Nutritional advice

Objectives:
Available studies in the literature on the selenium levels in Alzheimer's disease (AD) are inconsistent with some studies reporting its decrease in the circulation, while others reported an increase or no change as compared to controls. Therefore, this meta-analysis (review article) has been conducted.

Do lower circulatory (plasma/serum and blood), erythrocyte and cerebrospinal fluid (CSF) selenium levels increase Alzheimer's disease risk?

Study design:
This review article included 12 case-control/observational studies reporting selenium concentrations in Alzheimer's disease and controls.

Results and conclusions:
The investigators found random-effects meta-analysis indicated a decrease in circulatory [SMD = -0.44], erythrocellular [SMD = -0.52] and cerebrospinal fluid [SMD = -0.14] selenium levels in Alzheimer's disease patients compared to controls

The investigators found stratified meta-analysis demonstrated that the selenium levels were decreased in both the subgroups with [SMD = -0.55] and without [SMD = -0.37] age matching between Alzheimer's disease and controls.

The investigators also found a direct association between decreased selenium levels and glutathione peroxidase (GPx) in Alzheimer's disease.

The investigators concluded that circulatory selenium concentration is significantly lower in Alzheimer's disease patients compared to controls and this decrease in selenium is directly correlated with an important antioxidant enzyme, the glutathione peroxidase, in Alzheimer's disease.

Original title:
A systematic review and meta-analysis of the circulatory, erythrocellular and CSF selenium levels in Alzheimer's disease: A metal meta-analysis (AMMA study-I) by Reddya VS, Bukkeb S, […], Pandeye AK.

Link:
http://www.sciencedirect.com/science/article/pii/S0946672X1630205X%20

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Objectives:
Does higher protein intake increase bone mineral density?

Study design:
This review article included 6 RCTs and 20 prospective cohort studies.
There were no adverse effects of higher protein intakes.
Studies were heterogeneous and confounding could not be excluded.

Results and conclusions:
The investigators found moderate evidence suggested that higher protein intake may have a protective effect on lumbar spine bone mineral density compared with lower protein intake [net percentage change = 0.52%, 95% CI = 0.06%-0.97%, I2 = 0%, n = 5] but had no effect on total hip, femoral neck, or total body bone mineral density or bone biomarkers.

The investigators concluded that higher protein intake may have a protective effect on lumbar spine bone mineral density. May have because studies were heterogeneous and confounding could not be excluded. Therefore, high-quality, long-term studies are needed to clarify dietary protein's role in bone health.

Original title:
Dietary protein and bone health: a systematic review and meta-analysis from the National Osteoporosis Foundation by Shams-White MM, Chung M, […], Weaver CM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28404575

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A higher protein diet is a diet with 20-35 En% protein. The easiest way to meet a diet with 20-35 En% protein is to choose food items/meals with also 20-35 En% protein. Check here which products contain 20-35 En% protein.
 

Objectives:
Current studies evaluating the association of tea consumption and bone mineral density (BMD) have yielded inconsistent findings. Therefore, this meta-analysis (review article) has been conducted.

Does tea consumption increase bone mineral density?

Study design:
This review article included 4 cohort, 1 case-control and 8 cross-sectional studies including a total of 12,635 cases (6,059 in the tea consumption group and 6,576 individuals in non-tea consumption group).

Results and conclusions:
The investigators found tea consumption significantly reduced the occurrence of low bone mass with 34% [OR  =  0.66, 95% CI  =  0.47-0.94, p =  0.02].

The investigators found tea consumption significantly yielded higher mineral densities in several bones, including:
-the lumbar spine [standardized mean difference (SMD) = 0.19, 95% CI = 0.08-0.31, p  =  0.001];
-hip [SMD = 0.19, 95% CI = 0.05-0.34, p  =  0.01];
-femoral neck [mean difference (MD) = 0.01, 95% CI = 0.00-0.02, p  =  0.04];
-Ward triangle [MD = 0.02, 95% CI = 0.01-0.04, p  =  0.001] and;
-greater trochanter [MD = 0.03, 95% CI = 0.02-0.04, p  0.00001]
than the non-tea consumption group.

The investigators concluded that tea consumption increases bone mineral density, especially in the lumbar spine, hip, femoral neck, Ward triangle and greater trochanter, which can prevent bone loss.

Original title:
Updated association of tea consumption and bone mineral density: A meta-analysis by Zhang ZF, Yang JL, [...], Liu ZX.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371490/

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Objectives:
Is there a relationship between serum 25(OH)D (vitamin D blood level) and mortality risk in the general population?

Study design:
This review article included 14 prospective cohort studies that involved 5562 deaths out of 62548 individuals.
In the parametric model, which is based on 11 studies and 59231 individuals, the lowest quantile as the reference category has been used.

Evidence of heterogeneity for the RR was apparent when highest were compared with lowest categories [p = 0.008, I2 = 58%].

There was no evidence of publication bias.

Results and conclusions:
The investigators found for “highest compared with lowest” categories of 25(OH)D, a significant reduced risk of 29% for mortality [RR = 0.71, 95% CI = 0.50-0.91].

The investigators found in the parametric model, the estimated summary RRs of mortality were 0.86 [95% CI = 0.82-0.91], 0.77 [95% CI = 0.70-0.84] and 0.69 [95% CI = 0.60-0.78] for individuals with an increase of 12.5, 25 and 50 nmol 25(OH)D serum values/L, respectively, from a median reference category of ∼27.5 nmol/L.
However, no significant decrease in mortality was found above ∼87.5 nmol/L.

The investigators concluded there is a nonlinear decrease in mortality risk as circulating 25(OH)D increases, with optimal concentrations ∼75-87.5 nmol/L. Because many adults do not achieve these 25(OH)D values, large prospective randomized trials are urgently needed to investigate whether vitamin D supplementation is able to reduce mortality risk in the general population.

Original title:
Vitamin D deficiency and mortality risk in the general population: a meta-analysis of prospective cohort studies by Zittermann A, Iodice S, [...], Gandini S.

Link:
http://ajcn.nutrition.org/content/95/1/91.full

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Objectives:
Does soy isoflavone reduce the frequency and severity of hot flashes?

Study design:
This review article included 19 trials (13 included hot flash frequency, of which 10 for severity and 3 for composite scores).
17 trials were selected for meta-analyses to clarify the effect of soybean isoflavones on hot flash frequency (13 trials) and severity (9 trials).

Results and conclusions:
The investigators found intake of soy isoflavones (median = 54 mg aglycone equivalents) for 6 weeks to 12 months significantly reduced the frequency (combined fixed-effect and random effects model) of hot flashes by 20.6% [95% CI = -28.38 to -12.86, p 0.00001] compared with placebo [p heterogeneity = 0.0003, I2 = 67% for random effects model].

The investigators also found isoflavones significantly reduced hot flash severity by 26.2% [95% CI = -42.23 to -10.15, p = 0.001] compared with placebo [p heterogeneity 0.00001, I2 = 86% for random effects model].

The investigators found isoflavone supplements providing more than 18.8 mg of genistein (the median for all studies) were more than twice as potent at reducing hot flash frequency than lower genistein supplements.

The investigators concluded soy isoflavone supplements (54 mg per day for 6 weeks to 12 months), derived by extraction or chemical synthesis, are significantly more effective than placebo in reducing the frequency and severity of hot flashes. Additional studies are needed to further address the complex array of factors that may affect efficacy, such as dose, isoflavone form, baseline hot flash frequency and treatment duration.

Original title:
Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials by Taku K, Melby MK, […], Messina M.

Link:
http://journals.lww.com/menopausejournal/Abstract/2012/07000/Extracted_or_synthesized_soybean_isoflavones.11.aspx

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Objectives:
There is an ongoing debate on the involvement of systemic copper (Cu) dysfunctions in Alzheimer's disease (AD) and clinical studies comparing Cu levels in serum, plasma and cerebrospinal fluid (CSF) of AD patients with those of healthy controls have delivered non-univocal and often conflicting results. Therefore, this review article has been conducted.

Does blood level of copper increase in Alzheimer’s disease?

Study design:
This review article included 26 studies including a pooled total of 761 AD subjects and 664 controls for serum Cu studies, 205 AD subjects and 167 controls for plasma Cu and of 116 AD subjects and 129 controls for CSF Cu.

Results and conclusions:
The investigators found Alzheimer's disease patients have higher levels of serum copper than healthy controls. Plasma data did not allow conclusions, due to their high heterogeneity, but the meta-analysis of the combined serum and plasma studies confirmed higher copper levels in Alzheimer's disease patients. 

The investigators found the analysis of CSF data revealed no difference between Alzheimer's disease patients and controls.

The investigators concluded Alzheimer's disease patients have higher levels of serum and plasma copper than healthy controls.

Original title:
Copper in Alzheimer's disease: a meta-analysis of serum, plasma, and cerebrospinal fluid studies by Bucossi S, Ventriglia M, […], Squitti R.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/21187586

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Objectives:
The association between dietary vitamin K intake and the risk of fractures is controversial. Therefore, this meta-analysis (review article) has been conducted.

Does dietary vitamin K intake reduce risk of fractures?

Study design:
This review article included 4 cohort studies and 1 nested case-control study, including 80,982 total subjects and 1114 fracture cases.

The fractures were assessed using confirmed self-reported, medical and radiological report. Dietary vitamin K intake was assessed with a food-frequency questionnaire (FFQ) in 4 studies, only 1 study used 4-day or 7-day food record.
Vitamin K intake in all included studies refers exclusively to the intake of phylloquinone (vitamin K1), which is the predominant form of vitamin K in foods.
All subjects were more than 30 years old.
Duration of follow-up for the included studies ranged from 6.9 to 10 years.
Most studies provided RRs that were adjusted for age, BMI, BMD, physical activity, vitamin D and calcium intake, smoking and alcohol consumption.

The Begg and Egger tests did not show any substantial asymmetry (p  =  0.50 for Begg test and p  =  0.32 for Egger tests). Further trim and filled meta-analysis showed that there were no trimming data added.

Results and conclusions:
The investigators found for highest vs. the lowest dietary vitamin K intake a significant reduced risk of 22% [RR = 0.78, 95% CI = 0.56-0.99, I2  =  59.2%, p  = 0 .04] for fractures.

The investigators found for every increment of 50μg dietary vitamin K intake per day a significant reduced risk of 3% [RR  = 0.97, 95% CI = 0.95-0.99, I2  =  25.9%, p  = 0 .25] for fractures.

The investigators found a significant reduced risk of 24% [RR = 0.76, 95% CI = 0.58-0.93, I2  =  59.2%, p  = 0 .04] for fractures in studies with more than 10 years of follow-up.

The investigators concluded that higher dietary vitamin K intake; at least 50μg dietary vitamin K intake per day decreases the risk of fractures. This review article offers additional evidence on the relationship between dietary vitamin K intake and risk of fractures. The benefit of vitamin K should be confirmed in future well-designed prospective cohort studies and clinical trials.

Original title:
Vitamin K intake and the risk of fractures: A meta-analysis by Hao G, Zhang B, [...], Cao X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413254/

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Objectives:
In view of the vital role of oxidative stress in the pathogenesis of Alzheimer's disease (AD), the potential of antioxidant supplements to prevent AD have gained much interest, while there are conflicting results on this topic in recent years. Therefore, this review article has been conducted.

Does dietary intake of vitamin C and E and β-carotene decrease risk of Alzheimer's disease?

Study design:
This review article included 7 articles (dietary intake, but no supplements).

Results and conclusions:
The investigators found a significant decreased risk for Alzheimer disease of 24% [pooled relative risk = 0.76 95% CI = 0.67-0.84] for dietary intake of vitamin E and of 17% [pooled relative risk = 0.83, 95% CI = 0.72-0.94] for dietary intake of vitamin C.

However, the investigators found a non-significant decreased risk of 12% [pooled relative risk = 0.88, 95% CI = 0.73-1.03] for dietary intake of β-carotene.

The investigators concluded dietary intakes of vitamin C and E lower the risk of Alzheimer's disease, with vitamin E exhibiting the most pronounced protective effects. The findings will be of significance to the prevention and interventional treatment of Alzheimer's disease.

Original title:
Dietary intakes of vitamin E, vitamin C, and β-carotene and risk of Alzheimer's disease: a meta-analysis by Li FJ, Shen L and Ji HF.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/22543848

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Objectives:
Manganese (Mn) is one of the most studied environmental heavy metals linked to Alzheimer’s disease (AD). However, it remains unclear whether serum manganese levels are associated with Alzheimer’s disease and mild cognition impairment (MCI, a prodromal stage of AD). Therefore, this meta-analysis (review article) has been conducted.

Does a lower serum manganese level increase risk of cognitive decline?

Study design:
This review article included 17 studies, involving 836 cases and 1254 health controls (HC).

The sample size of the included studies ranged from 8 to 758. The average age of the patient groups ranged from 66.2 to 87.0 years. The proportion of female patients ranged from 33% to 80%.

Strong heterogeneity existed among the studies. Heterogeneity was not due to methods for measuring manganese levels, geographic locations, age and gender of patients.

There was no publication bias in the present meta-analysis evaluated by the Egger’s test (p = 0.258) and Begg’s test (p = 0.107).

Results and conclusions:
The investigators found random-effects meta-analysis showed that patients with Alzheimer’s disease had significantly reduced serum manganese levels compared with health control subjects [SMD = -0.39, 95% CI = -0.71 to -0.08, p = 0.015].

The investigators found mild cognition impairment individuals had a tendency toward reduced serum manganese levels compared with health control subjects [SMD = -0.31, 95% CI = -0.70 to 0.08, p = 0.117].

The investigators found a significant decrease in serum manganese levels in patients with cognitive impairment (including both AD patients and MCI patients) [SMD = -0.37, 95% CI = -0.60 to -0.13, p = 0.002].

The investigators found no significant differences between Alzheimer’s disease and mild cognition impairment patients in serum levels [SMD = 0.24, 95% CI = -0.23 to 0.72, p = 0.310].

The investigators concluded that the serum manganese levels are lower in Alzheimer’s disease patients and manganese deficiency may be a risk factor for Alzheimer’s disease. However, the results should be interpreted with caution due to the high heterogeneity of the studies.

Original title:
Association of Serum Manganese Levels with Alzheimer’s Disease and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis by Du K, Liu M, [...], Wei M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372894/

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Objectives:
Lutein and zeaxanthin are thought to have beneficial effects on protecting the lens against cataract formation, but findings from epidemiologic studies have been inconsistent. Therefore, this review article has been conducted.

Does dietary lutein and zeaxanthin intake reduce age-related cataract risk?

Study design:
This review article included 6 prospective cohort studies, involving 4416 cases and 41999 participants.

Results and conclusions:
The investigators found for comparing the highest with the lowest categories of dietary lutein and zeaxanthin intake, a significant reduced risk for nuclear cataract of 25% [RR = 0.75, 95% CI = 0.65-0.85], but the reduced risk was not significant for cortical cataract [RR = 0.85, 95% CI = 0.53-1.17] and for posterior subcapsular cataract [RR = 0.77, 95% CI = 0.40-1.13]. Significant means, there is an association with a 95% confidence.

The investigators found in dose-response analysis that every 300 μg/d increment in dietary lutein and zeaxanthin intake was significantly associated with a 3% [RR = 0.97, 95% CI = 0.94-0.99] reduction in the risk of nuclear cataract.

The investigators found in dose-response analysis that every 300 μg/d increment in dietary lutein and zeaxanthin intake was non-significantly associated with a 1% [RR = 0.99, 95% CI = 0.95-1.02] reduction in the risk of cortical cataract. Non-significantly means, there is no association with a 95% confidence.

The investigators found in dose-response analysis that every 300 μg/d increment in dietary lutein and zeaxanthin intake was non-significantly associated with a 3% [RR = 0.97, 95% CI = 0.93-1.01] reduction in the risk of posterior subcapsular cataract. Non-significantly because RR of 1 was found in 95% CI of 0.93 to 1.01. RR of 1 means no risk.

The investigators concluded dietary lutein and zeaxanthin intake (at least 300 μg/d) is associated with a reduced risk of age-related cataract, especially nuclear cataract in a dose-response manner, indicating a beneficial effect of lutein and zeaxanthin in age-related cataract prevention.

Original title:
A dose–response meta-analysis of dietary lutein and zeaxanthin intake in relation to risk of age-related cataract by Ma L, Hao ZX, [...], Pan JP.

Link:
http://link.springer.com/article/10.1007/s00417-013-2492-3

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Objectives:
Hormonal effects of soy and isoflavones have been investigated in numerous trials with equivocal findings. Therefore, this review article has been conducted.

What are hormonal effects of soy and isoflavones in both pre- and postmenopausal women?

Study design:
This review article included 47 (11 of pre-, 35 of post- and 1 of perimenopausal women) randomized or residential crossover trials of soy or isoflavones for 4 or more weeks on estrogens, SHBG, FSH, LH, progesterone and thyroid hormones in women was assessed independently in duplicate.

The studies ranged from 4 to 104 weeks long: 29 were 4-12 weeks in duration, 9 were 13-26 weeks, 7 were 27-52 weeks and 2 were >1 year.

Results and conclusions:
The investigators found in premenopausal women, soy or isoflavone consumption did not affect primary outcomes estradiol, estrone or SHBG concentrations, but significantly reduced secondary outcomes FSH and LH [by approximately 20% using standardized mean difference (SMD), p = 0.01 and p = 0.05, respectively].

The investigators found in 10 studies that soy or isoflavone consumption increased menstrual cycle length by 1.05 days [95% CI = 0.13-1.97].

The investigators found in post-menopausal women, soy or isoflavone consumption had no statistically significant effects on estradiol, estrone, SHBG, FSH or LH, although there was a small statistically non-significant increase in total estradiol with soy or isoflavones [by approximately 14% using standardized mean difference (SMD), p = 0.07, 21 studies].

The investigators concluded isoflavone-rich soy products decrease FSH and LH in premenopausal women and may increase estradiol in post-menopausal women. The clinical implications of these modest hormonal changes remain to be determined.

Original title:
Effects of soy protein and isoflavones on circulating hormone concentrations in pre- and post-menopausal women: a systematic review and meta-analysis by Hooper L, Ryder JJ, […], Cassidy A.

Link:
http://humupd.oxfordjournals.org/content/15/4/423.full

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Objectives:
Is there an association between serum non-ceruloplasmin copper and Alzheimer's disease risk?

Study design:
This review article included studies carried out from 1996 until March 2013.

Ten studies were analyzed in the meta-analysis for Non-Cp copper and % Non-Cp copper reaching a pooled total of 599 Alzheimer's disease subjects and 867 controls.
For Adj-Cp copper, 14 studies were analyzed with a pooled total of 879 Alzheimer's disease subjects and 1712 controls.
27 studies were considered for systemic total copper meta-analysis, with a pooled total of 1393 Alzheimer's disease subjects and 2159 controls.

Results and conclusions:
The investigators found all copper indices analyzed were significantly higher in Alzheimer's disease subjects compared to healthy controls.

The investigators concluded serum non-ceruloplasmin copper is higher in Alzheimer's disease.

Original title:
Meta-analysis of serum non-ceruloplasmin copper in Alzheimer's disease by Squitti R, Simonelli I, […], Bush AI.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/24072069

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Objectives:
Does DHA, alone or combined with EPA, contribute to improved memory function in older adults with mild memory complaints?

Study design:
This review article included 15 intervention trials and 13 observational studies. Most intervention trials were conducted with subjects ≥ 45 years of age (n = 11). The majority of studies were conducted in subjects without cognitive complaints (n = 9) and ranged from 28-730 days in duration, averaging 4-6 months.

Results and conclusions:
The investigators found episodic memory of subjects with mild memory complaints significantly improved in response to DHA supplementation, alone or in combination with EPA [p 0.004].

The investigators found regardless of cognitive status at baseline, >1 g/day DHA/EPA significantly improved episodic memory of subjects with mild memory complaints [p 0.04].

The investigators found there was a trend for episodic memory improvement in response to supplementation in subjects 45 years or older [p 0.058].

The investigators found DHA intake above the mean DHA level studied (580 mg/day) significantly improved episodic memory in all subjects [p 0.009] and in subjects with mild memory complaints [p 0.019]. Significant means that there is an association with a 95% confidence.

The investigators found observational studies supported a beneficial association between intake/blood levels of DHA/EPA and memory function in older adults.

The investigators concluded DHA (>580 mg/day), alone or combined with EPA (>1 g/day DHA/EPA), contributes to improved memory function in older adults (45 years or older) with mild memory complaints.

Original title:
Docosahexaenoic Acid and Adult Memory: A Systematic Review and Meta-Analysis by Yurko-Mauro K, Alexander DD and Van Elswyk ME.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364972/

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This meal provides at least 580 mg DHA.
1 g/day DHA/EPA corresponds to meals providing 4 days of DHA&EPA.

Episodic memory is the type of long-term, declarative memory in which we store memories of personal experiences that are tied to particular times and places.
Some examples of episodic memory:

• Your skiing vacation last winter;
• The first time you traveled by airplane;
• Your first high school day.

Objectives:
Increased consumption of fruit and vegetables has been shown to be associated with a reduced risk of cognitive impairment and dementia in many epidemiological studies; although sometimes the results are inconsistent. Moreover, the strength of the favorable relation remains uncertain due to the differences in sample selections, methodological approaches, analytical techniques and outcome definitions. Therefore, this meta-analysis (review article) has been conducted.

Does an increased consumption of fruit and vegetables reduce risk of cognitive impairment and dementia?

Study design:
This review article included 5 cohort studies and 4 cross-sectional studies with a total of 31,104 participants and 4,583 incident cases of cognitive impairment and dementia.

There was no potential publication bias in the meta-analysis and the dose-response meta-analysis.

Results and conclusions:
The investigators found an increased consumption of fruit and vegetables was associated with a significant reduction of 20% in the risk of cognitive impairment and dementia [OR = 0.80, 95% CI = 0.71-0.89, I2 = 55.2%, p = 0.005].

The investigators found subgroup analyses showed an inverse association between fruit and vegetable consumption and risk of cognitive impairment and dementia in participants with mean age over 65 years [OR = 0.80, 95% CI = 0.71-0.91] and combined sexes [OR = 0.71, 95% CI = 0.66-0.78]. However, studies from the United States and with full marks of study quality score did not show statistical significances.

The investigators found dose-response meta-analysis showed that an increment of 100g per day of fruit and vegetable consumption was related to a 13% [OR = 0.87, 95% CI = 0.77-0.99, I2 = 39.8%, p = 0.173] reduction in cognitive impairment and dementia risk.

The investigators concluded that an increased consumption of fruit and vegetables, at least 100g per day of fruit and vegetable consumption is associated with a reduced risk of cognitive impairment and dementia.

Original title:
Increased Consumption of Fruit and Vegetables Is Related to a Reduced Risk of Cognitive Impairment and Dementia: Meta-Analysis by Jiang X, Huang J, [...], Zhang Z.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293796/

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Objectives:
Data on the longitudinal association of walking pace with the risk of cognitive decline and dementia are inconsistent and inconclusive. Therefore, this meta-analysis (review) of prospective cohort studies has been conducted.

Does walking pace reduce risk of cognitive decline or dementia in elderly populations?

Study design:
This review article included 17 prospective cohort studies, including 10 studies reporting the RR of cognitive decline (9,949 participants and 2,547 events) and 10 presenting the RR of dementia (14,140 participants and 1,903 events).

Results and conclusions:
The investigators found for the lowest comparing to the highest category of walking pace, a significant increased risk of 89% [pooled RR = 1.89, 95% CI = 1.54-2.31] for cognitive decline in elderly populations.

The investigators found for the lowest comparing to the highest category of walking pace, a significant increased risk of 66% [pooled RR = 1.66, 95% CI = 1.43-1.92] for dementia in elderly populations.

The investigators found with every 1 dm/s (360 m/h) decrement in walking pace, the risk of dementia was significantly increased by 13% [RR = 1.13, 95% CI = 1.08-1.18].

The investigators concluded that slow or decreased walking pace is associated with elevated risk of cognitive decline and dementia in elderly populations.

Original title:
Walking Pace and the Risk of Cognitive Decline and Dementia in Elderly Populations: A Meta-analysis of Prospective Cohort Studies by Quan M, Xun P, [...], He K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27927757

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According to WHO in order to improve cardiorespiratory and muscular fitness, bone and functional health, reduce the risk of NCDs, depression and cognitive decline:

• Older adults (aged 65 and above) should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity.
• Aerobic activity should be performed in bouts of at least 10 minutes duration.
• For additional health benefits, older adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate-and vigorous-intensity activity.
• Older adults, with poor mobility, should perform physical activity to enhance balance and prevent falls on 3 or more days per week.
• Muscle-strengthening activities, involving major muscle groups, should be done on 2 or more days a week.
• When older adults cannot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.