Cognitive function is a predictor of the daily step count in subacute stroke patients with independent walking ability: A prospective cohort study

Abstract Background Older adults with diabetes take fewer steps per day than those without diabetes. The purpose of the present study was to investigate the association of daily step count with incident diabetes in community-dwelling 70-year-olds. Methods This prospective cohort study included N = 3055 community-dwelling 70-year-olds (52% women) who participated in a health examination in Umeå, Sweden during 2012–2017, and who were free from diabetes at baseline. Daily step count was measured for 1 week using Actigraph GT3X+ accelerometers. Cases of diabetes were collected from the Swedish National Patient Register. The dose-response association was evaluated graphically using a flexible parametric model, and hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regressions. Results During a mean follow-up of 2.6 years, diabetes was diagnosed in 81 participants. There was an inverse nonlinear dose-response association between daily step count and incident diabetes, with a steep decline in risk of diabetes from a higher daily step count until around 6000 steps/day. From there, the risk decreased at a slower rate until it leveled off at around 8000 steps/day. A threshold of 4500 steps/day was found to best distinguish participants with the lowest risk of diabetes, where those taking ≥ 4500 steps/day, had 59% lower risk of diabetes, compared to those taking fewer steps (HR, 0.41, 95% CI, 0.25–0.66). Adjusting for visceral adipose tissue (VAT) attenuated the association (HR, 0.64, 95% CI, 0.38–1.06), which was marginally altered after further adjusting for sedentary time, education and other cardiometabolic risk factors and diseases (HR, 0.58, 95% CI, 0.32–1.05). Conclusions A higher daily step count is associated with lower risk of incident diabetes in community-dwelling 70-year-olds. The greatest benefits occur at the lower end of the activity range, and much earlier than 10,000 steps/day. With the limitation of being an observational study, these findings suggest that promoting even a modest increase in daily step count may help to reduce the risk of diabetes in older adults. Because VAT appears to partly mediate the association, lifestyle interventions targeting diabetes should apart from promoting physical activity also aim to prevent and reduce central obesity.

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Are physical activity levels of health care professionals consistent with activity guidelines? A prospective cohort study in New Zealand

JRSM Cardiovascular Disease ◽

10.1177/2048004017749015 ◽

2018 ◽

Vol 7 ◽

pp. 204800401774901 ◽

Cited By ~ 2

Author(s):

Lydia Chan ◽

Harry McNaughton ◽

Mark Weatherall

Keyword(s):

Physical Activity ◽

Health Care ◽

Cohort Study ◽

New Zealand ◽

Prospective Cohort Study ◽

Health Care Professionals ◽

Prospective Cohort ◽

Daily Step ◽

Daily Step Count ◽

Steps Per Day

Objective We aimed to estimate the level of physical activity undertaken by health care professionals and the proportion that achieved a daily target of 10,000 steps. Design This was a prospective cohort study. Setting Participants were recruited in Wellington Regional Hospital, a tertiary hospital in New Zealand. Participants Neurology, Cardiology, and Endocrinology staff were invited to participate. Main outcome measures Pedometer-measured step counts were recorded over seven days and the proportion that achieved a daily target of 10,000 steps was calculated. Results We included 50 staff in the study. The mean daily step count was 10,620 (standard deviation = 3141) with a median daily step count of 10,606 (interquartile range = 7791–12,469). Sixty-five per cent of the staff achieved 10,000 steps per day. Conclusion This cohort was more active compared to other pedometer-based studies in health care professionals. The daily target of 10,000 steps per day was achieved at a higher proportion than reported in international studies and the general New Zealand.

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Fine or Gross Motor Index as a Simple Tool for Predicting Cognitive Impairment in Elderly People: Findings from The Irish Longitudinal Study on Ageing (TILDA)

Journal of Alzheimer s Disease ◽

10.3233/jad-210704 ◽

2021 ◽

pp. 1-8

Author(s):

Xiao Liu ◽

Ayiguli Abudukeremu ◽

Yuan Jiang ◽

Zhengyu Cao ◽

Maoxiong Wu ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Impairment ◽

Longitudinal Study ◽

Cognitive Function ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Simple Tool

Background: Several kinds of motor dysfunction can predict future cognitive impairment in elderly individuals. However, the ability of the fine motor index (FINEA) and gross motor index (GROSSA) to predict the risk of cognitive impairment has not been assessed. Objective: We investigated the associations between FINEA/GROSSA and cognitive impairment. Methods: The data of 4,745 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). We first assessed the correlation between the FINEA GROSSA and MMSE in a cross-sectional study. Then, we further investigated the predictive role of the incidence of cognitive impairment in a prospective cohort study. Results: We found that both FINEA and GROSSA were negatively correlated with MMSE in both the unadjusted (FINEA: B = –1.00, 95%confidence intervals (CI): –1.17, –0.83, t = –11.53, p < 0.001; GROSSA: B = –0.85, 95%CI: –0.94, –0.76, t = –18.29, p < 0.001) and adjusted (FINEA: B = –0.63, 95%CI: –0.79, –0.47, t = –7.77, p < 0.001; GROSSA: B = –0.57, 95%CI: –0.66, –0.48, t = –12.61, p < 0.001) analyses in a cross-sectional study. In a prospective cohort study, both high FINEA and high GROSSA were associated with an increased incidence of cognitive function impairment (FINEA: adjusted odds ratios (OR) = 2.35, 95%CI: 1.05, 5.23, p = 0.036; GROSSA adjusted OR = 3.00, 95%CI: 1.49, 6.03, p = 0.002) after 2 years of follow-up. Conclusion: Higher FINEA and GROSSA scores were both associated with an increased incidence of cognitive impairment. FINEA or GROSSA might be a simple tool for identifying patients with cognitive impairment.

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