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Independent and combined effects of cognitive and physical activity on incident MCI.

ABSTRACT: The objective of this study was to examine the independent and combined influences of late-life cognitive activity (CA) and physical activity (PA) on the risk of incident mild cognitive impairment (MCI).We used interval censored survival modeling to examine the risk of incident MCI (Clinical Dementia Rating [CDR] = 0.5) as a function of CA (high vs. low) and at least moderate intensity PA (any vs. none) among 864 cognitively normal (CDR = 0) older adults.During three annual follow-up waves, 72 participants developed MCI. Compared with low CA with no PA, significant reductions in risk for MCI were observed for high CA with any PA (hazards ratio (HR) = 0.20, 95% confidence interval (CI) 0.07-0.52) and low CA with any PA (HR = 0.52, 95% CI 0.29-0.93), but not for high CA without PA (HR = 0.94, 95% CI 0.45-1.95).These findings suggest that a combination of CA and PA may be most efficacious at reducing the risk for cognitive impairment.

SUBMITTER: Hughes TF

PROVIDER: S-EPMC4536189 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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Independent and combined effects of cognitive and physical activity on incident MCI.

Hughes Tiffany F TF Becker James T JT Lee Ching-Wen CW Chang Chung-Chou H CC Ganguli Mary M

Alzheimer's & dementia : the journal of the Alzheimer's Association 20150213 11

<h4>Introduction</h4>The objective of this study was to examine the independent and combined influences of late-life cognitive activity (CA) and physical activity (PA) on the risk of incident mild cognitive impairment (MCI).<h4>Methods</h4>We used interval censored survival modeling to examine the risk of incident MCI (Clinical Dementia Rating [CDR] = 0.5) as a function of CA (high vs. low) and at least moderate intensity PA (any vs. none) among 864 cognitively normal (CDR = 0) older adults.<h4> ...[more]

PMID: 25684687

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Project description:IntroductionPractice effects (PEs) on cognitive tests obscure decline, thereby delaying detection of mild cognitive impairment (MCI). Importantly, PEs may be present even when there are performance declines, if scores would have been even lower without prior test exposure. We assessed how accounting for PEs using a replacement-participants method impacts incident MCI diagnosis.MethodsOf 889 baseline cognitively normal (CN) Alzheimer's Disease Neuroimaging Initiative (ADNI) participants, 722 returned 1 year later (mean age = 74.9 ± 6.8 at baseline). The scores of test-naïve demographically matched "replacement" participants who took tests for the first time were compared to returnee scores at follow-up. PEs-calculated as the difference between returnee follow-up scores and replacement participants scores-were subtracted from follow-up scores of returnees. PE-adjusted cognitive scores were then used to determine if individuals were below the impairment threshold for MCI. Cerebrospinal fluid amyloid beta, phosphorylated tau, and total tau were used for criterion validation. In addition, based on screening and recruitment numbers from a clinical trial of amyloid-positive individuals, we estimated the effect of earlier detection of MCI by accounting for cognitive PEs on a hypothetical clinical trial in which the key outcome was progression to MCI.ResultsIn the ADNI sample, PE-adjusted scores increased MCI incidence by 19% (P < .001), increased proportion of amyloid-positive MCI cases (+12%), and reduced proportion of amyloid-positive CNs (-5%; P's < .04). Additional calculations showed that the earlier detection and increased MCI incidence would also substantially reduce necessary sample size and study duration for a clinical trial of progression to MCI. Cost savings were estimated at ≈$5.41 million.DiscussionDetecting MCI as early as possible is of obvious importance. Accounting for cognitive PEs with the replacement-participants method leads to earlier detection of MCI, improved diagnostic accuracy, and can lead to multi-million-dollar cost reductions for clinical trials.

Dataset Information

Independent and combined effects of cognitive and physical activity on incident MCI.

Publications

Independent and combined effects of cognitive and physical activity on incident MCI.

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