The Cooper Institute

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH


Can Aerobic Fitness Prevent Dementia? CCLS Study Examines the Connection

Posted in

Friday, Jun 28, 2019

As the average life expectancy of U.S. adults continues to increase, dementia has come to the forefront of public health issues. The most common form of dementia is Alzheimer’s, which is now the 6th leading cause of death in the U.S.  

Nearly 6 million Americans are living with Alzheimer’s and dementia, and their healthcare costs are projected to cost over $290 billion in 2019 - a number that could rise to over $1 trillion by 2050.

The World Health Organization (WHO) recently released guidelines for the prevention of cognitive decline and dementia. These guidelines are similar to those for cardiovascular disease and cancer prevention. More specifically, the WHO recommends avoiding tobacco and heavy alcohol use, increasing physical activity, managing blood pressure, striving for or maintaining healthy body weight, and eating a healthy diet such as the Mediterranean Diet.

One promising area in the prevention of dementia is the impact of cardiorespiratory fitness (aka aerobic fitness). The Cooper Institute research team, led by CEO and Chief Science Officer Dr. Laura DeFina, looked at the relationship between aerobic fitness and the later risk of dementia in a paper published in 2013 from the Cooper Center Longitudinal Study (CCLS). 

The CCLS study looked at over 19,000 healthy men and women around 50 years old who were given a comprehensive physical examination at the Cooper Clinic. During this baseline exam, patients took a maximal treadmill exercise test to assess their aerobic fitness level. Patients were then divided into five categories of fitness based on age and gender. During an average follow-up period of 24 years, nearly 1700 cases of dementia were diagnosed after cross-referencing with Medicare data. 

People with high levels of fitness are 36% less likely to develop dementia.

What the team found was that as baseline levels of cardiorespiratory fitness increased, the risk of developing dementia decreased. In fact, men and women in the highest fitness category at baseline were 36% less likely to develop dementia during the follow-up compared to men and women in the lowest fitness category. 

The study also looked at how cardiorespiratory fitness might protect against the development of dementia. For example, people with higher levels of aerobic fitness are less likely to develop hypertension and diabetes, both of which are risk factors for dementia. Higher fitness levels also seem to be associated with preservation of brain mass as we age. The authors emphasized the need for more studies on how brain structure and function are affected by physical activity and aerobic fitness in our middle-age years. 

In the meantime, all adults are urged to meet the public health guidelines for physical activity. The guidelines call for a minimum of 150 minutes per week of moderate-intensity aerobic activity, as well as a minimum of 2 days per week of strength training. The evidence seems to be clear - exercise is the best preventive medicine if we want to live #WELLintothefuture. 


DeFina, L.F., Willis, B.L., Radford, N.B., Gao, A., Leonard, D., Haskell, W.L., Weiner, M.G., Berry, J.D. (2013).  The association between midlife cardiorespiratory fitness levels and later-life dementia.  Annals of Internal Medicine, 158:162-168.