Cardiorespiratory fitness and cardiometabolic health are associated with distinct cognitive domains in cognitively healthy older adults.

Kałamała, P.; Ware, N.; Fabiani, M.; Michie, P. T.; Hunter, M.; Wade, A.; Simpson, F.; Mellow, M. L.; Low, K.; Keage, H.; Gratton, G.; Smith, A. E.; Karayanidis, F.

doi:10.1101/2025.04.06.646611

bioRxiv · 10.1101/2025.04.06.646611

Cardiorespiratory fitness and cardiometabolic health are associated with distinct cognitive domains in cognitively healthy older adults.

Kałamała, P.·Ware, N.·Fabiani, M.·Michie, P. T.·Hunter, M.·Wade, A.·Simpson, F.·Mellow, M. L.·Low, K.·Keage, H.·Gratton, G.·Smith, A. E.·Karayanidis, F.

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Abstract

BackgroundAging is associated with progressive cognitive decline, as well as increased prevalence of cardiometabolic risk factors and reduced cardiorespiratory fitness. In fact, reduced cardiometabolic health and cardiorespiratory fitness are both associated with a decline in cognitive functioning. This study examines the common and distinct contributions of these cardiovascular health factors on cognitive variability across different domains in cognitively healthy older adults. Methods and ResultsWe apply structural equation modelling (SEM) to model cross-sectional relationships between cardiometabolic health, cardiorespiratory fitness and performance across multiple cognitive domains in an age-restricted sample of healthy older adults from the ACTIVate Study (n=345; 60-70 yrs). Participants completed a series of cognitive and clinical assessments (including brachial blood pressure, heart rate, blood-based metabolic markers). We designed a cognitive model (Model 1) with four latent factors that are differentially impacted by aging (Processing Speed, Executive Function, Verbal Memory and Crystallized Ability) and used it to test effects on cognition of two theory-driven dimensions of cardiovascular health: Cardiorespiratory Fitness (Model 2) and Cardiometabolic Health (Model 3). Model 4 included both predictors and examined their joint and distinct effects on these cognitive domains. When controlling for their joint variance, Cardiometabolic Health and Cardiorespiratory Fitness showed evidence consistent with a double dissociation on cognitive domains. Specifically, cardiorespiratory fitness significantly predicted processing speed (r=0.28, p<0.05) and executive function (r=0.66, p<0.05), but not verbal memory and crystallized ability. In contrast, cardiometabolic health predicted crystallized ability (r=0.31, p<0.05) and verbal memory (r=0.28, p<0.05), but not executive function and processing speed. ConclusionsThis study shows the first evidence that cardiorespiratory fitness and cardiometabolic health are associated with distinct cognitive domains in a large cross-sectional, age-restricted and high functioning cohort. These findings emphasize the importance of healthy aging approaches that target both health literacy and lifestyle behaviors to promote functional capacity across the lifespan.

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Kałamała, P., Ware, N., Fabiani, M., Michie, P. T., Hunter, M., Wade, A., Simpson, F., Mellow, M. L., Low, K., Keage, H., Gratton, G., Smith, A. E., Karayanidis, F.. 2025-04-08. Cardiorespiratory fitness and cardiometabolic health are associated with distinct cognitive domains in cognitively healthy older adults.. https://doi.org/10.1101/2025.04.06.646611

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