabolism
Brain
Cross-Sectional Studies
Humans
Middle Aged
Prospective Studies

Substances

Amyloid beta-Peptides