Sedentary Behavior, Cognition, and Brain Health in Older Adults: A Systematic Review

Marissa A Gogniat^1*JUNYEON WON²Carlos Cruz³Amaya Aranda¹Aryan Verma⁴Swathi Gujral⁵Andrea Weinstein⁶Afsara Zaheed⁶Keith R. Cole⁷Kelsie Full⁷Beth Snitz¹

• ¹Department of Neurology, University of Pittsburgh, Pittsburgh, United States
• ²University of Texas Southwestern Medical School, Dallas, United States
• ³University of Texas Arlington, Arlington, United States
• ⁴Texas Health Presbyterian Hospital, Dallas, United States
• ⁵University of Pittsburgh, Pittsburgh, United States
• ⁶Department of Psychiatry, University of Pittsburgh, Pittsburgh, United States
• ⁷Vanderbilt University Medical Center, Nashville, United States

Sedentary behavior has been associated with poor health outcomes, especially in older adulthood. Given that sedentary behavior is a highly prevalent, modifiable health behavior, there has been a recent increased interest in examining how sedentary behavior relates to cognition and brain health. The current body of literature is limited and mixed. The purpose of this systematic review was to examine the associations of sedentary behavior with cognition and brain health in older adults across the cognitive spectrum. This study was pre-registered with PROSPERO (CRD42023477868). Six comprehensive databases were searched with preregistered search terms. A total of 33 studies were included. Overall, results indicated that greater sedentary behavior was associated with worse cognition and brain health, although associations varied based on differences in measurement and classification of sedentary behavior. We discuss next steps and implications for future research. Ovid (PsycINFO), ProQuest (PSYCArticles), PubMed, and Sedentary Behavior Research Database (SBRD) databases. The initial search began on December 8, 2023, and therefore all articles published prior to this date were eligible to be included in the search. Following this, reference lists from pertinent studies, reviews, and meta-analyses were manually searched by study authors (MAG, JW) for studies that may have not been captured in the original search. This search strategy was developed and pre-registered prior to beginning the search by MAG, JW, and SG. The first author (MAG) performed the initial search. Additional authors (CC, JW, AA) completed the screening. All records that were screened were double checked by AV and senior authors (MAG, JW). When discrepancies arose, a group consensus was discussed, and a decision was made.