Article

Research on Aging
2022, Vol. 44(9-10) 709–723
Prospective Associations between Physical © The Author(s) 2022

Activity and Memory in the Canadian Article reuse guidelines:

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Longitudinal Study on Aging: Examining DOI: 10.1177/01640275211070001
journals.sagepub.com/home/roa
Social Determinants

Nicole G. Hammond1  and Arne Stinchcombe2 

Abstract
Objectives: To examine associations between physical activity (PA) and prospectively assessed memory in a cohort of
cognitively healthy adults, after accounting for understudied social determinants.
Methods: We used data from the Canadian Longitudinal Study on Aging (CLSA). PA (exposure) and memory (outcome) were
assessed using validated measures in 2013–2015 and 2015–2018, respectively. Respondents reported their daily number of
hours spent engaging in five different PAs. We conducted multiple imputation and used linear regression (n = 41,394), adjusting
for five categories of covariates: demographics, sensory health characteristics, health behaviors, health status, and social
determinants (sex/gender, education, income, social support, perceived social standing, race, and sexual orientation).
Results: In crude models, nearly every intensity and duration of PA was associated with better memory. In fully adjusted
models, protective associations were attenuated; however, some associations held: all durations of walking, most durations of
light activities, moderate activities for ≥1 hour, and strenuous activities for 1 to <2 hours.
Discussion: Some forms of PA may be associated with better memory. The benefits of higher intensity PA may only be realized
after social determinants are addressed.

Keywords
exercise, social determinants, memory, Canadian Longitudinal Study on Aging, epidemiology

Introduction up, a protective effect of physical activity against cognitive

decline or dementia was not consistently demonstrated
Identifying modifiable lifestyle activities which may reduce or (Brasure et al., 2018). The authors summarized the evidence as
slow memory decline among older adults is important to insufficient or of low-strength, potentially attributable to
promoting healthy aging and cognitive function. Recent ob- between-study heterogeneity and common methodological
servational research suggests that a greater number of weekly challenges, including sample size issues and short follow-up
steps may be protective against cognitive decline (Rabin et al., (Brasure et al., 2018).
2019). In systematic reviews and meta-analyses of randomized Regular physical activity is recognized for its potential to
controlled trials (RCTs), the protective effects of physical ac- improve cognitive function and reduce dementia risk, in-
tivity on cognitive function in older adults have also been cluding Alzheimer’s disease (Piercy et al., 2018). Partici-
identified (Falck et al., 2019; Northey et al., 2018). In these trial pation in physical activity may protect against dementia
reviews, clinical samples (Northey et al., 2018) and participants
with clinical disorders (Falck et al., 2019), including depression
(i.e., a risk factor for cognitive decline), were excluded to meet 1
School of Epidemiology and Public Health, University of Ottawa, Ottawa,
the study aims but reduce the generalizability of the findings. ON, Canada
Other reviews of interventional research have mixed findings 2
School of Psychology, University of Ottawa, Ottawa, ON, Canada
and cite short follow-up periods (Hoffmann et al., 2021; Young
Corresponding Author:
et al., 2015). However, Hoffman and colleagues (2021) ob- Arne Stinchcombe, Assistant Professor, School of Psychology, University of
served that aerobic exercise had a large effect on memory (g Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada.
= 0.80). In a review of RCTs with at least 6 months of follow- Email: [email protected]
710 Research on Aging 44(9-10)

through cardiovascular, neurogenesis, or anti-inflammatory and social support) may attenuate the prospective relation-
mechanisms (Valenzuela et al., 2020). For example, physical ships between health behaviors such as physical activity and
activity has cardiovascular benefits and may affect cognitive memory remains largely understudied.
health by promoting cerebral blood flow (Valenzuela et al., Existing evidence recognizes race and gender as important
2020). Exercise may also increase neurogenesis, production social determinants associated with disparities in physical
of brain-derived neurotrophic factor in the hippocampus, and activity. Race and gender are also related to the risk of de-
circulation of anti-inflammatory cytokines (IL-10β and IL-4β), mentia (Ferretti et al., 2018; Steenland et al., 2015). Sturman
actions that may improve cognitive function (Valenzuela et al., et al. (2005) found that in a biracial community in Chicago,
2020). Long-term memory has specifically been identified for physical activity was no longer associated with a slower rate of
its potential to be modified by engagement in physical activity cognitive change after accounting for demographics and often
(Pontifex et al., 2016). excluded covariates of race, baseline cognitive function, and
Observational studies of cohorts often demonstrate positive cognitive stimulation. Thus, the additional factors (e.g., race)
associations between physical activity and cognitive function. entirely explained their associations. The authors concluded
For example, physical activity (vs. non-activity) (Beckett that there was no evidence to suggest that physical activity
et al., 2015) and high (vs. low) physical activity (Beydoun solely protects against cognitive decline in adults ≥65 years
et al., 2014) were associated with a reduced risk of dementia in (Sturman et al., 2005). In the same study, older women were
reviews published in the past decade. Blondell et al. (2014) documented to engage in 2 hours less of physical activity, on
demonstrated a longitudinal relationship between greater average, per week, when compared to older men (Sturman
physical activity and a reduced risk of cognitive decline and et al., 2005). Forrester and colleagues’ (2019) biopsychosocial
dementia. More recently, Erickson and colleagues (2019) model of minority cognitive aging delineates the relationship
published a review of the physical activity literature and found between minority stress and cognitive aging outcomes. The
strong observational evidence for beneficial, prospective as- authors suggest that the accumulation of social disadvantage
sociations between greater physical activity and cognitive and stressors stemming from minoritized identities (e.g.,
decline and dementia. However, the individual prospective racism) are associated with cognitive aging and increased risk
cohort studies available for inclusion in the review differed of dementia (Forrester et al., 2019). The model further posits
markedly in their range of adjustment for potential con- that psychosocial factors (e.g., discrimination, education, and
founders (Beckett et al., 2015; Sofi et al., 2011). socioeconomic status) lead to unhealthy behavioral determi-
Sofi and colleagues (2011) found that their meta-analyzed nants such as poor diet and physical inactivity, which in turn
studies included differing numbers of confounders, with some lead to manifestations of physical/biological conditions, ul-
including two or less. Similarly, Beckett et al. (2015) reported timately increasing risk for cognitive decline (Forrester et al.,
that studies in their review usually included a selection of 2019).
certain confounders, a list that omitted race, sexual orientation, Physical activity disparities by sexual orientation are ev-
income, and baseline cognitive function. In an earlier cited ident as early as adolescence (Mereish & Poteat, 2015). This is
review (Blondell et al., 2014), the authors conducted a sen- of concern as physical activity is associated with numerous
sitivity analysis of studies (n = 9) that controlled for 10 or more health benefits (Piercy et al., 2018), and among lesbian, gay,
confounders, finding evidence of attenuation of the strength of and bisexual (LGB) adults has been linked to better mental
the associations between physical activity and cognition. Two health (Pharr et al., 2021). Although Nelson and Andel (2020)
of the sensitivity analysis studies adjusted for race, one ac- found little evidence to support a relationship between sexual
counted for social support, none considered sexual orientation, orientation and physical activity, and there were no observed
and some considered certain social determinants (Blondell differences between heterosexual persons and sexual minorities
et al., 2014). Race and sexual orientation have both been on self-reported memory. The authors concluded their work by
excluded by studies (Laurin et al., 2001; Rovio et al., 2005) in calling for more representative, longitudinal, and cognitive re-
other review work (Beydoun et al., 2014), or sometimes race search on sexual orientation to address the dearth of literature in
but not sexual orientation is captured (Larson et al., 2006; the area (Nelson & Andel, 2020). Systemic and structural issues
Podewils et al., 2005). Of interest, Podewils et al. (2005) may prevent engagement in sufficient amounts of physical
included race and adjusted for several health characteristics activity (Bantham et al., 2021), a positive health behavior that
and behaviors (e.g., apolipoprotein E genotype, hormone may help prevent or slow dementia (Valenzuela et al., 2020).
replacement therapy, and alcohol use), and the lesser-studied However, with sufficient knowledge and resources, these
social support. While some longitudinal associations between barriers may be addressed and surmounted (Bantham et al.,
physical activity and dementia risk persisted after their ex- 2021). In short, there is a large literature base tying physical
tensive multivariable adjustment, the statistical associations activity to better cognitive health; however, the extent to which
were reduced in magnitude as the number of adjustment a range of social determinants influence findings has not been
factors increased, and some statistical relationships dis- comprehensively explored. Prospective research with adequate
appeared (Podewils et al., 2005). The extent to which social sample sizes which permit adjustment for a range of potential
determinants of cognitive aging (e.g., race, social standing, confounders and with a broad spectrum of studied ages is
Hammond and Stinchcombe 711

needed to determine whether physical activity may confer a persons (Raina et al., 2008). Long-term care residents are
protective memory benefit across time. included in the definition of institutionalized persons, and
We expand the previous body of work by investigating more information is available in the CLSA Study Protocol
several understudied determinants of health in a prospective (Raina et al., 2008). CLSA participants voluntarily provided
examination of the relationship between physical activity and written informed consent (Raina et al., 2009). These analyses
memory. To do so, we used a large Canadian cohort study of received ethical clearance from the University of Ottawa
community-dwelling older adults between the ages of 45–85 Research Ethics Board (REB).
years at baseline. Using the Canadian Longitudinal Study on
Aging (CLSA) we sought to: (1) confirm a prospective,
protective association between physical activity and objec-
Measures
tively assessed memory, and (2) determine whether a pro- Memory. Memory was objectively ascertained using the Rey
tective association between physical activity and memory Auditory Verbal Learning Test (RAVLT) (Rey, 1964) in both
persists after adjusting for known confounders and under- the tracking (Tuokko et al., 2017) and comprehensive cohorts
studied social determinants. (Tuokko et al., 2020). Trained interviewers followed a stan-
dardized protocol and administered the first of the five RAVLT
learning trials, followed by a delayed recall trial administered
Methods five minutes later (Tuokko et al., 2017, 2020). For the first
trial, participants listened to an audio recording of 15 words
Study Sample
and were asked to immediately recall as many responses as
The CLSA is extensively described elsewhere (Raina et al., they could within 90 seconds (Canadian Longitudinal Study
2009, 2019). The CLSA is a longitudinal study of aging and on Aging, 2019). Delayed recall was assessed 5 minutes later
general well-being. Over 50,000 community-dwelling adults when participants were asked to recall as many words from the
between the ages of 45–85 were recruited at baseline. Pro- earlier list within 60 seconds (Canadian Longitudinal Study on
spective measurements will be collected every 3-years until Aging, 2019). A score of 0 was assigned if the interviewer had
2033 or participant death (Raina et al., 2019). Baseline data to prompt the participant for the delayed recall trial (Canadian
collection was completed in 2015 and first follow-up in 2018 Longitudinal Study on Aging, 2019). One point was given for
(Raina et al., 2019). The CLSA is comprised of two study each correctly recalled response, up to a maximum of 15
cohorts that required differing amounts of participation. (Canadian Longitudinal Study on Aging, 2019); thus, raw
Participants recruited into the comprehensive cohort (n = scores for both the immediate and delayed recall trials range
30,097) were required to live within a certain radius (25– from 0 to 15 (Tuokko et al., 2020). More information on the
50 km) of one of 11 national data collection sites (Raina et al., RAVLT scoring and data quality checks are described else-
2019). In-person participation for the comprehensive cohort where (Canadian Longitudinal Study on Aging, 2019). The
was required for some samples not used here (e.g., blood). The RAVLT is regularly used clinically and in research (Tuokko
tracking cohort (n = 21,241) was interviewed using a et al., 2020) and was demonstrated to perform similarly in the
computer-assisted telephone interview (CATI) system, but CLSA as it has in other French and English speaking samples,
both cohorts share overlapping core CLSA content, including supporting its utility as a marker of memory in the present
measures of health determinants and memory (Raina et al., study (Tuokko et al., 2017, 2020). For purposes of this study,
2019). The cohorts were designed to be complementary so that we combined the raw scores from the immediate and delayed
they can be combined for researchers to have access to a larger recall trials to have a single continuous measure of memory
national population-based sample (Raina et al., 2019). (range: 0–30) at baseline (covariate) and follow-up (outcome).
Participants of the tracking cohort were recruited via the Visual inspection confirmed that the baseline and follow-up
Canadian Community Health Survey (CCHS) – Healthy measures of memory approximated a normal distribution.
Aging Component (Raina et al., 2008). The eligibility criteria Exposure. Physical activity was assessed using the Physical
for the CCHS then defined the characteristics of the Canadian Activity Scale for the Elderly (PASE), developed by Washburn
population eligible for participation in the CLSA, a process and colleagues (Washburn et al., 1993). The psychometric
that enables merging of the two cohort’s data (Raina et al., properties of the scale were originally studied in a community-
2008). Provincial health care registration databases and ran- dwelling sample of adults aged 65 or older, where the PASE
dom digit dialing were used to recruit the comprehensive was found to have adequate reliability and validity, and was
cohort and supplement recruitment into the tracking cohort ultimately recommended for use in epidemiologic surveys
(Raina et al., 2008). In accord with the sampling frame of the (Washburn et al., 1993). A modified version of the PASE
CCHS, certain persons or groups of persons were not eligible (Canadian Longitudinal Study on Aging, 2015) was admin-
for CLSA survey participation: Canadian persons living in the istered as part of a short telephone interview designed to help
territories or select remote regions, persons living on First mitigate CLSA attrition by maintaining participant engage-
Nations reserves and settlements, full-time members of the ment (maintaining contact questionnaire) (Raina et al., 2009).
Canadian Armed Forces, and incarcerated or institutionalized Respondents were asked to report their past-week frequency
712 Research on Aging 44(9-10)

of engagement in five different intensities of physical activity: respondents retained for data analysis completed both the
walking, light activities, moderate activities, strenuous ac- baseline and follow-up memory tests in the same language
tivities, and strength-based activities. Specifically, respon- (French/English).
dents were asked: “over the past 7 days, how often did you…” Sensory health characteristics. At baseline, participants
“…take a walk outside your home or yard for any reason? For self-reported the quality of their hearing and vision on a five-
example, for pleasure or exercise, walking to work, and walking point scale from “poor” to “excellent.” Specifically, partici-
the dog”, “…engage in light sports or recreational activities pants were asked: “Is your hearing, using a hearing aid if you
such as bowling, golf with a cart, shuffleboard, badminton, use one…” and “Is your eyesight, using glasses or corrective
fishing or other similar activities?”, “…engage in moderate lens if you use them…”. For both sensory health character-
sports or recreational activities such as ballroom dancing, istics, responses were collapsed to represent the presence
hunting, skating, golf without a cart, softball or other similar (poor/fair) or absence (good/very good/excellent) of low
activities?”, “…engage in strenuous sports or recreational hearing and vision, respectively.
activities such as jogging, swimming, snowshoeing, cycling, Health behaviors. Participants self-reported the frequency
aerobics, skiing, or other similar activities?”, and “…how of their alcohol consumption, their fruit and vegetable intake,
often did you do any exercises specifically to increase muscle and how often they smoke cigarettes. Frequency of alcohol
strength and endurance, such as lifting weights or push-ups?” consumption was captured by a single question: “About how
Response options were “never,” “seldom (1–2 days),” often during the past 12 months did you drink alcohol?”
“sometimes (3–4 days),” and “often (5–7 days).” Respondents Participant responses ranged from “never, “once a week,” to
who answered “never” were not asked the follow-up average “almost every day/every day”. Response options were cate-
daily duration question, whereas those who reported that they gorized as never (referent), infrequent (≤2–3 times/month),
had engaged in each respective activity at least 1–2 days over regular (1–3 times/week), and frequent (≥4 times/week). As
the past week were subsequently asked to report “on average, part of an eating and nutrition screener (SCREEN-II) (Keller
how many hours per day did you”: “spend walking?”, “engage et al., 2005), CLSA participants reported how many servings
in these…” “…light sports or recreational activities?”, of fruits and vegetables they generally eat per day, from ≤2
“moderate sports or recreational activities?”, “strenuous sports servings to ≥7 servings. We categorized fruit and vegetable
or recreational activities?”, and “engage in exercises to increase consumption as <5 servings (referent) and ≥5 servings to align
muscle strength and endurance?” Response options ranged with recent evidence, which suggests that approximately 5
from “less than 30 minutes,” “30 minutes but less than 1 hour,” servings are most protective against reducing mortality risk
“1 hour but less than 2 hours,” “2 hours but less than 4 hours,” (Wang et al., 2021). Participants indicated whether they had
and “4 hours or more.” Due to a small number of respondents in ever smoked 100 or more cigarettes in their lives (yes/no). We
the upper most duration category (4 hours or more per day), for classified those who responded “no” as never smokers (refer-
each intensity of physical activity (e.g., light and moderate ent). Respondents who positively endorsed having ever smoked
activities), we collapsed the two highest average daily duration 100 or more cigarettes were subsequently asked, “At the present
categories to represent a combined 2 or more hours per day time, do you smoke cigarettes daily, occasionally or not at all?”
category. It is important to note that while the two overall PASE Respondents who had smoked 100 or more cigarettes in their
questions both pertain to past-week transportation and leisure lifetime but had not smoked in the past month were considered
time physical activity, they can be differentiated by the fact that former smokers, while the remaining respondents (daily/
the former asks about frequency (days) whereas the latter asks occasional smokers) were considered current smokers.
about average daily duration (time per day). Health status. We used four measures of health status:
Covariates. Potential covariates were measured at baseline body mass index (BMI: weight in kilograms/height in meters2
and grouped into five categories: demographics, sensory health [continuous]), health-professional diagnosed mood and anxiety
characteristics, health behaviors, health status, and social disorders, neurological disorders, and cardiac/cardiovascular
determinants. health disorders. Participants were asked to report whether
Demographics. Demographic measures consisted of par- “…a doctor ever told you that you have…” a mental health
ticipant age (continuous), marital status, cohort (tracking disorder (“anxiety disorder” or “mood disorder”), a neuro-
[referent]/comprehensive), language of test administration logical disorder (“a memory problem?”, “dementia or Alz-
(English [referent]/French), and baseline memory (described heimer’s disease?”, “Parkinsonism or Parkinson’s disease?”,
above). Marital status was classified as single/never married “multiple sclerosis?”, “epilepsy?”, or “migraine head-
(referent), married/common-law, divorced/separated/widowed. aches?”), and/or a cardiac/cardiovascular disorder (“stroke or
Cohort status was adjusted for given the previously outlined CVA? [cerebrovascular accident]?”, “ministroke or TIA
differences in participant recruitment and data collection [transient ischemic attack]?”, “high blood pressure or hy-
methodology. We included the language of administration of pertension?”, “heart disease [including congestive heart
the baseline memory test since others have demonstrated that failure or CHF]?”, “heart attack or myocardial infarction?”,
memory scores in the CLSA vary according to language “diabetes, borderline diabetes or that your blood sugar is
(Tuokko et al., 2017, 2020). We confirmed that those high?”, “angina [or chest pain due to heart disease]?”, or
Hammond and Stinchcombe 713

“peripheral vascular disease or poor circulation in your health behaviors, mental health, physical health, and self-
limbs?”). Our disorder groupings overlap with the CLSA rated health even after controlling for objective socioeco-
groupings (Canadian Longitudinal Study on Aging, 2018), nomic indicators (Zell et al., 2018). For this measure, par-
also reported in Zhang and Sun (2020), except that persons ticipants are presented with an image of a 10-rung ladder
with a memory problem or dementia/Alzheimer’s type de- representing social status and asked to indicate the rung
mentia were excluded (see analytic sample). For mental which corresponds to their perceived social standing within
health disorders, we created a single variable to represent their community (Adler et al., 2000). Higher scores reflect
neither diagnosis (referent), anxiety disorder only, mood greater perceived social standing. Participants were also
disorder only, or both. For the neurological and cardiac/ asked to report their race: “People living in Canada come
cardiovascular diagnosed conditions, we summed the from many different cultural and racial backgrounds. Are
number of disorders for each respective category and then you…”. Answer options included “White,” “Black,”
reclassified them into none (referent), one, or two or more. “Korean,” “Filipino,” etc. The information was used to
This follows a similar practice used in other literature ex- inform a CLSA derived variable which indicated whether
amining the potential dose–response relationship of a det- respondents self-identified as White, Black, or of other
rimental health exposure (Felitti et al., 1998) and shares cultural/racial backgrounds (e.g., “multiple racial or cul-
overlap with the deficit accumulation conceptualization of tural origins”). Due to some small cell sizes, we collapsed
frailty markers (Rockwood & Mitnitski, 2007). some categories in order to have a three-level measure of
Social determinants. We included seven recognized social race: White, Black, and other non-White. Finally, sexual
determinants (Government of Canada, 2020): sex/gender orientation was captured using one item: “Do you consider
(men [referent]/women), education, income, social support, yourself to be:” “Heterosexual?”, “homosexual?”, or
perceived social standing, race, and sexual orientation. Par- “bisexual?”.
ticipants were categorized as men and women. Unfortunately,
we could not determine if participants responded based on
their sex (i.e., biological attributes) or gender (i.e., socially
Statistical Analyses
constructed roles, behaviors, expressions, and identities). Basic descriptive statistics were used to describe respondent
Thus, in this study, we refer to sex/gender. Respondents’ characteristics at baseline (percentage [%], mean [M] and
educational attainment was classified as <secondary school standard deviation [SD]). Respondents lost to follow-up and
(referent), secondary school graduation, some post-secondary, those with missing data were compared with retained re-
and post-secondary graduation. Participants were asked to spondents and those without missing data, respectively. To
report their household’s income: “What is your best estimate do so, we used chi-square tests of independence (χ 2) and
of the total household income received by all household independent sample t-tests. For our primary analyses, we ran
members, from all sources, before taxes and deductions, in the crude (unadjusted) linear regression models between phys-
past 12 months?” Responses were categorized as <$20,000 (ref- ical activity and memory at follow-up, followed by multi-
erent), $20–49,999, $50–99,999, $100–149,999, and ≥$150,000. variable linear regression models adjusted for covariates and
Social support was measured using the Medical Outcomes social determinants. Therefore, there is a crude and multi-
Study-Social Support Survey (MOS-SSS) (Sherbourne & variable model for each physical activity-memory relation-
Stewart, 1991). The MOS-SSS is comprised of 19 items ship. Physical activity, covariates, and social determinants
rated on a five-point Likert scale which altogether produce a were all measured at baseline. We conducted multiple im-
total index of functional social support ranging from 0 to 100, putation using multivariate imputation by chained equations
with higher scores indicating a greater perceived availability (MICE) (van Buuren et al., 1999) with an augmented ap-
of social support (Sherbourne & Stewart, 1991). The scale proach (White et al., 2010) and m = 28 imputations.
has good psychometric properties, and the total score rep- Unimputed (complete case) results are presented as a
resents a multidimensional social support construct that supplementary. Missing on the exposures (measures of PA)
captures elements of emotional and informational, tangible, ranged from 0.07 to 0.40%, missing on the outcome
positive social, and affectionate social support (Sherbourne (memory at first follow-up) was 6.98%, and missing on the
& Stewart, 1991). We computed tertile cut-offs and recoded covariates was in most cases ≤3% (range: 0.03–3.21%)
social support as low, medium, and high. The recoding except for income (6.12%), language of test administration
addressed the substantial negative skew in the measure in- (5.95%), and baseline memory (6.73%). There was no
dicating a large buildup of scores at the higher end of the missing data for cohort status, age, and sex/gender. We did
distribution, as has been documented by the scale developers not use CLSA-derived survey weights. Others in the field
(Sherbourne & Stewart, 1991) and others who have exam- have found that when using CLSA data, unweighted and
ined the social support-memory association in the CLSA weighted regression models are highly similar when mea-
(Oremus et al., 2020). Perceived social standing was mea- sures of cognition, including memory measured by the
sured using the MacArthur Scale of Subjective Social Status RAVLT, are the outcome (O’Connell et al., 2019). Findings
(Adler et al., 2000), a well-used measure which is related to were considered statistically significant at p <0.05. All
714 Research on Aging 44(9-10)

Figure 1. Flow diagram of respondents participating in the Canadian Longitudinal Study on Aging (CLSA) and followed from baseline to first
follow-up.

analyses were conducted using Stata (release 15: College problems (n = 893), at baseline. We removed these partic-
Station, TX: StataCorp LLC). ipants (Figure 1) to ensure that our analytic sample was
cognitively healthy at baseline. After removal of respondents
who did not participate in the initial maintaining contact
Analytic Sample questionnaire, when baseline physical activity was captured,
While participants were free of cognitive impairment at the exclusion of respondents lost to follow-up and those with
time of recruitment into the CLSA (Raina et al., 2009), some missing data, the final analytic sample size was n = 30,173
respondents self-reported a health-professional diagnosis of before multiple imputation. Baseline data were collected
dementia or Alzheimer’s type dementia (n = 111), or memory between September 2011 and May 2015. The maintaining
Hammond and Stinchcombe 715

Table 1. Participant characteristics (nunimputed = 30,173).

Characteristic n (%) Characteristic n (%)

Demographics Health status measures continued

Age 61.63 (9.93) Neurological disorders
Cohort None 25,905 (85.6)
Tracking 11,233 (37.2) One 4162 (13.8)
Comprehensive 18,940 (62.8) ≥Two 106 (0.4)
Marital status Cardiac and cardiovascular disorders
Single 2294 (7.6) None 15,822 (52.4)
Married/common-law 22,103 (73.3) One 8788 (29.1)
Widowed/divorced/separated 5776 (19.1) ≥Two 5563 (18.4)
Language Social determinants
English 24,296 (80.5) Sex/gender
French 5877 (19.5) Men 15,238 (50.5)
Baseline memory 10.42 (4.02) Women 14,935 (49.5)
Sensory health characteristics Education
Low vision <Secondary school 1528 (5.1)
No 28,133 (93.2) Secondary school 3072 (10.2)
Yes 2040 (6.8) Some post-secondary 2168 (7.2)
Low hearing Post-secondary 23,405 (77.6)
No 26,192 (89.2) Income
Yes 3261 (10.8) <$20K 1254 (4.2)
Health behaviors $20–49,999 6581 (21.8)
Fruit and vegetable intake $50–99,999 11,015 (36.5)
<5 servings 17,739 (58.8) $100–149,999 6081 (20.2)
≥5 servings 12,434 (41.2) ≥$150K 5242 (17.4)
Smoking status Social support
Never 14,217 (47.1) Low 10,023 (33.2)
Former 13,509 (44.8) Medium 9185 (30.4)
Current 2447 (8.1) High 10,965 (36.3)
Alcohol use frequency Perceived social standing [M (SD)] 6.13 (1.90)
Never 3066 (10.2) Race
Infrequent 9180 (30.4) White 28,931 (95.9)
Regular 10,109 (33.5) Black 1082 (3.6)
Frequent 7818 (25.9) Other non-White 160 (0.5)
Health status measures Sexual orientation
Body mass index (BMI) 27.81 (5.27) Heterosexual 29,521 (97.8)
Mood and anxiety disorders Lesbian/gay 514 (1.7)
None 24,537 (81.3) Bisexual 138 (0.5)
Anxiety disorder only 1045 (3.5)
Mood disorder only 3382 (11.2)
Both mood and anxiety disorders 1209 (4.0)

contact questionnaire was administered between baseline follow-up were more likely to be members of the tracking
and follow-up (September 2013 to December 2015). First cohort (62.2%) (χ 2 = 801.57, p<0.001), men (51.9%) (χ 2 =
follow-up data were collected between December 2015 and 12.91, p<0.001), and of older age (M = 66.35, SD = 11.48) (t =
July 2018. 20.57, p <0.001).

Results Respondents with Missing Data

Respondents with missing data were more likely to be part of
Respondents Lost to Follow-Up
the comprehensive cohort (55.7%) (χ 2 = 173.88, p <0.001),
A comparison of respondents lost to follow-up versus retained women (54.7%) (χ 2 = 88.91, p <0.001), and of older age (M =
in the CLSA at first follow-up revealed that those lost to 65.22, SD = 10.52) (t = 32.20, p <0.001).
716 Research on Aging 44(9-10)

Table 2. Baseline distribution of engagement in different intensities Linear Regression Models

and durations of physical activity in the Canadian Longitudinal Study
on Aging (CLSA) (n = 30,173). In crude models, nearly all intensities and durations of physical
activity were associated with better memory at first follow-up
Percentage (%) (Table 3). At the highest duration (≥2 hours) of two types of
Walking physical activity, light and strength-based activities, there was a
Never 14.7 negative association with memory. For strength-based activi-
<30 minutes 17.7 ties, the association was not statistically significant.
30 minutes to <1 hour 37.9 After adjustment for all covariates, prospective associa-
1 hour to <2 hours 22.8 tions between physical activity and memory were greatly
≥2 hours 6.9 attenuated (Table 4). In adjusted models, all walking durations
Light physical activities were associated with better memory at follow-up when
Never 77.9 compared to those who never walked (B range: 0.13–0.21).
<30 minutes 5.3 Engagement in any duration of light activities was almost
30 minutes to <1 hour 4.4 always associated with better memory at follow-up, except for
1 hour to <2 hours 5.8 the 30 minutes to <1 hour category, when compared to those
≥2 hours 6.6 who never engaged in light activities (B = 0.09, p = 0.328).
Moderate physical activities Only the two highest moderate activity duration categories
Never 85.7 were statistically associated with better memory at follow-up,
<30 minutes 1.00 when compared to those who never engaged in moderate
30 minutes to <1 hour 2.2
activities (1 hour to <2 hours: B = 0.34, p <0.001; ≥2 hours: B
1 hour to <2 hours 4.5
= 0.30, p <0.001). Engagement in moderate activities for less
≥2 hours 6.6
intensive durations was not prospectively related to better
Strenuous physical activities
memory (<30 minutes: B = 0.02, p = 0.909; 30 minutes to <1
Never 66.6
<30 minutes 4.8 hour: B = 0.18, p = 0.131). For strenuous activities, we ob-
30 minutes to <1 hour 11.9 served one statistical association with better memory at
1 hour to <2 hours 11.9 follow-up. Respondents who reported engaging in strenuous
≥2 hours 4.8 activities for 1 to ≤2 hours per day, when compared to those
Strength based physical activities who reported never taking part in strenuous activities, had
Never 70.5 better memory at follow-up (B = 0.19, p <0.001). Therefore,
<30 minutes 13.5 there was no statistical evidence that engagement in strenuous
30 minutes to <1 hour 9.9 activities at the shortest durations (<30 minutes: B = 0.10, p =
1 hour to <2 hours 5.5 0.216; 30 minutes to <1 hour: B = 0.11, p = 0.066) and the
≥2 hours 0.6 longest (≥2 hours: B = 0.06, p = 0.479) were prospectively
associated with memory at follow-up. In multivariable models,
there were no statistical relationships between strength-based
Respondent Characteristics activities and memory.
Respondents retained in the analytic sample are described in Across all physical activity models, all social determinants
detail in Table 1. At baseline, respondents were on average of health were statistically associated with memory except for
61.63 years (SD = 9.93), most participants were married or in a sexual orientation. There were no differences between lesbian/
common-law relationship (73.3%), and English speaking gay and bisexual respondents when compared to heterosexual
(80.5%). In terms of social determinants, there was approxi- respondents. However, there was consistent evidence of an in-
mately an equal representation of men and women, though verse association between lesbian/gay sexual orientation identity
slightly more men (50.5%) were included in the sample. Most and memory, suggesting that while not statistically significant,
respondents held a post-secondary degree (77.6%), had a total lesbian/gay respondents tended to show poorer memory scores at
household income within the range of $50,000 to $99,999 follow-up. For both education and income, there was a protective
(CAD) (36.5%), had high social support (36.3%), perceived relationship with greater educational attainment and higher total
themselves to have an average social standing approximately household income associated with better memory. As both social
one point higher than the social ladder’s middle rung (M = 6.13, support and perceived social standing increased, so too did
SD = 1.90), were White (95.9%), and heterosexual (97.8%). In memory. Across all models, Black and other non-White re-
terms of physical activities, walking was the most frequently spondents had lower memory scores at follow-up when com-
reported activity (85.3%) (Table 2). Only 14.7% of the sample pared to White respondents; the strength of associations was
reported never walking, whereas most respondents reported a noticeably stronger for Black respondents. Specifically, the
lack of daily engagement in light (77.9%), moderate (85.7%), magnitude of observed associations for Black respondents was
strenuous (66.6%), and strength-based activities (70.5%). more than twice the magnitude for other non-White respondents.
Hammond and Stinchcombe 717

Table 3. Crude linear regression models of the prospective relationship between physical activity at baseline and memory at first three-year
follow-up in the Canadian Longitudinal Study on Aging (CLSA): multiple imputation results (n = 41,394).

Model 1 Model 2 Model 3 Model 4 Model 5

Strength-based
Walking Light activities Moderate activities Strenuous activities activities

Characteristic B (SE) p B (SE) p B (SE) p B (SE) p B (SE) p

Physical activity
<30 minutes 0.59 (0.08) <0.001 0.50 (0.10) <0.001 0.44 (0.22) 0.046 0.51 (0.11) <0.001 0.35 (0.07) <0.001
30 minutes to <1 hour 0.95 (0.07) <0.001 0.89 (0.11) <0.001 0.91 (0.15) <0.001 1.16 (0.07) <0.001 0.64 (0.08) <0.001
1 hour to <2 hours 0.80 (0.07) <0.001 1.01 (0.10) <0.001 1.09 (0.11) <0.001 1.34 (0.07) <0.001 0.68 (0.10) <0.001
≥2 hours 0.68 (0.10) <0.001 0.47 (0.09) <0.001 0.32 (0.09) 0.001 0.99 (0.11) <0.001 0.01 (0.30) 0.971

Complete case (unimputed) results can be found in the health characteristics, behaviors, and social determinants, less
Supplemental eTables (1, 2) and were mostly similar to those intensive physical activities may be of most benefit for memory
for our previously reported primary findings. In crude models, in this national sample of mid-life and older Canadians.
unimputed results were nearly always weaker, except in some Our findings support recent advances in 24-hour movement
cases. For example, for the two negative associations (light guidelines for Canadian adults (Canadian Society for Exercise
and strength-based activities for ≥2 hours) and some inten- Physiology, 2021a; 2021b) and United States (US) recom-
sities (moderate and strenuous activities) at <30 minutes, the mendations for adults (Piercy et al., 2018). Recent guidelines
results were somewhat stronger. In adjusted models, there for both countries recognize the potential health benefits of
were some differences, including lack of statistical associa- any physical activity, including light activities, over sedentary
tions between walking and memory at the shortest (<30 behaviors (Canadian Society for Exercise Physiology, 2021b,
minutes) and highest (≥2 hours) durations. The remaining 2021a; Piercy et al., 2018). Guidelines from the US (Piercy
findings for social determinants and physical activity were et al., 2018) also address that not all older adults can meet
generally consistent, with some variability in the magnitude of recommended moderate to vigorous activity recommenda-
associations. tions due to health considerations but should strive to engage
in any amount of physical activity that they are able to. Such
advances are relevant because they may be considered more
Discussion accessibility and equity orientated. However, our findings also
We sought to confirm whether physical activity was pro- share some similarities with those of Sturman and colleagues
spectively associated with better memory at first follow-up in (2005), who found that after adjustment for covariates often
the CLSA. In unadjusted models and across nearly every missing from the existing literature (race, baseline cognition,
intensity and duration of physical activity, there was evidence cognitive stimulation), there was no association between
of a prospective relationship between physical activity and physical activity and cognition. Consistent with their work, we
better memory at follow-up. After adjusting for known co- did not observe statistical relationships between shorter du-
variates and lesser-studied social determinants, walking and rations of moderate intensity activities, and almost no asso-
light activities remained almost always associated with better ciations for strenuous and strength-based activities, in fully
memory. In contrast, only the highest durations of moderate adjusted models. There is some evidence to suggest that
activities (>1 hour) and engaging in 1 to <2 hours of strenuous among older adults, strength-based activities may be better
activities were associated with better memory. Although in the tied to executive function and overall cognition than memory
fully adjusted models, the observed associations were reduced (Li et al., 2018).
in size. As expected, our observation of some prospective, In addition to physical activity, cognitive aging outcomes
protective associations between physical activity and memory have been linked to other health behaviors (e.g., fruit and
aligns with existing review evidence from cohort studies vegetable intake) and sensory health (e.g., hearing) (Stinchcombe
suggesting that overall physical activity is beneficial (Beckett & Hammond, 2021), mental health (e.g., depression), as well as
et al., 2015; Beydoun et al., 2014; Blondell et al., 2014; social determinants such as social support (Oremus et al., 2020).
Erickson et al., 2019). This study adds to the existing literature The strength and direction of associations for our relation-
base by separating different intensities and durations of ships between social determinants and memory correspond
physical activity. What physical activity “dose” is best for with earlier CLSA cross-sectional work, showing disparities
cognitive health remains unknown, and whether it may vary in memory by income, education, and race (Stinchcombe &
by population or age remains to be determined (Erickson et al., Hammond, 2021). In their review of how to address social
2019). Our results suggest that after accounting for numerous inequities in physical activity, Ball and colleagues (2015)
Table 4. Multivariable linear regression models of the prospective relationship between physical activity at baseline and memory at first three-year follow-up in the Canadian
718

Longitudinal Study on Aging (CLSA): multiple imputation results (n = 41,394).

Model 1 Model 2 Model 3 Model 4 Model 5

Walking Light activities Moderate activities Strenuous activities Strength-based activities

Characteristic B (SE) p B (SE) p B (SE) p B (SE) p B (SE) p

Demographics
Age 0.09 (0.002) <0.001 0.09 (0.002) <0.001 0.09 (0.002) <0.001 0.09 (0.002) <0.001 0.09 (0.002) <0.001
Cohort—comprehensive 0.83 (0.04) <0.001 0.83 (0.04) <0.001 0.83 (0.04) <0.001 0.82 (0.04) <0.001 0.83 (0.04) <0.001
Marital status
Married/common-law 0.02 (0.07) 0.813 0.02 (0.07) 0.754 0.02 (0.07) 0.778 0.02 (0.07) 0.826 0.02 (0.07) 0.819
Widowed/divorced/separated 0.01 (0.08) 0.871 0.02 (0.08) 0.817 0.02 (0.08) 0.801 0.02 (0.08) 0.838 0.01 (0.08) 0.844
Language—French 0.09 (0.05) 0.044 0.10 (0.05) 0.045 0.10 (0.05) 0.027 0.11 (0.05) 0.026 0.10 (0.05) 0.040
Baseline memory 0.51 (0.005) <0.001 0.51 (0.005) <0.001 0.51 (0.005) <0.001 0.51 (0.005) <0.001 0.51 (0.005) <0.001
Sensory health characteristics
Low vision 0.08 (0.07) 0.239 0.08 (0.07) 0.225 0.08 (0.07) 0.236 0.08 (0.07) 0.239 0.08 (0.07) 0.228
Low hearing 0.31 (0.06) <0.001 0.31 (0.06) <0.001 0.31 (0.06) <0.001 0.31 (0.06) <0.001 0.31 (0.06) <0.001
Health behaviors
Fruit and vegetable intake: ≥5 servings 0.23 (0.04) <0.001 0.23 (0.04) <0.001 0.23 (0.04) <0.001 0.23 (0.04) <0.001 0.23 (0.04) <0.001
Smoking status
Former 0.21 (0.04) <0.001 0.22 (0.04) <0.001 0.22 (0.04) <0.001 0.21 (0.04) <0.001 0.21 (0.04) <0.001
Current 0.31 (0.07) <0.001 0.31 (0.07) <0.001 0.31 (0.07) <0.001 0.30 (0.07) <0.001 0.31 (0.07) <0.001
Alcohol use frequency
Infrequently 0.15 (0.06) 0.019 0.15 (0.06) 0.017 0.15 (0.06) 0.018 0.15 (0.06) 0.018 0.15 (0.06) 0.018
Regularly 0.22 (0.06) 0.001 0.22 (0.06) 0.001 0.22 (0.06) 0.001 0.22 (0.06) 0.001 0.23 (0.06) <0.001
Frequently 0.32 (0.07) <0.001 0.32 (0.07) <0.001 0.32 (0.07) <0.001 0.32 (0.07) <0.001 0.33 (0.07) <0.001
Health status measures
Body mass index 0.009 (0.004) 0.013 0.009 (0.004) 0.008 0.009 (0.004) 0.013 0.009 (0.004) 0.013 0.009 (0.004) 0.010
Mood and anxiety disorders
Anxiety disorder 0.20 (0.10) 0.042 0.20 (0.10) 0.040 0.20 (0.10) 0.042 0.19 (0.10) 0.044 0.20 (0.10) 0.042
Mood disorder 0.06 (0.06) 0.288 0.06 (0.06) 0.282 0.06 (0.06) 0.326 0.06 (0.06) 0.293 0.06 (0.006) 0.284
Both mood and anxiety disorders 0.04 (0.09) 0.678 0.04 (0.09) 0.660 0.04 (0.09) 0.689 0.03 (0.09) 0.698 0.04 (0.09) 0.667
Neurological disorders
One 0.02 (0.05) 0.744 0.02 (0.05) 0.744 0.02 (0.05) 0.775 0.02 (0.05) 0.734 0.02 (0.05) 0.760
≥Two 0.40 (0.29) 0.162 0.42 (0.29) 0.145 0.42 (0.29) 0.145 0.41 (0.29) 0.160 0.42 (0.29) 0.145
Cardiac and cardiovascular disorders
One 0.01 (0.04) 0.780 0.01 (0.04) 0.808 0.01 (0.04) 0.858 0.01 (0.04) 0.882 0.01 (0.04) 0.799
≥Two 0.20 (0.05) <0.001 0.20 (0.05) <0.001 0.20 (0.05) <0.001 0.20 (0.05) <0.001 0.21 (0.05) <0.001
Social determinants
Sex/gender—women 1.35 (0.04) <0.001 1.34 (0.04) <0.001 1.35 (0.04) <0.001 1.35 (0.04) <0.001 1.35 (0.04) <0.001

(continued)
Research on Aging 44(9-10)
Table 4. (continued)

Model 1 Model 2 Model 3 Model 4 Model 5

Walking Light activities Moderate activities Strenuous activities Strength-based activities

Hammond and Stinchcombe

Characteristic B (SE) p B (SE) p B (SE) p B (SE) p B (SE) p

Education
Secondary school 0.20 (0.09) 0.033 0.21 (0.09) 0.028 0.21 (0.09) 0.027 0.20 (0.09) 0.029 0.20 (0.09) 0.030
Some post-secondary 0.39 (0.10) <0.001 0.39 (0.10) <0.001 0.39 (0.10) <0.001 0.39 (0.10) <0.001 0.39 (0.10) <0.001
Post-secondary 0.54 (0.08) <0.001 0.54 (0.08) <0.001 0.54 (0.08) <0.001 0.54 (0.08) <0.001 0.54 (0.08) <0.001
Income
$20–49,999 0.11 (0.09) 0.221 0.11 (0.09) 0.231 0.11 (0.09) 0.242 0.11 (0.09) 0.240 0.11 (0.09) 0.233
$50–99,999 0.39 (0.09) <0.001 0.38 (0.09) <0.001 0.38 (0.09) <0.001 0.38 (0.09) <0.001 0.38 (0.09) <0.001
$100–149,999 0.45 (0.10) <0.001 0.45 (0.10) <0.001 0.44 (0.10) <0.001 0.44 (0.10) <0.001 0.45 (0.10) <0.001
≥$150K 0.49 (0.11) <0.001 0.49 (0.11) <0.001 0.48 (0.11) <0.001 0.47 (0011) <0.001 0.48 (0.11) <0.001
Social support
Medium 0.16 (0.04) <0.001 0.16 (0.04) <0.001 0.15 (0.04) <0.001 0.16 (0.04) <0.001 0.16 (0.04) <0.001
High 0.22 (0.05) <0.001 0.22 (0.05) <0.001 0.21 (0.05) <0.001 0.22 (0.05) <0.001 0.22 (0.05) <0.001
Perceived social standing 0.07 (0.01) <0.001 0.07 (0.01) <0.001 0.07 (0.01) <0.001 0.07 (0.01) <0.001 0.07 (0.01) <0.001
Race
Other non-White 0.33 (0.09) <0.001 0.33 (0.09) <0.001 0.33 (0.09) <0.001 0.33 (0.09) <0.001 0.33 (0.09) 0.001
Black 0.67 (0.24) 0.004 0.69 (0.23) 0.003 0.68 (0.23) 0.004 0.70 (0.23) 0.003 0.70 (0.23) 0.003
Sexual orientation
Lesbian/gay 0.10 (0.14) 0.464 0.09 (0.14) 0.517 0.09 (0.14) 0.533 0.10 (0.14) 0.491 0.10 (0.14) 0.486
Bisexual 0.14 (0.26) 0.598 0.15 (0.26) 0.570 0.14 (0.26) 0.592 0.16 (0.26) 0.554 0.15 (0.26) 0.573
Physical activity
<30 minutes 0.15 (0.06) 0.021 0.17 (0.08) 0.032 0.02 (0.17) 0.909 0.10 (0.08) 0.216 0.09 (0.05) 0.091
30 minutes to <1 hour 0.19 (0.05) 0.001 0.09 (0.09) 0.328 0.18 (0.12) 0.131 0.11 (0.06) 0.066 0.07 (0.06) 0.237
1 hour to <2 hours 0.13 (0.06) 0.028 0.21 (0.08) 0.006 0.34 (0.09) <0.001 0.19 (0.06) 0.001 0.10 (0.08) 0.189
≥2 hours 0.21 (0.08) 0.008 0.15 (0.07) 0.037 0.30 (0.07) <0.001 0.06 (0.09) 0.479 0.03 (0.23) 0.905
Note. All models adjusted for the following sets of covariates: demographics (age, cohort, marital status, language of test administration, and baseline memory), sensory health characteristics (low vision and
hearing), health behaviors (fruit and vegetable intake, smoking status, and alcohol use frequency), health status measures (body mass index, health-professional diagnosed mood and anxiety disorders,
neurological disorders, and cardiac/cardiovascular disorders), and social determinants (sex/gender, education, income, social support, perceived social standing, race, and sexual orientation).
719
720 Research on Aging 44(9-10)

draw attention to the social gradient. The authors (Ball et al., objective means. On average, self-report of physical activity is
2015) cite Australian work (Australian Bureau of Statistics, over-estimated compared to data collected via accelerometer
2013) that found that the most socioeconomically privileged (Prince et al., 2008). Strengths included the population-based
adults are more likely to engage in “sufficient physical ac- survey methodology and our inclusion of several health-
tivity.” Health behavior change is already notoriously dif- professional diagnosed neurological and cardiac/cardiovascular
ficult at the level of the individual (Samdal et al., 2017) and health disorders. In accounting for health disorders, we took a
the population (Kelly & Barker, 2016). Adding to the challenge deficit accumulation type approach (Rockwood & Mitnitski,
of general public health promotion of healthy lifestyles, some 2007), increasing confidence in the likelihood that frailty
population groups are more likely to experience barriers to may not explain our observed associations. Further, the pro-
participation in physical activity (Bantham et al., 2021). While spective relationship between physical activity and memory is
our findings support engagement in physical activity for lesser studied in mid-life adults (Erickson et al., 2019), an age
memory benefits in mid-life and older adulthood, particularly group included here.
the potentially more widely accessible walking and light ac-
tivities, some persons may be socially obstructed from par-
ticipating. Members of minority communities often experience
Conclusions
disadvantage and barriers to engaging in health promoting From a health equity perspective, population-level benefits of
behaviors that are linked to cognitive aging (Forrester et al., physical activity on memory may only be observed for less
2019). Equitable ways to promote physical activity are needed intense physical activities, especially walking. Our results
and may be realized through various methods, including suggest that walking and light activities were associated with
community-based approaches and engagement (Ball et al., better memory, and to a lesser extent, moderate physical ac-
2015; Bantham et al., 2021). tivity, but only at high levels (>1 hour per day), after accounting
In the present study, we did not find a protective rela- for social determinants. Less intensive activities may be more
tionship for muscle strengthening activities, for engagement in broadly accessible to a wider range of the older adult general
moderate activities <1 hour per day, or most durations of population. Therefore, more people may be able to engage in
strenuous activities. In terms of memory, the benefits of light activities more regularly, increasing their potential long-
aerobic activities may outweigh those of muscle strengthening term cognitive health benefits. The benefit of light exercise may
activities when activities are considered in isolation. A be underestimated.
combination of aerobic and muscle strengthening activities
may be best and is supported by clinical trial evidence Acknowledgments
(Bossers et al., 2015). Our findings build on previous work by The authors would like to thank the participants of the Canadian
including social determinants of cognitive aging and dem- Longitudinal Study on Aging (CLSA) for their contributions to
onstrate that in a real-world context, where participants may be research.
diverse in their sociodemographic profiles and experience of
inequality and disadvantage, the benefits of physical activity Declaration of Conflicting Interests
may only be observed for some less intense physical activities,
or for certain durations. This is also after accounting for other The author(s) declared no potential conflicts of interest with respect to
potential daily stressors: medical conditions and loss of a the research, authorship, and/or publication of this article.
partner (e.g., widowed).
Funding
The author(s) disclosed receipt of the following financial support for
Strengths and Limitations the research, authorship, and/or publication of this article: This research
Our study included the first available follow-up data from the was made possible using the data/biospecimens collected by the
CLSA, yet a limitation is that the follow-up period may still be Canadian Longitudinal Study on Aging (CLSA). Funding for the
considered short. While we were able to study how many CLSA is provided by the Government of Canada through the Canadian
social determinants are related to cognitive aging, minority Institutes of Health Research (CIHR) under grant reference: LSA
stress experiences may be better captured through perceived 94473 and the Canada Foundation for Innovation. This research has
discrimination or other markers of social disadvantage. We been conducted using the CLSA Baseline Tracking Dataset version
captured multiple minoritized identities in the present study, 3.6, Baseline Comprehensive Dataset version 4.2, Follow-up 1
but these persons comparatively made up a small proportion of Tracking Dataset version 2.1, Follow-up 1 Comprehensive Dataset
the sample. For example, <4.5% of participants in the sample version 3.0, under Application Number 190238. The CLSA is led by
were racialized and <2.5% identified as LGB. These findings Drs. Parminder Raina, Christina Wolfson, and Susan Kirkland. This
require replication, and cognitive aging research that engages work was supported by a grant from the Alzheimer’s Society of Canada
members of minoritized communities is needed. Another Research Program awarded to Dr. Arne Stinchcombe. Ms. Nicole G.
limitation is our use of a past-week self-report measure of Hammond is funded by the Frederick Banting and Charles Best Canada
physical activity instead of physical activity data collected via Graduate Scholarship Doctoral Awards (CGS-D) program.
Hammond and Stinchcombe 721

Disclaimer Brasure, M., Desai, P., Davila, H., Nelson, V. A., Calvert, C.,
Jutkowitz, E., Butler, M., Fink, H. A., Ratner, E., Hemmy,
The opinions expressed in this manuscript are the author’s own and
L. S., McCarten, J. R., Barclay, T. R., & Kane, R. L. (2018).
do not reflect the views of the Canadian Longitudinal Study on Aging
Physical activity interventions in preventing cognitive decline
(CLSA).
and Alzheimer-type dementia: A systematic review. Annals
of Internal Medicine, 168(1), 30. https://doi.org/10.7326/
Data Availability Statement
M17-1528
Data are available from the Canadian Longitudinal Study on Aging Canadian Longitudinal Study on Aging. (2015, January). Main-
(www.clsa-elcv.ca) for researchers who meet the criteria for access to taining contact questionnaire (tracking and comprehensive)
de-identified CLSA data. wave 1 version v2.7. Canadian Longitudinal Study on Aging.
https://clsa-elcv.ca/doc/540
ORCID iDs Canadian Longitudinal Study on Aging. (2018, June). 60-min.
Nicole G. Hammond  https://orcid.org/0000-0001-9404-8416 questionnaire (tracking main wave) v4.0. Canadian Longitu-
Arne Stinchcombe  https://orcid.org/0000-0002-2101-3535 dinal Study on Aging. https://clsa-elcv.ca/doc/446
Canadian Longitudinal Study on Aging. (2019, January). CLSA
Supplementary Material tracking and comprehensive cognition measurements (baseline)
portal dataset overview. Canadian Longitudinal Study on Ag-
Supplementary material for this article is available online.
ing. https://www.clsa-elcv.ca/doc/3457
Canadian Society for Exercise Physiology. (2021a). Canadian 24-
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Dr. Arne Stinchcombe: Dr. Arne Stinchcombe is an assistant
1080/13854046.2016.1254279
professor at the University of Ottawa in the School of Psy-
Tuokko, H., Griffith, L. E., Simard, M., Taler, V., O’Connell, M. E.,
chology. He maintains expertise in cognitive aging and the
Voll, S., Kadlec, H., Wolfson, C., Kirkland, S., & Raina, P.
psychosocial aspects of health, aging, and older adulthood. He
(2020). The Canadian longitudinal study on aging as a platform
has a particular interest in the social determinants of health in
for exploring cognition in an aging population. The Clinical
older adulthood.
Neuropsychologist, 34(1), 174–203. https://doi.org/10.1080/
13854046.2018.1551575 Nicole G. Hammond: Ms. Hammond is a PhD candidate in
Valenzuela, P. L., Castillo-Garcı́a, A., Morales, J. S., de la Villa, P., the School of Epidemiology and Public Health at the Uni-
Hampel, H., Emanuele, E., Lista, S., & Lucia, A. (2020). Ex- versity of Ottawa and a Psychiatric Epidemiologist. Her
ercise benefits on Alzheimer’s disease: State-of-the-science. doctoral research focuses on family-level risk and protective
Ageing Research Reviews, 62, 101108. https://doi.org/10.1016/ factors for adolescent onset self-harm and suicidality. She also
j.arr.2020.101108 studies behavioral determinants of health.