Background: Cerebral blood flow (CBF) is critical for brain metabolism and overall function. Age-related changes in CBF have been associated with cognitive deficits and increased risk of neurocognitive disorders and vascular events such as stroke. Exercise is considered among the protective factors for age-related brain and cognitive impairment, but how different lifestyle characteristics, such as low or moderate-to-vigorous physical activity or frequency of everyday activities, relate to cross-sectional and longitudinal measures of CBF has not been established. Objective: With the main aim of identifying potential targets for interventions, our objective was to examine associations between cortical and subcortical CBF and frequency of diverse everyday activities in healthy community-dwelling adults aged 65-89 years, and assess to which degree activity level at baseline is associated with longitudinal changes in CBF across a one-to-two years interval. Method: One hundred nineteen (N = 119) adults underwent brain magnetic resonance imaging (MRI), neurocognitive, physical, and activity assessment at baseline. CBF was obtained using pseudo-continuous arterial spin labelling (ASL) MRI. Frequency of everyday activities were measured using Frenchay Activities index, while minutes of low and moderate-to-vigorous intensity physical activity were measured using a StepWatch Activity Monitor. Eighty-six participants completed a follow-up ASL MRI, on average 506 (SD = 113) days after the baseline scan. Results: Bayesian multilevel modelling revealed positive associations between baseline cortical and subcortical CBF and various everyday activities. Higher baseline accumbens, putamen and pallidum CBF was associated with more time spent on low intensity (> 0 steps/minute to < 100 steps/minute) physical activity, higher accumbens and caudate CBF with more moderate to vigorous intensity (≥ 100 steps/minute) physical activity, higher cerebral cortical CBF with more participation in social activity, higher cortical and thalamic CBF with more reading, and higher baseline pallidum CBF with more actively pursuing hobbies. We did not find evidence for an association between baseline activity level and longitudinal changes in CBF. Conclusion: The identified associations between everyday activity measures and CBF provide new knowledge on malleable lifestyle factors that may indicate or contribute to healthy brain aging. In addition to the relevance for prioritizing targets for public health guidelines, our findings contribute to disclose parts of the intricate connection between brain metabolism and everyday activities in aging.

The authors have declared no competing interest.

The study was funded by the Research Council of Norway [249795, 248238, 276082], the South-Eastern Norway Regional Health Authority [2014097, 2015044, 2015073, 2018037, 2018076, 2019107, 2020086], the Norwegian ExtraFoundation for Health and Rehabilitation [2015/ FO5146], the European Research Council under the European Union's Horizon 2020 research and Innovation program [ERC StG Grant 802998], Sunnaas Rehabilitation Hospital HT, and the Department of Psychology, University of Oslo.

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