Longitudinal changes in physical function and physical activity in older adults

AbstractBackgroundphysical function (PF) and physical activity (PA) both decline as adults age and have been linked to negative outcomes, including dementia, depression and cardiovascular diseases. Although declines in each are associated with numerous negative outcomes, the longitudinal relationship between these two measures is unclear.Objectiveto examine the dynamic, bidirectional associations between declines in PF and PA.Designprospective cohort.Settingthe Monongahela–Youghiogheny Healthy Aging Team (MYHAT) study.Subjectsabout 1,404 men and women, 76.96 ± 7.2 years, 62.4% female and 95.2% white.Methodsover nine annual assessment cycles, PF was evaluated via the timed Up-and-Go task and PA via a self-reported questionnaire. Piecewise latent growth models examined bidirectional associations between PA and PF to determine whether the initial values (intercept) or early slope (cycles 1–5) (in either PF or PA) predicted later slope (cycles 5–9) (in either PF or PA).Resultsinitial PF significantly predicted early (standardised β= −0.10, P < 0.001) and later (standardised β= −0.09, P = 0.01) PA slopes. Initial PA significantly predicted later (standardised β = −0.09, P = 0.04) but not early PF slope. Associations were independent of baseline memory test scores, baseline cognitive status, later cognitive status and age. Early physical function slope neither predicts later PA slope nor did early PA slope predict later PF slope (both P values >0.10).Conclusionsthe relationship between PF and PA is bidirectional, with PF more consistently predicting declines of PA, both in the short- and long-term. Intervening on PF impairments may improve PA engagement, which could in turn promote PF and translate to beneficial effects on cognitive function, cardiovascular health and mood.

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Relation between cognitive disorders and type of physical activity: Results of the FréLE cohort

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.883 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C Dupré ◽

N Barth ◽

A El Moutawakkil ◽

F Béland ◽

F Roche ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Decline ◽

Proportional Hazards ◽

Cognitive Disorders ◽

The Elderly ◽

Cognitive Status ◽

Global Test ◽

Professional Activities ◽

Beneficial Effects ◽

The Impact

Abstract Background Few previous cohorts have studied the different type of physical activities and the degree of cognitive decline. The objective of this work was to analyze the leisure, domestic and professional activities with mild and moderate cognitive disorders in older people living in community. Methods The study used data from the longitudinal and observational study, FrèLE (FRagility: Longitudinal Study of Expressions). The collected data included: socio-demographic variables, lifestyle, and health status (frailty, comorbidities, cognitive status, depression). Cognitive decline was assessed by using: MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment). MoCA was used with two cut-offs (26 and 17) so as to define mild and moderate cognitive disorders Physical activity was assessed by the PASE (Physical Activity Scale for the Elderly), structured in three sections: leisure, domestic and professional activities. Spline and proportional hazards regression models (Cox) were used to estimate the risk of cognitive disorders. Results At baseline, 1623 participants were included and the prevalence of cognitive disorders was 6.9% (MMSE) and 7.2% (MoCA), mild cognitive disorders was 71.3%. The mean age was 77 years, and 52% of the participants were women. After a 2 years long follow-up, we found 6.9% (MMSE) and 6% (MoCA) cognitive disorders on participants. Analyses showed that domestic activities were associated to cognitive decline (HR = 0.52 [0.28-0.94] for MMSE and HR = 0.48 [0.28-0.80] for MoCA). No association were found with leisure and professional activities, and no spline were significant with mild cognitive disorders. Conclusions Analysis showed a relationship between cognitive disorders and type of physical activity, thanks to the use of specific questionnaire of elderly and two global test of cognition. These findings will contribute to the debate on the beneficial effects of physical activity on cognition. Key messages This work allowed to compare two test of cognition and their link with physical activity. It contributes to the debate on the beneficial effects of physical activity on cognition. The work allowed us to see the effect of the different types of physical activity and the impact of the statistical method on the results.

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Observed Physical Function Is Associated With Better Cognition Among Elderly Adults: The Adventist Health Study-2

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317520960868 ◽

2020 ◽

Vol 35 ◽

pp. 153331752096086 ◽

Cited By ~ 1

Author(s):

Nicole M. Gatto ◽

Jennifer Garcia-Cano ◽

Crissy Irani ◽

Tiantian Liu ◽

Cameron Arakaki ◽

...

Keyword(s):

Physical Activity ◽

Physical Function ◽

Dietary Patterns ◽

Processing Speed ◽

Performance Test ◽

Vigorous Physical Activity ◽

Health Study ◽

Elderly Adults ◽

Timed Up And Go ◽

Speed Factor

Lifestyle factors may individually protect against the development of mild cognitive impairment. We investigate the relationships between both self-reported physical activity and measured physical function with cognition in a population of elderly adults, more than half of whom follow vegetarian dietary patterns. Otherwise healthy adults (n = 127, mean age 74.9 ± 7.9 years, 61.3% current vegetarians) were assessed using a comprehensive neuropsychological battery. A principal components analysis derived processing speed, executive function, and memory/language factors. Participants reported current levels of vigorous physical activity on questionnaires, and physical function and mobility were measured with the Physical Performance Test (PPT) and Timed Up and Go (TUG) Test. Generalized linear models estimated β coefficients for cross-sectional associations between cognitive factors and indicators of physical abilities and self-reported physical activity. Better physical function indicated by PPT was associated with higher scores on the processing speed factor (β = 0.21 SDs for each 4.4-point increase in PPT score; p = 0.02). Faster TUG times were also associated with higher processing speed factor scores (β = 0.21 SDs increase for each 2.8 second less TUG time; p = 0.02). Self-reported levels of vigorous physical activity were not associated with any area of cognitive function; the association between PPT, TUG and processing speed was independent of physical activity. Associations between PPT and TUG and processing speed were stronger among participants who followed vegetarian dietary patterns. Better physical function may have an effect on cognition in a context of healthy lifestyles.

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Does Gender Influence Physical Activity and Psychosocial Factors in Older Exercisers? A Pilot Study

Women in Sport and Physical Activity Journal ◽

10.1123/wspaj.21.1.61 ◽

2012 ◽

Vol 21 (1) ◽

pp. 61-70

Author(s):

Elizabeth Orsega-Smith ◽

Nancy Getchell ◽

Lindsay Palkovitz

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Function ◽

Older Women ◽

Satisfaction With Life ◽

Activity Levels ◽

Psychosocial Characteristics ◽

Timed Up And Go ◽

Physically Active ◽

Gender Influence

How does gender influence physical and psychosocial characteristics in physically active older adults? Much of the previous research on physical function in older women focuses on either the frailty of older women or on physical function irrespective of gender. These studies leave unknown the specific influence of regular physical activity on older women.Furthermore, few studies have examined the relationship between physical activity and psychosocial characteristics in older exercisers. We wanted to investigate whether differences exist between groups of older female and male adults who maintain a physically active lifestyle. Twenty-three female and 14 male physically active older adults performed physical function tests (i.e., chair stands, timed up-and-go, 6-minute walk) and filled out questionnaires related to psychosocial measures (i.e., social support, self-esteem, satisfaction with life). There were no differences in any physical function between the groups, and only one psychosocial measure (guidance) statistically differed (F (1, 31) = 4.14, p = .044). These results suggest that physically active women may not necessarily follow the trajectory towards frailty. More research needs to be done with a greater range of ages and physical activity levels.

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Physical activity profiles in Parkinson’s disease

BMC Neurology ◽

10.1186/s12883-021-02101-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Philip von Rosen ◽

Maria Hagströmer ◽

Erika Franzén ◽

Breiffni Leavy

Keyword(s):

Physical Activity ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Physical Function ◽

Vigorous Physical Activity ◽

Functional Mobility ◽

Clinical Test ◽

Accelerometer Data ◽

Balance Performance ◽

Timed Up And Go

Abstract Background Identifying physical activity (PA) profiles of people with Parkinson’s Disease (PD) could provide clinically meaningful knowledge concerning how to tailor PA interventions. Our objectives were therefore to i) identify distinct PA profiles in people with PD based on accelerometer data, ii) explore differences between the profiles regarding personal characteristics and physical function. Methods Accelerometer data from 301 participants (43% women, mean age: 71 years) was analysed using latent profile analyses of 15 derived PA variables. Physical function measurements included balance performance, comfortable gait speed and single and dual-task functional mobility. Results Three distinct profiles were identified; “Sedentary” (N = 68), “Light Movers” (N = 115), “Steady Movers” (N = 118). “Sedentary” included people with PD with high absolute and relative time spent in Sedentary behaviour (SB), little time light intensity physical activity (LIPA) and negligible moderate-to-vigorous physical activity (MVPA). “Light Movers” were people with PD with values close to the mean for all activity variables. “Steady Movers” spent less time in SB during midday, and more time in LIPA and MVPA throughout the day, compared to the other profiles. “Sedentary” people had poorer balance (P = 0.006), poorer functional mobility (P = 0.027) and were more likely to have fallen previously (P = 0.027), compared to “Light Movers. The Timed Up and Go test, an easily performed clinical test of functional mobility, was the only test that could distinguish between all three profiles. Conclusion Distinct PA profiles, with clear differences in how the time awake is spent exist among people with mild-moderate PD.

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Participant Variation by Delivery Site Type in an Evidence-Based Physical Activity Program

Journal of Aging and Physical Activity ◽

10.1123/japa.2013-0252 ◽

2015 ◽

Vol 23 (3) ◽

pp. 401-408 ◽

Cited By ~ 7

Author(s):

Marlana J. Kohn ◽

Basia Belza ◽

Miruna Petrescu-Prahova ◽

Christina E. Miyawaki ◽

Katherine H. Hohman

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Function ◽

Demographic Variables ◽

Evidence Based ◽

Test Results ◽

Timed Up And Go ◽

Chair Stand ◽

Activity Program ◽

Function Test

This study examined participant demographic and physical function characteristics from EnhanceFitness, an evidence-based physical activity program for older adults. The sample consisted of 19,964 older adults. Participant data included self-reported health and demographic variables, and results for three physical function tests: chair stand, arm curls, and timed up-and-go. Linear regression models compared physical function test results among eight program site types. Participants were, on average, 72 years old, predominantly female, and reported having one chronic condition. Residential site participants’ physical function test results were significantly poorer on chair stand and timed up-and-go measures at baseline, and timed up-and-go at a four-month follow-up compared with the reference group (senior centers) after controlling for demographic variables and site clustering. Evidence-based health-promotion programs offered in community settings should assess demographic, health, and physical function characteristics to best serve participants’ specific needs, and offer classes tailored to participant function and ability while maintaining program fidelity.

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Duration or Timing? What is the Optimal Core for Older Adults to Engage in Moderate-to-vigorous Physical Activity to Prevent Disability?

10.21203/rs.3.rs-41437/v1 ◽

2020 ◽

Author(s):

Ting-Fu Lai ◽

Yung Liao ◽

Chien-Yu Lin ◽

Wan-Chi Huang ◽

Ming-Chun Hsueh ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Function ◽

Gait Speed ◽

Handgrip Strength ◽

Vigorous Physical Activity ◽

Total Duration ◽

Functional Mobility ◽

Linear Regression Models ◽

Timed Up And Go

Abstract Background The positive association between the total duration of physical activity and performances of physical function may vary at different times of the day as circadian rhythm regulates individuals in response to external stimulations. We aimed to examine the association of timing-specific and overall moderate-to-vigorous physical activity (MVPA) with performances of physical function in older adults. Methods A cross-sectional analysis was conducted among 118 older adults (mean age = 70.0 ± 5.0 years). We assessed and identified timing-specific (morning: 06:01-12:00; afternoon: 12:01-18:00; evening: 18:01-24:00) and overall MVPA using a triaxial accelerometer. Different measures of physical function were evaluated including handgrip strength (by grip dynamometer), gait speed (five-meter walk test), basic functional mobility (timed up and go test), and lower limb strength (five times sit-to-stand test). Multivariate linear regression models adjusting for covariates were used to investigate the associations. Results Participants spent 0.4 hours in MVPA per day on average, half the time spent during the morning (47.7%), followed by during the afternoon (29.9%) and evening (21.6%). The time spent on overall MVPA was generally associated with better physical function performances. There was statistical evidence for the percentages of MVPA engagement during the morning ( B = 0.214, 95% confidence interval [CI] 0.001 to 0.428) and afternoon ( B = -0.273, 95% CI -0.518 to -0.027) associated with basic functional mobility but with contrary directions; the percentage of MVPA engagement during the evening was associated with less time spent in gait speed performance ( B = -0.237, 95% CI -0.468 to -0.006). Conclusions Our findings inform implications that the overall MVPA engagement was more important than timing-specific MVPA to older adults’ physical function performances. Strategies for accumulating time of MVPA is more practical and effective than encouraging to engage MVPA in specific timing for the enhancement of functional ability and therefore prevent disability among older adults.

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Relationship between early physical activity after total knee arthroplasty and postoperative physical function: are these related?

Knee Surgery and Related Research ◽

10.1186/s43019-021-00118-y ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Daisuke Takamura ◽

Kentaro Iwata ◽

Tatsuya Sueyoshi ◽

Tadashi Yasuda ◽

Hideki Moriyama

Keyword(s):

Physical Activity ◽

Total Knee Arthroplasty ◽

Linear Regression ◽

Multiple Linear Regression ◽

Physical Function ◽

Knee Arthroplasty ◽

Postoperative Period ◽

Early Postoperative Period ◽

Timed Up And Go ◽

Total Knee

Abstract Background Physical activity is associated with physical function; however, the relationship between early physical activity after total knee arthroplasty (TKA) and postoperative physical function remains unclear. The purpose of this study was to evaluate the association of early physical activity after TKA with postoperative physical function. Methods Timed Up and Go test (TUG) of 47 patients was assessed preoperatively and at 10 days, 3 months, and 6 months postoperatively. Physical activity from the second to the ninth day after TKA was measured with accelerometer, and the correlation with pre- and postoperative physical function was evaluated . A multiple linear regression was used to predict TUG at 6 months after TKA. Results Postoperative physical activity correlated with preoperative TUG (ρ = −0.485, p < 0.001), TUG at 10 days (ρ = −0.675, p < 0.001), 3 months (ρ = −0.441, p < 0.01), and 6 months (ρ = −0.368, p < 0.05) after surgery. Multiple linear regression indicated that only the preoperative TUG was associated with TUG at 6 months. Postoperative physical activity was not an independent factor predicting TUG at 6 months after TKA. Conclusion Our study demonstrated that patients with better physical function have higher physical activity in the early postoperative period, whereas it does not affect physical function at 6 months after TKA. In the early postoperative period, increasing physical activity may not always be necessary to improve postoperative physical function. We also confirmed that preoperative physical function affects postoperative physical function. These findings may be beneficial in improving rehabilitation programs in the early postoperative period.

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Effects of adjuvant 5FU/oxaliplatin chemotherapy in individuals treated for colon cancer on cognitive and mobility function.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.750 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 750-750

Author(s):

Howard John Lim ◽

Negin Niksirat ◽

Stanley Hung ◽

Sarah Neil-Sztramko ◽

Teresa Liu-Ambrose ◽

...

Keyword(s):

Physical Activity ◽

Pilot Study ◽

Physical Function ◽

Leisure Time Physical Activity ◽

Verbal Learning ◽

Functional Mobility ◽

Activity Levels ◽

Mobility Impairment ◽

Timed Up And Go ◽

Small Pilot Study

750 Background: Cognitive impairment has been reported for patients receiving chemotherapy; however, the data is limited with respect to 5FU/oxaliplatin based therapy in colorectal cancer patients. We conducted a pilot study to determine if there was cognitive or mobility impairment in patients receiving adjuvant 5Fu/oxaliplatin chemotherapy. Methods: At baseline, end of chemotherapy and 6 months post chemotherapy, participant completed a neuropsychological test battery, which included the Stroop, Hopkins Verbal Learning Test-Revised (HVLT-R), and Trail Making A & B (TMT A&B), a 6-minute walk test (6MWT), a measure of physical function, and a functional mobility testing battery, which included timed up and go (TUG) and gait speed. Demographic information and self-reported physical activity, using the International Physical Activity Questionnaire (IPAQ), were also collected at these time points. For the analysis of neuropsychological and mobility test scores, the paired t-test was used to test for the differences and assess the change in the mean scores from the baseline, 6-months and 12 months. Results: 13 patients were enrolled, 10 have completed the 12 month evaluation. No significant changes were noted in the HVLT-R, Stroop, and TMT-A and -B mean scores after completion of chemotherapy compared to baseline. Compared to baseline, no significant changes were observed for 6MWT, TUG, GS, or leisure-time physical activity after completion of chemotherapy. Conclusions: In this small pilot study, there were no significant changes in chemotherapy-associated cognitive, physical function, or functional mobility noted from baseline to the end of chemotherapy. In addition, physical activity levels and average time spent sitting did not change significantly.

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Moderate-to-vigorous physical activity duration is more important than timing for physical function in older adults

Scientific Reports ◽

10.1038/s41598-020-78072-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Ting-Fu Lai ◽

Yung Liao ◽

Chien-Yu Lin ◽

Wan-Chi Huang ◽

Ming-Chun Hsueh ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Function ◽

Gait Speed ◽

Handgrip Strength ◽

Vigorous Physical Activity ◽

Total Duration ◽

Functional Mobility ◽

Linear Regression Models ◽

Timed Up And Go

AbstractThe positive association between the total duration of physical activity and performances of physical function may vary at different times of the day as circadian rhythm regulates individuals in response to external stimulations. We aimed to examine the association of timing-specific and overall moderate-to-vigorous physical activity (MVPA) with performances of physical function in older adults. A cross-sectional analysis was conducted among 118 older adults (mean age = 70.0 ± 5.0 years). We assessed and identified timing-specific (morning: 06:01–12:00; afternoon: 12:01–18:00; evening: 18:01–24:00) and overall MVPA using a triaxial accelerometer. Different measures of physical function were evaluated including handgrip strength (by grip dynamometer), gait speed (5-m walk test), basic functional mobility (timed up and go test), and lower limb strength (five times sit-to-stand test). Multivariate linear regression models adjusting for covariates were used to investigate the associations. Participants spent 25.0 (± 26.2) minutes in MVPA per day on average, half the time spent during the morning (47.7%), followed by during the afternoon (29.9%) and evening (21.6%). The time spent on overall MVPA was generally associated with better physical function performances. There was statistical evidence for the percentages of MVPA engagement during the morning [B = 0.214, 95% confidence interval (CI) 0.001 to 0.428] and afternoon (B = − 0.273, 95% CI − 0.518 to − 0.027) associated with basic functional mobility but with contrary directions; the percentage of MVPA engagement during the evening was associated with less time spent in gait speed performance (B = − 0.237, 95% CI − 0.468 to − 0.006). Our findings inform implications that the overall MVPA engagement was more important than timing-specific MVPA to older adults’ physical function performances. Strategies for accumulating time of MVPA is more practical and effective than encouraging to engage MVPA in specific timing for the enhancement of functional ability and therefore prevent disability among older adults.

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Abstract P021: Association of AHA Cardiovascular Health Metrics With Cognitive Function, Depression, and Anxiety: The Emory Healthy Aging Study

Circulation ◽

10.1161/circ.135.suppl_1.p021 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Alvaro Alonso ◽

Felicia C Goldstein ◽

Viola Vaccarino ◽

Allan I Levey ◽

James J Lah ◽

...

Keyword(s):

Physical Activity ◽

Depressive Symptoms ◽

Cognitive Function ◽

Healthy Aging ◽

Cardiovascular Health ◽

Emotional Health ◽

Sociodemographic Variables ◽

Aging Study ◽

Life’S Simple 7 ◽

Life's Simple 7

Background: The American Heart Association (AHA) has developed the Life’s Simple 7 metric (no smoking, high levels of physical activity, normal body mass index, no hypertension, no diabetes, no hyperlipidemia, healthy diet) to track behaviors and risk factors associated with cardiovascular health (CVH). Given the potential role that CVH has in cognition and psychological well-being, we aimed to study the association of the Life’s Simple 7 with cognitive function, anxiety, and depressive symptoms in the Emory Health Aging Study (EHAS). Methods: EHAS is an ongoing cohort study with the overall goal of understanding determinants of healthy aging in the general population. Participants 18 years of age or older are recruited at primary care clinics, community events, and through social media, primarily from the Atlanta (GA) area. Information on sociodemographic variables (age, sex, race, education, income), anthropometrics (weight, height), lifestyles (smoking, physical activity), and clinical variables (history of hypertension, diabetes, hypercholesterolemia, cardiovascular disease [CVD]) was collected through online questionnaires. Life’s Simple 7 score (excluding diet; information not available) was defined based on self-reported data, giving 1 point per achieved metric [range 0 (lowest)-6(highest CVH)]. Neurobehavioral variables were measured using validated scales (Cognitive Function Instrument (CFI), range 0-14, for cognition; Patient Health Questionnaire (PHQ)-8, range 0-24, for depressive symptoms; Generalized Anxiety Disorder (GAD) questionnaire, range 0-21, for anxiety; higher scores represent worse function/symptoms). Cross-sectional associations between Life’s Simple 7 score and these scales were assessed using multivariable linear regression adjusting for sociodemographic variables. Results: We included 3,774 participants [mean age (standard deviation, SD) 58 (13), 79% women, 84% white, 9% African American, 7% other) free of self-reported CVD, recruited between October 2015 and October 2016. Levels of CVH in the cohort were relatively high, with 62% participants meeting at least 4 health criteria [mean (SD) score 3.9 (1.3)]. The mean (SD) of CFI, PHQ-8, and GAD were 1.9 (2.1), 3.2 (3.8), 2.4 (3.4), respectively. In analyses adjusted for age, sex, race, education, and income, higher values of Life’s Simple 7 score were related to better cognitive function and lower levels of depressive symptoms and anxiety: estimates (95% confidence interval) per 1-point in Life’s Simple 7 score were -0.16 (-0.22, -0.11) for CFI, -0.5 (-0.6, -0.4) for PHQ-8, and -0.3 (-0.4, -0.2) for GAD. Conclusion: Higher levels of CVH, as assessed with the AHA Life’s Simple 7, were cross-sectionally associated with a beneficial neurobehavioral profile. Prospective studies should evaluate the impact of improving CVH on cognitive and emotional health.

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