Dataset Information

Longitudinal associations between physical and cognitive performance among community-dwelling older adults.

ABSTRACT: To assess the directionality of the association between physical and cognitive decline in later life, we compared patterns of decline in performance across groups defined by baseline presence of cognitive and/or physical impairment [none (n = 217); physical only (n = 169); cognitive only (n = 158), or both (n = 220)] in a large sample of participants in a cognitive aging study at the Knight Alzheimer's Disease Research Center at Washington University in St. Louis who were followed for up to 8 years (3,079 observations). Rates of decline reached 20% for physical performance and varied across cognitive tests (global, memory, speed, executive function, and visuospatial skills). We found that physical decline was better predicted by baseline cognitive impairment (slope = -1.22, p<0.001), with baseline physical impairment not contributing to further decline in physical performance (slope = -0.25, p = 0.294). In turn, baseline physical impairment was only marginally associated with rate of cognitive decline across various cognitive domains. The cognitive-functional association is likely to operate in the direction of cognitive impairment to physical decline although physical impairment may also play a role in cognitive decline/dementia. Interventions to prevent further functional decline and development of disability and complete dependence may benefit if targeted to individuals with cognitive impairment who are at increased risk.

SUBMITTER: Tolea MI

PROVIDER: S-EPMC4395358 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Longitudinal associations between physical and cognitive performance among community-dwelling older adults.

Tolea Magdalena I MI Morris John C JC Galvin James E JE

PloS one 20150413 4

To assess the directionality of the association between physical and cognitive decline in later life, we compared patterns of decline in performance across groups defined by baseline presence of cognitive and/or physical impairment [none (n = 217); physical only (n = 169); cognitive only (n = 158), or both (n = 220)] in a large sample of participants in a cognitive aging study at the Knight Alzheimer's Disease Research Center at Washington University in St. Louis who were followed for up to 8 ye ...[more]

PMID: 25875165

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Project description:Background: Whether multiple nutritional deficiencies have a synergic effect on mobility loss remains unknown. This study aims to evaluate associations between multi-nutritional deficits and physical performance evolution among community-dwelling older adults. Methods: We included 386 participants from the Multidomain Alzheimer Preventive Trial (MAPT) (75.6 ± 4.5 years) not receiving omega-3 polyunsaturated fatty acid (PUFA) supplementation and who had available data on nutritional deficits. Baseline nutritional deficits were defined as plasma 25 hydroxyvitamin D <20 ng/ml, plasma homocysteine >14 μmol/L, or erythrocyte omega-3 PUFA index ≤ 4.87% (lower quartile). The Short Physical Performance Battery (SPPB), gait speed, and chair rise time were used to assess physical performance at baseline and after 6, 12, 24, 36, 48, and 60 months. We explored if nutrition-physical performance associations varied according to the presence of low-grade inflammation (LGI) and brain imaging indicators. Results: Within-group comparisons showed that physical function (decreased SPPB and gait speed, increased chair rise time) worsened over time, particularly in participants with ≥2 nutritional deficits; however, no between-group differences were observed when individuals without deficit and those with either 1 or ≥2 deficits were compared. Our exploratory analysis on nutritional deficit-LGI interactions showed that, among people with ≥2 deficits, chair rise time was increased over time in participants with LGI (adjusted mean difference: 3.47; 95% CI: 1.03, 5.91; p = 0.017), compared with individuals with no LGI. Conclusions: Accumulated deficits on vitamin D, homocysteine, and omega-3 PUFA were not associated with physical performance evolution in older adults, but they determined declined chair rise performance in subjects with low-grade inflammation. Clinical Trial Registration: [https://clinicaltrials.gov/ct2/show/NCT00672685], identifier [NCT00672685].

Project description:Background:Regular exercise training stimulates physiological adaptations to improve physical performance, reduce chronic disease risk, and slow age-related cognitive decline. Since the physiological mechanisms responsible for aging-associated cognitive decline are not yet fully understood, and training-induced physiological adaptations responsible for performance measure improvements are specific to the type (aerobic vs. strength) and intensity of training, studies are needed to assess the relationships between physical performance measures and cognitive performance in older adults. These results could be used to guide exercise prescriptions with the goal of improving age-related cognitive performance. The purpose of this study was to investigate the relationship between physical performance measures and cognitive performance in a population of community dwelling, ethnically diverse older adults. Methods:The cognitive performance of ninety independent, community dwelling participants (69 female, 21 male), aged 75 ± 9.5 years (mean ± SD) was measured with the Modified Mini-Mental State Test (3MS), Trailmaking Tests A and B (TMT A & B), and the Animal Naming test. Sociodemographic (age, sex, ethnicity, medication use, years of education) and anthropometric data were collected, physical activity was assessed with the Physical Activity Scale for the Elderly (PASE), peak hand-grip strength, distance walked in the 6MWT, and heart rate pre-, during, and up to 5 min. post- 6MWT were measured. Forward stepwise multiple regression analyses were performed with each cognitive measure as a dependent variable. Results and Discussion:Controlling for sociodemographic covariates, peak heart rate during the 6MWT (6MWT HRPEAK) was positively correlated with performance in the 3MS (p < 0.017), and TMT A (p < 0.001) and B (p < 0.029). Controlling for sociodemographic covariates, PASE was positively (p = 0.001), and ?-blocker use negatively (p = 0.035), correlated with performance on the Animal Naming test. Also, controlling for sociodemographic covariates, PASE was positively correlated with performance on the TMT A (p = 0.017). Here we show that higher peak heart rate during the 6MWT is positively correlated with cognitive performance in a population of community dwelling, ethnically diverse older adults (ages 60-95 years). Conclusion:Higher peak heart rate during the 6MWT was found to be independently and positively correlated with cognitive function in community-dwelling older adults. Although additional work is needed, these results are promising and suggest that physicians, exercise professionals, and/or fitness/fall prevention programs may use peak heart rate during the 6MWT to easily monitor exercise intensity to support cognitive health.

Project description:BackgroundPhysical performance declines and executive dysfunctions are predictors of dementia. However, their associations are not well understood in Asian older adults without dementia (cognitively normal [CN] and mild cognitive impairment [MCI]), especially in a single study.ObjectiveExamine the associations between physical performance measures with executive function (EF)-based and non-EF-based neurocognitive tests and whether preclinical dementia cognitive status i.e., CN and MCI, moderated these associations.MethodsWe examined cross-sectional cohort of 716 community-dwelling older adults without dementia (CN = 562 and MCI = 154) using multivariable linear regression models. We associated three simple physical performance measures, namely timed-up-and-go (TUG), fast gait speed (FGS), and 30-s chair stand test (30 s-CST), with a comprehensive neurocognitive test battery measuring EF and non-EF cognitive functions. Moderating effects of cognitive status on the associations were examined. In all models, we controlled for pertinent covariates, including age, education, medical and psychiatric status.ResultsUpon controlling for covariates, TUG was most strongly and positively associated with multiple EF-based neurocognitive tests, followed by FGS, with 30 s-CST having the weakest associations. For all physical performance measures, no significant associations with non-EF-based neurocognitive tests were detected. Cognitive status significantly moderated the associations between all physical measures and several neurocognitive tests, with stronger associations in the MCI than CN.ConclusionCompared to FGS and 30 s-CST, TUG had the most robust associations with multiple EF-based cognitive functions. Given their differential associations with global and detailed neurocognitive tests and significant moderating effects of cognitive status, findings highlight a need to carefully consider the choices of simple physical performance tests when using these tests with a heterogenous group of community-dwelling older adults without dementia.

Project description:We investigated the associations between hearing aids (HA) and the maintenance of cognitive function among community-dwelling older adults with moderate hearing loss. A total of 407 participants aged 60 years or older with moderate hearing loss were recruited from the National Institute for Longevity Sciences, Longitudinal Study for Aging (NILS-LSA). Moderate hearing loss was defined as a pure-tone average of 40-69 dB at 500, 1000, 2000, and 4000 Hz of the better ear, according to the definition proposed by the Japan Audiological Society. Cognitive function was evaluated using the four subtests of the Japanese version of the Wechsler Adult Intelligence Scale-Revised Short Forms (WAIS-R-SF): Information, Similarities, Picture completion, and Digit Symbol Substitution (DSST). A longitudinal analysis of 1192 observations with a mean follow-up period of 4.5 ± 3.9 years was performed. The HA use rate at any time during the follow-up period was 31.4%, and HA users were significantly younger (t-test, p = 0.001), had worse hearing (p < .0001) and higher education (p = 0.001), participated more frequently in the survey (p < .0001), and were less depressed (χ2 test, p = 0.003) than the older adults not using HA. General linear mixed models consisted of the fixed effects of HA use, follow-up time, and an HA use × time interaction term adjusted for age and pure-tone average thresholds at baseline, sex, education, and other possible confounders. HA use showed significant main effects on the scores for Picture completion and DSST after adjustment; scores were better in the HA use group than in the no HA use group. The HA use × time interaction was significant for the Information score (p = 0.040). The model-predicted 12-year slope with centralizing age indicated that the no HA use group showed greater decline over time on Information scores than did HA use group. The slopes did not differ between HA users and non-users for the Similarities, Picture completion and DSST. In conclusion, HA use may have a protective effect on the decline in general knowledge in older adults with moderate hearing loss.

Project description:BACKGROUND:Although many governments are promoting workforce participation (WP) by older people, evidence of WP's effects on active aging is inadequate. We examined whether there is a gender-specific beneficial effect of lifetime WP from adulthood though old age against self-reported cognitive decline (CD) among community-dwelling older adults. METHODS:We used data from a community-based prospective study of 2,422 men and 2,852 women aged ?65 with neither poor cognition nor disability in basic activities of daily living at baseline. Self-reported CD was measured using the Cognitive Performance Scale. Lifetime WP evaluated the presence or absence of WP at baseline, the longest-held occupation, and lifetime working years (total working years throughout lifetime). Generalized estimating equations of the multivariable Poisson regression model were applied to evaluate a cumulative incidence ratio (CIR) for self-reported CD and a 95% confidence interval (CI), controlled for age, education, self-perceived economic status, chronic medical conditions, smoking history, physical activity, depression, and instrumental activities of daily living. To examine any gender-specific association, stratified analyses by gender were performed. RESULTS:The 33-month cumulative incidence of self-reported CD was 15.7% in men and 14.4% in women. After covariate adjustments and mutual adjustment for three items of lifetime WP, men who had their longest held job in a white-collar occupation reported significantly decreased self-reported CD compared to men engaged in blue-collar jobs (CIR 0.72; 95% CI, 0.57-0.91), and women had a significant dose-response relationship between longer lifetime working years and less decline in subjective cognitive functioning (P for trend <0.029). Among both genders, WP at baseline was not associated with self-reported CD. CONCLUSIONS:Our results suggest that lifetime WP, especially lifetime principal occupation in men and lifetime working years in women, may play a more prominent role in preventing self-reported CD than later-life WP.

Project description:BackgroundOlder adults are recommended to sleep 7-8 h/day. Time in bed (TIB) differs from sleep duration and includes also the time of lying in bed without sleeping. Long TIB (≥9 h) are associated with self-reported sedentary behavior, but the association between objectively measured physical activity, sedentary behavior and TIB is unknown.MethodsThis study was based on cross-sectional analysis of the Healthy Ageing Network of Competence (HANC Study). Physical activity and sedentary behaviour were measured by a tri-axial accelerometer (ActiGraph) placed on the dominant wrist for 7 days. Sedentary behavior was classified as < 2303 counts per minute (cpm) in vector magnitude and physical activity intensities were categorized, as 2303-4999 and ≥ 5000 cpm in vector magnitude. TIB was recorded in self-reported diaries. Participants were categorized as UTIB (usually having TIB 7-9 h/night: ≥80% of measurement days), STIB (sometimes having TIB 7-9 h/night: 20-79% of measurement days), and RTIB (rarely having TIB 7-9 h/night: < 20% of measurement days). Multinominal regression models were used to calculate the relative risk ratios (RRR) of being RTIB and STIB by daily levels of physical activity and SB, with UTIB as the reference group. The models were adjusted for age, sex, average daily nap length and physical function.ResultsThree hundred and fourty-one older adults (median age 81 (IQR 5), 62% women) were included with median TIB of 8 h 21 min (1 h 10 min)/day, physical activity level of 2054 (864) CPM with 64 (15) % of waking hours in sedentary behavior. Those with average CPM within the highest tertile had a lower RRR (0.33 (0.15-0.71), p = 0.005) for being RTIB compared to those within the lowest tertile of average CPM. Accumulating physical activity in intensities 2303-4999 and ≥ 5000 cpm/day did not affect the RRR of being RTIB. RRR of being RTIB among highly sedentary participants (≥10 h/day of sedentary behavior) more than tripled compared to those who were less sedentary (3.21 (1.50-6.88), p = 0.003).ConclusionsFor older adults, being physically active and less sedentary was associated with being in bed for 7-9 h/night for most nights (≥80%). Future longitudinal studies are warranted to explore the causal relationship sbetween physical activity and sleep duration.

Dataset Information

Longitudinal associations between physical and cognitive performance among community-dwelling older adults.

Publications

Longitudinal associations between physical and cognitive performance among community-dwelling older adults.

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