NewsMakers
Older people in good shape have fitter brains
Seventy- to eighty-year-olds who train for better fitness are better at solving cognitive tasks and are less likely to suffer cognitive impairment.
“Our findings suggest that being fit can protect against mild cognitive impairment in older people,” says Ekaterina Zotcheva.
Just before Christmas, Zotcheva defended her doctoral dissertation on exercise and brain health at the Norwegian University of Science and Technology, NTNU. The day before the defence, the last study for her doctoral degree was published in the highly regarded Sports Medicine journal.
The article is just one of three recent research articles from NTNU that show how important it is for the brain to stay in good physical shape as you get older. Common to all three articles is that they are based on data from the world’s largest training study for older adults, the Generation 100 study from the Cardiac Exercise Research Group.
Dementia risk
“The Generation 100 study has been going on for almost ten years now. After the study participants had been exercising for five years, we tested the cognitive function of almost 1000 of them.”
“The men and women who had maintained or increased their physical fitness during the study had better brain health than those whose fitness had declined over the five years,” says Zotcheva.
The cognitive test that the participants took is the same one that is often used to check whether people are at risk of developing dementia.
The test assesses short-term memory, execution function and the ability to orient oneself in time and space. Scoring below a certain number indicates a risk of mild cognitive impairment.
“We know that mild cognitive impairment can lead to dementia for some individuals. The greater the increase in a participant’s fitness level during the five years of the study, the lower their probability was of developing mild cognitive impairment,” says Zotcheva.
Better at problem solving
Good conditioning appears to be an important prerequisite for good brain function in the elderly in the other two research articles as well. In both of these studies, the researchers tested the brain health of more than 100 of the participants in the Generation 100 study at start-up and after one, three and five years of training.
“Participants who were in good shape, both when the study started and later in the study, had a faster reaction time. The ones who improved their fitness level gained a somewhat better working memory,” says NTNU professor Asta Håberg.
The ability to solve cognitive problems was tested using the web-based Memoro platform, which Håberg developed in collaboration with neuropsychologist Tor Ivar Hansen.
Less brain atrophy
Håberg has been involved in the work with all three recent research articles. In the third study, the researchers performed MRI scans of the participants’ brains to see how the brain volume and thickness of the cerebral cortex changed throughout the study. Here, too, the most energetic participants came out best.
“Participants who were in good shape when the study started had a thicker cerebral cortex after one, three and five years, as compared with those who had lower maximum oxygen uptake. But we didn’t find any effect from increasing fitness during the study,” says Håberg.
The cerebral cortex is the outermost layer of the brain and is important for several important brain functions, such as attention, ability to make choices, working memory, abstract thinking and memory. This part of the brain becomes thinner with age, and thinning of the cerebral cortex in different areas is linked to different types of dementia, such as Alzheimer’s disease and frontotemporal dementia.
Fitness more important than type of exercise
All 70- to 77-year-olds in Trondheim were invited to the Generation 100 study in 2012. Those who agreed to participate were randomly assigned to five years of exercise of various kinds. One group would primarily do high intensity intervals, a second group would mainly go for walks or do other exercise with moderate intensity, and the last group would try to follow the activity recommendations of the health authorities to be physically active for at least 150 minutes each week.
The first two groups were followed up most closely by the researchers, and were offered two organized training sessions each week. The NTNU researchers looked beyond the connection between fitness and brain health and also investigated whether the type of training follow-up that participants received made a difference.
“Our results show that organized training follow-up may have given older men, but not older women, better cognitive function and lowered the probability of mild cognitive impairments. But all in all, it seems that the most important thing is that you actually train in a way that increases your fitness, regardless of whether you get organized help to be physically active or not,” says Zotcheva.
Less brain atrophy than expected
“In the groups that received follow-up with high-intensity training and training with moderate intensity, respectively, we found somewhat greater loss of brain volume in deep areas of the brain than among those who trained themselves. But we have to emphasize that everyone in the Generation 100 study – regardless of the form of exercise they did – had less brain loss than expected for people in their 70s. The group that trained on their own without organized follow-up had the least shrinkage in the hippocampus and thalamus,” Håberg says.
The training follow-up in Generation 100 was not decisive for the participants’ ability to solve cognitive tasks.
“The groups that were able to attend organized training didn’t perform any better than the group that trained on their own on various tasks, such as remembering where an object is located, memorizing words, processing information quickly or planning,” says Håberg.
Maintained good cognitive function
“It’s still worth noting that the 70-77-year-old participants on average had the same cognitive abilities after five years as at start-up, and that during the study period they even improved on some of the tests. The results show that being in good shape like the Generation 100 participants were, is important for maintaining good brain function,” Håberg says.
The training effect thus seems to be greatest for people who enter retirement age in good shape, and exercise that improves fitness can provide further benefits. So how should the elderly train to get in better shape?
“Several paths can lead to that goal, and the most important factor is to find an activity you enjoy and can continue with over time. In order to maintain or increase your fitness, you should in any case exercise regularly in a way that gets you out of breath and sweaty,” says Zotcheva.
NewsMakers
‘Drunk riding’ behind almost half of fatal electric scooter crashes
Tatal crashes occur mainly in the evenings or through the night, and in all cases, no helmet has been worn.
In almost half of all fatal electric scooter crashes in Sweden, the rider has been under the influence of alcohol. These fatal crashes occur mainly in the evenings or through the night, and in all cases, no helmet has been worn. This is shown by a new study from Chalmers University of Technology, in Sweden, and the Swedish Transport Administration. The study also states that most fatal crashes occur with private electric scooters, rather than rentals.
The researchers have analysed all fatal crashes involving electric scooters, electric bicycles and conventional bicycles in Sweden between 2016 and 2024.
Alcohol is often a factor in fatal crashes occurring with all three of these vehicle types – but the figures for electric scooters stand out. Of the fatal e-scooter crashes, 44 per cent of the riders were under the influence of alcohol, compared to 27 per cent among e-bike riders and 13 per cent among cyclists.
More specifically the levels of alcohol in the blood have been shown to be high across all three groups. Of the e-scooter riders that were under the influence of alcohol, the median blood alcohol content was 1.8 per mille. This can be compared to the legal limit of alcohol content in the blood for driving a car in Sweden, which is 0.2 per mille, above which it is considered drunk driving, and 1.0 per mille in the blood which is considered aggravated drunk driving.
“Alcohol intoxication is a common issue among all road users, but it appears to be particularly severe among riders of electric scooters. Not only were many fatally injured e‑scooter riders intoxicated, but their levels of intoxication were also extremely high,” says Marco Dozza, Professor of Active Safety and Road User Behaviour at Chalmers University of Technology, and senior researcher in the study.
Lack of helmets worn in those killed
The study also showed that helmet use in fatal crashes was very low. Of those fatally injured riding an e-scooter, none were wearing a helmet. And for those killed riding an e-bike or a bicycle, only about 25 per cent were wearing a helmet.
Head injuries were the most common cause of death in all groups.
“The numbers speak for themselves. Since the head is the area of the body that is most affected by a fatal injury and almost no one wears a helmet, we have a clear opportunity to save lives. A helmet is not a guarantee but improves the chances dramatically, so we should do everything we can to encourage helmet use,” says Rahul Rajendra Pai, doctoral student at Chalmers and first author of the study.
“I think many people don’t understand the danger of using an electric scooter under the influence of alcohol, and think that the vehicle doesn’t go that fast,” says Marco Dozza. “But it is enough hitting a stone on the road or a small hole in the ground to lose balance, especially when intoxicated, because alcohol slows down cognition and reactions. If you don’t wear a helmet, it may end up even worse”.
Different crash patterns for different vehicles
The study included 204 deaths, and the researchers saw clear differences between the three vehicle types in terms of rider and crash patterns.
In fatal crashes involving ordinary bicycles, the median age of the cyclist was 71 years old. The crashes often occurred on weekdays and usually involved collisions with motor vehicles.
Fatal e-scooter crashes looked different. The riders had a median age of 47.5 years old, and most of the crashes were single vehicle crashes that occurred at weekends, evenings and nights.
According to the researchers, the results indicate the need for measures and regulations to be adapted to the different types of vehicles.
“The typical fatal bicycle crash, with an elderly cyclist being hit by a motor vehicle in daylight, may require completely different countermeasures than the typical fatal electric scooter crash, where a younger rider crashes alone at night while intoxicated,” says Marco Dozza.
Fatal crashes most common with private electric scooters
Almost nine out of ten alcohol-related e-scooter deaths occurred with privately owned vehicles. Public debate and regulations have largely focused on rented electric scooters, and operators have introduced measures such as speed limits and night restrictions. However, these measures do not affect privately owned electric scooters.
According to the researchers, rules and measures can to some extent counteract crashes with electric scooters. Marco Dozza, for example, is leading an ongoing study on how today’s sensor technology in rented electric scooters can make it possible to detect impaired riding ability in real time.
“If a vehicle can identify that its rider is not in control, it is possible to take various measures before a crash occurs. That kind of intelligent intervention can save lives, and is within reach,” he says.
At the same time, he emphasises that neither rules nor sensor technology alone can solve the problem.
“The big challenge with electric scooter riding is social norms and rider behaviour, and this does not disappear with regulations. Training is an important key to understanding how the vehicle should be handled and what you can, and cannot, do.
Rikard Fredriksson, Senior Advisor in Vehicle Safety at the Swedish Transport Administration and co-author of the study, agrees:
“Alcohol is still a major problem for road safety in Sweden. Alcohol is involved in about 20 per cent of all fatal road crashes. This study shows that the number of alcohol-related fatalities involving electric scooters is more than twice as high, at 44 per cent. We are committed to the development of technology to counteract electric scooter driving under the influence of alcohol. It is also important to always wear a helmet, and to use only a vehicle that cannot exceed legal speed,” he says.
The study, “Three modes, three profiles: Characterizing fatal crashes on e-scooters, e-bikes and conventional bicycles in Sweden”, has been published in the Journal of Safety Research. The authors are Rahul Rajendra Pai and Marco Dozza at Chalmers University of Technology, Sweden, as well as Rikard Fredriksson at the Swedish Transport Administration and Chalmers University of Technology.
NewsMakers
Move to quit: Exercise boosts smoking quit rates
Researchers found that people taking part in exercise programs were 15% more likely to achieve continuous abstinence and 21% more likely to report not smoking over a seven-day period, compared with control groups.
A pack-a-day smoker can spend around $14,000 a year on cigarettes, yet despite the financial and health costs, quitting remains one of the most difficult changes many people will ever attempt.
Now, new research from Adelaide University shows that exercise can help people quit smoking by reducing cigarette consumption, easing cravings and improving their chances of quitting.
Researchers found that people taking part in exercise programs were 15% more likely to achieve continuous abstinence and 21% more likely to report not smoking over a seven-day period, compared with control groups.
They also found that exercise could reduce cigarette consumption by two cigarettes per day, and that a single bout of exercise immediately reduced cigarette cravings for up to 30 minutes after exercise.
The systematic review and meta-analysis examined 59 randomised controlled trials involving more than 9000 participants, exploring the effects of both single bouts of exercise and long-term exercise programs on smoking cessation, cravings, withdrawal symptoms and mood.
Globally, tobacco smoking remains the leading preventable cause of premature morbidity and mortality, accounting for about 7 million deaths, including an estimated 1.6 million non-smokers who are exposed to second-hand smoke.
Around the world, e-cigarette use has now reached more than 100 million people.
The researchers say exercise should be viewed as an additional tool that can be used alongside established smoking cessation support.
Lead researcher, Dr Ben Singh said the findings provide smokers with a practical, low-cost tool that can support their quitting journey.
“Quitting smoking is one of the best things a person can do for their health, but it’s also one of the hardest,” Dr Singh said.
“Many smokers want to quit, but the current approaches don’t work for everyone. That’s why we need more strategies that people can incorporate into their daily lives at little or no cost.
“Something as simple as regular exercise can make a meaningful difference to people trying to quit, helping them manage cravings, smoke less and improve their chances of quitting.”
While smoking rates have reduced over the past two decades, demand for e-cigarettes and heated-tobacco products have risen, targeting the younger generation.
Today, 80% of the 1.3 billion tobacco users worldwide live in low- and middle-income countries, yet in contrast, vaping has risen across many OECD countries.
Senior researcher Adelaide University’s Professor Carol Maher said exercise could be used strategically to ward off tobacco cravings.
“Quitting smoking does not have to begin and end with willpower alone,” Prof Maher said.
“Cravings can be difficult to manage, but they often pass. Our review found that even a single bout of exercise can reduce cravings for up to 30 minutes, which may help people get through some of the hardest moments of a quit attempt.
“Exercise should not replace evidence-based quit supports such as counselling and smoking cessation medication, but it may be a practical, low-cost strategy that people can use alongside them.”
The researchers say the next step is to test how exercise can be built into real-world quit programs, including digital, community and clinical services, and to examine whether it can also support people trying to quit vaping, where evidence is currently lacking.
NewsMakers
Why taking a sick day depends on more than being sick
The study revealed a clear divide: workers in casual and fixed term jobs take only around one day of sick leave a year on average, compared with about four days for permanent employees.
As winter illness spreads and households face cost-of-living pressure, many Australians cannot treat a sick day as a simple health decision. They may be too sick to work – but their job is too insecure to stay home.
New research led by the University of Technology Sydney (UTS) shows the decision is heavily influenced by pay, job security and gender. The study, published in Applied Economics, examines how workers’ health and economic circumstances dictate how many sick days they actually take.
“Employers and policymakers often focus on reducing absence, but workers who attend while unwell may recover more slowly, spread infection to colleagues, and be less productive,” said lead researcher Dr Nancy Kong, a Senior Research Fellow at the UTS Centre for Health Economics Research & Evaluation.
Drawing on data from the Household, Income and Labour Dynamics in Australia (HILDA) survey from more than 15,000 Australians between 2005 and 2016, Dr Kong and her co-authors, Dr David Rowell from the University of Queensland and Professor Peter Zweifel from the University of Zurich, examined patterns of sick leave across the workforce.
“We focused on this period to avoid the COVID years, when major changes in public health rules, workplace practices and leave policies occurred at the same time, and could have blurred the relationship between job conditions and sick leave,” said Dr Kong.
The study revealed a clear divide: workers in casual and fixed term jobs take only around one day of sick leave a year on average, compared with about four days for permanent employees.
Even accounting for variables such as occupation, job satisfaction, household circumstances, living arrangements, marital status, education and place of residence, non-permanent workers still take around three fewer sick days each year.
“This does not necessarily mean casual and fixed-term workers are healthier,” said Dr Kong.
“A more likely explanation is that taking time off is riskier when work is insecure. Non-permanent workers may have less access to paid sick leave. They may also worry that saying no to work, even when ill, could affect future hours or their chances of keeping their job.”
“For a permanent employee, staying home with influenza might be inconvenient; but for a casual worker it may trigger financial stress.”
The study also found that economic insecurity plays a role, with workers living in areas with higher unemployment tending to take less sick leave.
For instance, when the local unemployment rate rises by five percentage points, sick leave drops. While this amounts to a fraction of a day per individual, across a standard team this adds up to significant forgone recovery time.
This pattern is consistent with a simple concern: when jobs feel harder to replace, workers may be less willing to take time off.
“They may worry that being absent could make them seem less reliable or increase the risk of losing work,” said Dr Kong.
The effect of wages proved more nuanced. Higher wages alone did not consistently dictate leave behaviour. However, among workers in poorer health, higher wages were strongly associated with taking more sick leave, suggesting higher income earners possess a financial buffer.
“Higher-paid workers generally have workplace support and leave entitlements that mean they are supported to take time off when they are unwell without fear of a potential financial penalty,” said Dr Kong.
The most consistent finding was a distinct gender gap. Across every analysis, men take fewer sick days than women, averaging about half a day less per year (a 23% difference), even when matching with similar health and job circumstances.
“This may reflect differences in health needs, caring responsibilities or how likely people are to seek medical care,” Dr Kong said.
“But it also points to workplace cultures and gender expectations about ‘toughness’, reliability and working through illness.”
Ultimately, the study highlights that sick leave rates are not simply a reflection of physical health. For employers, low sick leave rates should not be automatically viewed as a sign of success; they may also indicate a culture of fear.
“Workplace cultures should not reward people for attending when unwell or treat legitimate sick leave as a lack of commitment,” said Dr Kong.
“Reducing stigma is also particularly important in addressing the gender gap.”
Dr Kong said for policymakers, the study points to the importance of secure work, accessible paid leave and workplace practices that support people to recover when unwell.
This is particularly relevant during periods of increased cost-of-living pressure, workforce shortages and seasonal illness.
“A fair and effective sick leave system should support productivity while ensuring workers do not have to choose between protecting their health and protecting their income.”
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