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Physical inactivity in older adults with cognitive impairment without dementia: room for improvement



Persons with cognitive impairment without dementia are at high risk of adverse health outcomes. Tailored intervention targeting moderate–vigorous physical activity (MVPA) may reduce these risks.


To identify the prevalence and predictors of physical inactivity among older adults with cognitive impairment, no dementia (CIND); and estimate the proportion of inactive people with CIND who are capable of greater MVPA.


We studied 1875 community dwelling participants (over age 65) with CIND in the Health and Retirement Study. Physical inactivity was defined as MVPA ≤ 1x/week. Associations of physical inactivity with sociodemographic, health, and physical function were examined using chi-square and modified Poisson regression. We considered physically inactive participants capable of greater MVPA if they reported MVPA at least 1–3x/month, no difficulty walking several blocks, or no difficulty climbing several flights of stairs.


Fifty-six percent of participants with CIND were physically inactive. Variables with the highest age, sex, and race/ethnicity adjusted risk ratio (ARR) for physical inactivity were self-rated health (poor [76.9%]vs. excellent [34.2%]; ARR [95% CI] 2.27 [1.56–3.30]), difficulty walking (across the room [86.5%] vs. none [40.5%]; ARR [95% CI] 2.09 [1.87–2.35]), total assets (lowest quartile [62.6%] vs. highest quartile [43.1%]; ARR [95% CI] 1.54 [1.29–1.83]), and lower education attainment (less than high school [59.6%] vs college graduate [42.8%]; ARR [95% CI] 1.46 [1.17–1.83]). Among physically inactive older adults with CIND, 61% were estimated to be capable of greater MVPA.


Although physical inactivity is prevalent among older adults with CIND, many are capable of greater MVPA. Developing tailored physical activity interventions for this vulnerable population may improve cognitive, health, and quality of life outcomes.

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This study was supported by grants from the National Institutes of Health (P01 AG066605, P30 AG044281). Dr. Miller was also supported by funding from the NIH (5T32 AG000212-27). The sponsor did not have any role in the design, conduct, or reporting of this study.

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All authors read and approved of the submission of this manuscript. IS contributed to data acquisition. IS and MJM contributed to data analysis. All authors contributed to the study concept, design, data interpretation, and manuscript draft and critical review.

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Correspondence to Matthew J. Miller.

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KEC reports funding from the NIA. The other authors report no relevant disclosures.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national  research committee (University of California, San Francisco Institutional Review Board (IRB), IRB number 16-19185) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was provided by participants before entering the HRS.

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Miller, M.J., Cenzer, I., Barnes, D.E. et al. Physical inactivity in older adults with cognitive impairment without dementia: room for improvement. Aging Clin Exp Res (2021).

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  • Cognitive impairment
  • Physical activity
  • Physical function
  • Disability