Cardiorespiratory fitness is associated with cognitive function in late adulthood: baseline findings from the IGNITE study.

Objectives: To evaluate the association between cardiorespiratory fitness (CRF) and cognition in a large sample of older adults, and to examine clinical and demographic factors that might moderate these associations.
Methods: CRF was measured with a graded exercise test performed on a motorised treadmill. A confirmatory factor analysis was conducted using data from a comprehensive neuropsychological battery to obtain latent factors reflecting core cognitive domains. Linear regression models evaluated the association between CRF and each of the cognitive composites, and potential moderators including demographic factors (age, sex, education), apolipoprotein E ε4 ( APOE4 ) carriage, beta-blocker use and components of maximal effort criteria during CRF testing.
Results: The sample consisted of 648 adults (mean (SD) age 69.88 (3.75)), including 461 women (71.1%). The highest oxygen consumption obtained during testing (VO _2max ) was mean (SD) = 21.68 (5.06) mL/kg/min. We derived a five-factor model composed of episodic memory, processing speed, working memory, executive function/attentional control and visuospatial function. Higher CRF was associated with better performance across all five cognitive domains after controlling for covariates. Age and APOE4 carriage did not moderate observed associations. The relationship between CRF and cognitive performance was greater in women, those with fewer years of education and those taking beta-blockers in the domains of processing speed (sex: β=-0.447; p=0.015; education: β=-0.863; p=0.018) and executive function/attentional control (sex: β=-0.417; p=0.022; education β=-0.759; p=0.034; beta-blocker use: β=0.305; p=0.047).
Conclusion: Higher CRF in older adulthood is associated with better cognitive performance across multiple domains susceptible to age-related cognitive decline. Sex, education and use of beta-blockers moderated observed associations within select cognitive domains.
Competing Interests: Competing interests: The authors declare no conflicts of interest relevant to this article. KIE consults for MedRhythms, Inc., and Neo Auvra, Inc. JMJ is on the Scientific Advisory Board for Wondr Health, Inc., and was the site principal investigator for a research study supported by Epitomee Medical, Inc., awarded to the University of Kansas Medical Center.
(© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.)