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Long-term television viewing patterns and gray matter brain volume in midlife


The purpose of this study was to investigate whether long-term television viewing patterns, a common sedentary behavior, in early to mid-adulthood is associated with gray matter brain volume in midlife and if this is independent of physical activity. We evaluated 599 participants (51% female, 44% black, mean age 30.3 ± 3.5 at baseline and 50.2 ± 3.5 years at follow-up and MRI) from the prospective Coronary Artery Risk Development in Young Adults (CARDIA) study. We assessed television patterns with repeated interviewer-administered questionnaire spanning 20 years. Structural MRI (3T) measures of frontal cortex, entorhinal cortex, hippocampal, and total gray matter volumes were assessed at midlife. Over the 20 years, participants reported viewing an average of 2.5 ± 1.7 h of television per day (range: 0–10 h). After multivariable adjustment, greater television viewing was negatively associated with gray matter volume in the frontal (β = − 0.77; p = 0.01) and entorhinal cortex (β = − 23.83; p = 0.05) as well as total gray matter (β = − 2.09; p = 0.003) but not hippocampus. These results remained unchanged after additional adjustment for physical activity. For each one standard deviation increase in television viewing, the difference in gray matter volume z-score was approximately 0.06 less for each of the three regions (p < 0.05). Among middle-aged adults, greater television viewing in early to mid-adulthood was associated with lower gray matter volume. Sedentariness or other facets of television viewing may be important for brain aging even in middle age.

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Anonymized data are available from the CARDIA Coordinating Center ( A description of the National Heart, Lung, and Blood Institute policies governing the data and describing access to the data can be found online (


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The authors gratefully acknowledge the support of the CARDIA staff for their assistance in recruitment and data collection. Above all, the authors thank their dedicated volunteers for their participation in this research.


The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by Contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood Institute (NHLBI). CARDIA was also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005). Ryan J Dougherty was supported by an NIA training Grant (T32AG027668). Kristine Yaffe was supported in part by NIA Grants K24AG031155 and R01AG063887.

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Drafting/revising the manuscript for content: RJD, TDH, LJL, DRJ, SS, KY. Study concept or design: RJD, TDH, KY. Analysis or interpretation of data: RJD, TDH, LJL, DRJ, SS, KY.

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Correspondence to Ryan J. Dougherty.

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Conflict of interest

Ryan J. Dougherty, Tina D. Hoang, Lenore J. Launer, David R. Jacobs, Jr, and Stephen Sidney declare no conflicts of interest. Kristine Yaffe serves on DSMBs for Eli Lilly and several National Institute on Aging–sponsored studies and is also a member of the Beeson Scientific Advisory Board and the Global Council on Brain Health.

Ethical approval

The CARDIA study and brain MRI ancillary study were approved by the Institutional Review Board (IRB) of each of the participating sites as well as the University of Pennsylvania and University of California, San Francisco. All procedures followed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. At each examination participants were provided and signed a separate written informed consent for the CARDIA study and the brain MRI ancillary study.

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Dougherty, R.J., Hoang, T.D., Launer, L.J. et al. Long-term television viewing patterns and gray matter brain volume in midlife. Brain Imaging and Behavior 16, 637–644 (2022).

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  • Lifestyle factors
  • Sitting time
  • Volumetric MRI
  • Epidemiology
  • Cohort studies