It is your doctor's responsibility to get you recovered enough that sedentary behaviour doesn't occur. You are energetic and on the go all the time.
YOUR DOCTOR'S RESPONSIBILITY!
Sedentary behaviour and brain health in middle-aged and older adults: a systematic review
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1. Introduction
Physical inactivity is one of the twelve modifiable risk factors that together might explain 40% of the global dementia cases, according to the Lancet Commission (Livingston et al., 2020). In the absence of pharmaceutical treatments for dementia, focus on altering these modifiable risk factors through lifestyle changes has become increasingly important (Norton et al., 2014). The impact of physical inactivity on the risk of dementia is in part related to the neuroprotective effects of exercise (Rashid et al., 2020, Chieffi et al., 2017). Exercise increases cerebral blood flow (CBF) and neurotrophic factors, which have a positive impact on angiogenesis and neurogenesis (Rashid et al., 2020). These effects translate to beneficial effects on structural brain measures associated with cognitive function (Chieffi et al., 2017). However, exercise is not always feasible for older adults due to physical limitations. Independent from exercise, physical inactivity also entails the fact that most people spend a substantial part of their day in sedentary activities (Brownson et al., 2005). Sedentary behaviour (SB) is known to have multiple detrimental cardiovascular and metabolic effects (Carter et al., 2017), which are not completely reversed by exercise (Knaeps et al., 2018, Patterson et al., 2018). Interestingly, many of these cardiovascular and metabolic effects of SB, such as hypertension, in turn have been identified as vascular risk factors for dementia (Claassen, 2015).
In light of this rationale, excessive amounts of SB might be a risk factor for dementia and cognitive decline via its cardiovascular effects. If proven true, this would open up possibilities to target sitting as a feasible way to intervene in efforts to prevent cognitive decline. However, before starting intervention programmes that aim to reduce sitting to prevent or slow down the progression of dementia, more evidence is needed to link SB and cognitive function. Recent epidemiological studies were unable to demonstrate an association between SB and cognitive decline (Olanrewaju et al., 2020, Maasakkers et al., 2020a), possibly due to the long time needed for SB to result in cognitive decline. Therefore, studying more proximal physiological effects of SB on the brain may provide novel insights. Moreover, several studies specifically focused on healthy young individuals, whilst it takes decades before these individuals may experience the potential detrimental effects of SB. Therefore, it seems more relevant to examine if these potential physiological manifestations in the brain as a consequence of a sedentary lifestyle are already present in middle-aged and older adults. Focusing on these age groups, and exploring the potential relation with cognitive decline, is therefore clinically relevant. With this field still in its infancy, studies have only recently started to investigate associations between SB and the brain. Summarising the evidence currently available in the literature will inform how to move this field forward. Therefore, we aimed to systematically review if and how acute and habitual SB are associated with brain health in middle-aged and older adults. By summarising these studies we will get a first impression if there is a physiological rationale for an association between SB and dementia burden.
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