1 Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada.
2 Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada.
3 Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
4 Department of Health, Kinesiology, and Applied Physiology, Faculty of Arts and Science, Concordia University, Montreal, Québec, Canada.
5 Department of Psychology, Northeastern University, Boston, Massachusetts, USA.
6 Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
7 Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA.
8 Iowa Neuroscience Institute, University of Iowa, Iowa City, Iowa, USA.

Introduction: The 24-hour activity cycle (24-HAC) includes physical activity (PA), sedentary behavior (SB), and sleep. The 24-HAC composition and brain health relationship in adults with mild cognitive impairment (MCI) remains underexplored. We examined associations between 24-HAC composition and gray matter (GM) volume.

Methods: Cross-sectional study in 110 adults with MCI. Actigraphy assessed 24-HAC behaviors. FreeSurfer quantified GM. Compositional linear regressions and isotemporal substitution determined 24-HAC composition and GM volume associations.

Results: Higher moderate-to-vigorous physical activity (MVPA) relative to remaining behaviors was associated with greater right inferior temporal gyrus volume (ß = 0.30, false-discovery rate (FDR)-corrected-p = 0.030). Higher SB relative to remaining behaviors was associated with lower volume in the same region (ß = -0.45, FDR-corrected-p = 0.015). Reallocating 30 min from SB to MVPA predicted 2.1% greater (ß = 0.06, p < 0.001) and from MVPA to SB predicted 2.8% lower volume (ß = -0.08, p < 0.001).

Discussion: Increasing MVPA at the expense of SB may protect GM in regions prone to Alzheimer's disease-related atrophy.

Trial registrations: ClinicalTrials.gov, NCT02926157, NCT02737878, and NCT02669394.

Highlights: The 24-hour behaviors are associated to inferior temporal volume in older adults with mild cognitive impairment (MCI). More moderate-to-vigorous physical activity (MVPA) is linked with greater inferior temporal volume in older adults with MCI. Allocation from sedentary time to MVPA predicts greater inferior temporal volume.