Mitchell, John Joseph; (2025) Life course physical activity participation, physical activity contexts, and their supporting role for cognitive health. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

As we age, our memory, reasoning and speed of processing declines. Limited options exist to mitigate this decline. There is increasing focus on early prevention through adopting a lifelong healthy lifestyle to build resilience against future decline. Physical activity (PA) is one factor under intense scrutiny, as a potential universal therapy. However, research has often overlooked the role of PA in other life stages, and the broader context of daily movement behaviours for cognitive health. This thesis investigates the importance of PA and its contexts for cognitive health, with a focus on midlife. Data were drawn from the 1970 British Cohort Study (BCS70), MRC National Survey of Health and Development (NSHD) and British Regional Heart Study (BRHS) which together include prospective measurement of participants across almost the entire life course. Participants in each cohort completed PA questionnaires and/or wore accelerometers at one or more ages. Participants also undertook tests of memory, executive function and processing speed during midlife, or global cognition tests in later life. Selected analytical procedures included compositional data analysis, structural equation modelling, life course models, and linear, logistic and multilevel models. In midlife, moderate-to-vigorous intensity PA (MVPA) proved the critical intensity associated with midlife cognition (Chapter 3). Associations between midlife leisure-time PA, and midlife cognition, were strengthened by also being active during childhood or adolescence (Chapter 4). Recreational forms of PA, particularly those involving social elements showed the strongest associations with mid and later life cognition compared to other contexts of PA, and persisted above and beyond device-measured MVPA (Chapter 5). Yet, when directly tested, associations between PA and cognition proved bidirectional, revealing a degree of reverse causality (Chapter 6). This thesis highlights the importance of PA at a wide range of ages for healthy cognition, beyond existing evidence, and the additional, unique importance of PA context.

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