Physical Activity Throughout the Adult Life Span and Domain-Specific Cognitive Function in Old Age: A Systematic Review of Cross-Sectional and Longitudinal Data

Toward a Self-Report Cumulative Deficits Frailty Scale (Sr-CDFS): Development and Clinimetric Properties of a Novel Frailty Scale

BACKGROUND AND PURPOSE

Frailty, a multidimensional syndrome, is linked with heightened risk of adverse outcomes. Targeted physical therapy interventions for individuals with frailty have proven beneficial, underscoring the value of routine frailty assessment in both clinical and research settings. This study aimed to: (1) describe development of a simple self-report cumulative deficits frailty scale (Sr-CDFS); (2) establish the criterion validity of Sr-CDFS against the commonly used Fried's frailty scale and Study of Osteoporotic Fracture criteria (SOF); and (3) assess other concurrent validity and internal consistency of the new Sr-CDFS.

METHODS

The study included 230 older adults (M age = 79.27 ± 7.42 years), with 76.5% being women. Outcome measures were: (1) validated frailty scales, including Fried's frailty phenotype, SOF, and Sr-CDFS; and (2) a battery of tests for impairment, activity limitations, and health status. Data analysis involved calculating frailty prevalence using the validated frailty scales. The clinimetric properties of the Sr-CDFS were assessed against validated frailty scales. Convergent and discriminative validity of the Sr-CDFS were examined. Internal consistency and structure were evaluated using Cronbach's alpha and exploratory factor analysis.

RESULTS AND DISCUSSION

No differences (P = .80) in frailty prevalence were found between Fried (26.1%) and SOF (25.2%) methods. The Sr-CDFS exhibited excellent internal consistency (Cronbach's alpha = .92), with reliability of questionnaire components (health, falls, physical, cognitive, socioemotional function) ranging from .73 (falls) to .90 (physical ability). Additionally, the Sr-CDFS demonstrated convergent and discriminative validity, with its total score and various parts correlating significantly with most outcomes (r = .25-.59, P < .05). Using K1-criterion and a scree plot, we identified a 5-factor solution that had a common variance of 63.9%.

CONCLUSION

The newly developed Sr-CDFS exhibits robust clinimetric properties with good-to-excellent reliability and validity. The newly developed Sr-CDFS has the potential to increase the feasibility of assessing frailty in clinical settings or large-scale epidemiological studies.

Effects of exercise on cognition and Alzheimer's biomarkers in a randomized controlled trial of adults with mild cognitive impairment: The EXERT study

INTRODUCTION

The EXERT study (Exercise in Adults with Mild Memory Problems) was a Phase 3, multicenter, randomized controlled trial that examined effects of exercise on cognition and other measures of brain health in sedentary older adults with amnestic mild cognitive impairment (MCI).

METHODS

Participants were randomized to moderate-high intensity aerobic training (AX) or low-intensity stretching/balance/range of motion (SBR) for 18 months. Exercise was supervised for the first 12 months. Assessments were administered at baseline and every 6 months. The primary outcome was a global cognitive composite.

RESULTS

A total of 296 participants were enrolled, and intervention adherence was high (supervised session attendance: AX = 81%, SBR = 87%). Intervention effects on cognition did not differ for AX and SBR (regression = -0.078, standard error [SE] = 0.074; p = 0.3). Notably, there was no 12 month  cognition decline for either group, and mean 12 month  hippocampal volume loss for both groups was low at 0.51%.

DISCUSSION

Exercise intensity did not differentially affect cognitive trajectory. Intervention delivery was successful (high adherence) and cognition remained stable over 12 months  for both MCI groups, an association that warrants further study.

HIGHLIGHTS

Exercise in Adults with Mild Memory Problems (EXERT) was a large multisite randomized controlled trial of moderate-high intensity aerobic training versus lower-intensity flexibility and balance exercise in sedentary older adults with amnestic mild cognitive impairment (MCI). A sensitive and validated measure of global cognitive function, the Alzheimer's Disease Assessment Scale-Cognition supplemented with tests of executive function (ADAS-Cog-Exec), was used to assess intervention efficacy with 12 months of supervised exercise. There was no intervention group difference on the 12-month cognitive trajectory of the ADAS-Cog-Exec. Intervention delivery was successful (high adherence), and cognition remained stable over 12 months for both exercise groups. Regular supported moderate-high or lower-intensity exercise may stall decline in adults with amnestic MCI, but further investigation is needed.

Cross-sectional and longitudinal associations between physical activity and intrinsic capacity in healthy older adults from the MAPT study

BACKGROUND

The construct of intrinsic capacity (IC) has been recently developed with the aim of assessing and monitoring life-long individuals' functional trajectories. Physical activity (PA) is recognized for its benefits on health but its associations with IC remain less investigated. We explored the cross-sectional and longitudinal associations of PA with IC in non-demented older adults.

METHODS

Eight hundred and thirty-seven males and females aged 70 years and over, were included in the present work. IC and its domains (mobility, vitality, cognition, psychology and sensory) were assessed over 2 years and converted to a 0-100 scale. Participants were categorized into 5 PA groups (0-29; 30-499; 500-999; 1000-1999; and 2000+ MET-min/week) using questionnaires. The associations between PA and IC variables (all reflected and square-root-transformed) observed over 2 years were examined using mixed-effect linear regressions.

FINDINGS

Over the 2-year follow-up, ordinal PA was associated with higher scores in IC (B = -0.066, SE = 0.015, p < .001) In addition, compared to the inactive group, most of the active groups had a slower decline in IC (B30-499 MET-min/week = -0.196, SE = 0.078; B500-999 MET-min/week = -0.208, SE = 0.076; B1000-1999 MET-min/week = -0.165, SE = 0.073; B2000+MET-min/week = -0.187, SE = 0.074; all p < .05). Subdomain analyses revealed that these associations were driven by mobility, vitality and psychological domain.

INTERPRETATION

This study suggests that PA may help preventing IC decline, especially mobility, vitality, and psychology in older adults.

Cognitive function and its longitudinal predictability by intensity of physical activity in Chinese middle-aged and older adults

BACKGROUND

The aging population faces several health problems, including cognitive decline that can progress to Alzheimer's disease. Regular physical activity is widely recognized for its extensive benefits, including physical and mental health improvements especially for older adults.

OBJECTIVE

This study aimed to examine the prediction of physical activity intensities on cognitive function of older adults.

METHODS

Data from 8 years prospective survey among Chinese population aged 45 years and older is used. Cognitive function was measured by word recall, orientation, numeric subtraction, and copying a picture. Physical activity was assessed with three intensity levels. General estimating equations (GEE) with unstructured correlation matrix is used to test the prediction of physical activity intensity on cognitive function.

RESULTS

Cognitive function of participants significantly declined from 9.81 at baseline to 8.81 after 8 years. Moderate-intensity physical activity for 3 days/week was strongest positive predictor of cognitive function with a betta coefficient of 0.64. Light-intensity physical activity also positively predicted cognitive function, however vigorous physical activity for more than 3 days/week negatively predicted cognitive function.

CONCLUSIONS

Cognitive function of the Chinese population is found to continuously decline after 60 years old age. Fortunately, this decline can be delayed with age-tolerable light to moderate-intensity physical activities.

The effectiveness of real-life cognitive and physical interventions on cognitive functioning in healthy older adults: A systematic review of the effects of education and training duration

Physical and cognitive interventions are deemed the primary methods of improving cognitive functioning in healthy older adults. However, the effectiveness of these interventions is still debated. This systematic review, synthesised findings from the literature on four different types of interventions: physical activities, cognitive training, cognitive stimulation and a combined intervention. We searched six databases for each intervention category. Findings demonstrated that 65% of the studies across all intervention groups reported improvement in the experimental group following the intervention. Furthermore, memory, executive and global cognitive functions were the most reported improvements post-intervention. Additionally, participants with higher education benefited more from cognitive training (an intervention that targets a specific cognitive domain), while those with lower education gained more following cognitive stimulation (an intervention that targets general domains). Lastly, in sub-types of physical activity, cognitive stimulation and combined category, longer durations (more than 20 sessions) were associated with significant cognitive improvements. Conversely, in cognitive training, having less than 20 sessions led to significant results. Findings indicated an interaction of education and intervention duration with significant outcomes post-intervention. In conclusion, this review demonstrated the importance of intervention type, duration and education in understanding cognitive improvement post-intervention.

Multi-domain Online Therapeutic Investigation Of Neurocognition (MOTION) - A randomized comparative-effectiveness study of two remotely delivered mind-body interventions for older adults with cognitive decline

BACKGROUND

Research suggest that mind-body movement programs have beneficial effects on cognitive outcomes for older adults with cognitive decline. However, few studies have directly compared specific approaches to mind-body movement or studied the impact of remote program delivery.

METHODS

In a 3-arm randomized controlled trial (RCT) for older adults with cognitive impairment, we are comparing a multidomain mind-body program that emphasizes movement, body awareness, personal meaningfulness, and social connection, and a traditional Chinese mind-body exercise (Tai Chi) to a health and wellness education control condition. All 3 interventions are delivered remotely two times per week (onehour per session) for 12 weeks. The two active interventions are live-streamed. Outcomes are assessed prior to, after, and 6-months after the interventions. The co-primary outcomes are changes on the Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-cog) and brain functional connectivity in the Default Mode Network (DMN). Secondary outcomes include measures of specific cognitive domains (e.g., executive function, attention), mobility, and self-report measures of general well-being, quality of life, social engagement, self- and attention-regulation.

CONCLUSION

This RCT will directly compare the effects of two mind-body movement programs versus an education control delivered remotely over 12 weeks on cognitive, neuroimaging, and participant-reported outcomes. If successful, these programs may provide scalable strategies for slowing cognitive decline, which could potentially delay dementia onset in some individuals.

TRIAL REGISTRATION ID

NCT05217849.

Late-life physical activity, midlife-to-late-life activity patterns, APOE ε4 genotype, and cognitive impairment among Chinese older adults: a population-based observational study

BACKGROUND

Although physical activity (PA) has been linked to cognitive health, the nuanced relationships between different dimensions of PA and cognitive impairment remain inconclusive. This study investigated associations between late-life PA levels, midlife-to-late-life activity patterns, and cognitive impairment in Chinese older adults, considering potential moderation by apolipoprotein E (APOE) ε4 genotype.

METHODS

We analyzed baseline data from 6,899 participants (median age 68 years, 55.78% female) in the West China Health and Aging Cohort study, with 6,575 participants having APOE genotyping data. Late-life PA and midlife-to-late-life activity patterns were assessed using the Global Physical Activity Questionnaire and a standardized question, respectively. Cognitive function was evaluated using the Chinese version of Mini-Mental State Examination. Logistic regression models were used to examine associations.

RESULTS

Compared to low PA level, moderate (odds ratio [OR] = 0.74, 95% confidence interval [CI] = 0.55 ~ 0.99) and high PA levels (OR = 0.60, 95%CI = 0.48 ~ 0.75) were associated with lower risk of cognitive impairment. Engaging in work-, transport-, recreation-related, and moderate-intensity PA were each significantly associated with lower cognitive impairment risk. Maintaining activity levels from midlife to late life was associated with lower cognitive impairment risk compared to decreasing levels (OR = 0.75, 95%CI = 0.60 ~ 0.94). These associations were more pronounced in APOE ε4 non-carriers, with an interaction observed between APOE ε4 genotype and recreation-related PA (P-value = 0.04).

CONCLUSIONS

Our findings underscore the multifaceted benefits of PA in mitigating cognitive impairment risk among older Chinese adults. Public health strategies should focus on promoting overall late-life PA levels, especially moderate-intensity PA, and maintaining activity levels comparable to midlife, with potential for personalized interventions based on genetic risk profiles.

Metacognitive function in young adults is impacted by physical activity, diet, and sleep patterns

Our cognitive capacities like working memory and attention are known to systematically vary over time with our physical activity levels, dietary choices, and sleep patterns. However, whether our metacognitive capacities--such as our strategic use and optimization of cognitive resources--show a similar relationship with these key lifestyle factors remains unknown. Here we addressed this question in healthy young adults by examining if physical activity, diet, and sleep patterns were predictive of self-reported metacognitive status. Participants completed a set of validated surveys assessing these lifestyle factors over the past week to month, as well as three measures of metacognition. Using multiple regression and exploratory factor analyses we identified four clusters of metacognitive processes that are sensitive to lifestyle behaviours. Specifically, knowledge of and offline regulation of cognition is linked with physical activity, on-line cognitive regulation is related to diet, and metacognitive worry is associated with sleep behaviours. These findings suggest that lifestyle behaviours do not just affect objective cognitive functioning, but also the meta-level processes we use to monitor our cognitive performance and exert strategic control over our cognitive resources.

Associations of Muscle-Strengthening Activity and Cognitive Function in Community-Dwelling Middle-Aged and Older Adults

OBJECTIVE

To determine the associations between muscle-strengthening activity (MSA) and cognitive function among middle-aged and older adults.

METHODS

This cross-sectional study included 2973 participants aged ≥55 in the Cooper Center Longitudinal Study. Participants self-reported leisure-time physical activity. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). The associations of reported MSA frequency (0-1 vs. ≥2 sessions/week) and volume (zero, low: ≤250, medium: 250-420, high: >420 MET minutes/week) with mild cognitive impairment (MCI, defined as MoCA<26) and MoCA total score were examined using logistic and linear regression.

RESULTS

Individuals who participated in ≥2 MSA sessions/week had a significantly higher MoCA total score. Participants with medium MSA volume were significantly associated with lower odds of being classified as MCI and associated with a higher MoCA total score than those with zero volume.

CONCLUSIONS

Engaging in MSA is associated with cognitive health among middle-aged and older adults independent of aerobic exercise.

Physical activity promotes the development of cognitive ability in adolescents: the chain mediating role based on self-education expectations and learning behaviors

Cognitive ability plays a crucial role in adolescents' academic performance and subsequent career development. Although previous studies have demonstrated that physical activity, self-education expectations, and learning behaviors positively affect the cognitive development of adolescents, the extent of their influence and their mediating roles require further elucidation. This study is based on tracking survey data from 2,688 adolescents in Chinese households collected in 2018. Multiple linear regression, Propensity Score Matching, and Quantile regression were employed to analyze the impact and heterogeneity of physical activity on adolescents' cognitive ability. Furthermore, the Bootstrap mediation test was used to explore the mediating roles of self-education expectations and learning behaviors in this process. The results indicate the following: Physical activity significantly promotes adolescents' cognitive ability; for those with poorer cognitive ability, it exerts a greater impact. Moreover, in addition to its direct effects, physical activity indirectly enhances adolescents' cognitive ability through the mediation of three factors (self-education expectations, learning behaviors, self-education expectations and learning behaviors). These discoveries offer significant insights into diverse strategies for developing cognitive ability in adolescents, contributing to both theoretical research and practical interventions.

Self-reported physical activity and sleep quality is associated with working memory function in middle-aged and older adults during the COVID-19 pandemic

While previous work has shown a positive relationship between cognitive performance and lifestyle factors in younger adults, evidence for this relationship among middle-aged and older adults has been mixed. The current study aimed to further test the relationship among physical activity, sleep quality, and memory performance in middle-aged and older adults, and to test whether this relationship holds up during the COVID-19 pandemic. Our results showed that physical activity was associated with better sleep quality and better working memory performance, and better sleep quality was associated with better working memory and self-perceptions of everyday memory abilities. Additionally, we found that the effects of physical activity on working memory were partially mediated by sleep quality. While these effects were small and only correlational in nature, they lend further support to the notion that sleep quality and physical activity are beneficial to memory later in life, even during a global pandemic.

Evidence of the Long-Term Protective Effect of Moderate-Intensity Physical Activity on Cognitive Function in Middle-Aged and Elderly Individuals: A Predictive Analysis of Longitudinal Studies

OBJECTIVE

To investigate the effects of different intensities of physical activity (PA) on cognitive function in middle-aged and elderly individuals, and to predict future trends in cognitive ability using longitudinal data to assess the long-term role of PA in cognitive preservation.

METHODS

Data from the China Health and Retirement Longitudinal Study (CHARLS) were utilized. Mixed-effects models were employed to analyze the impacts of low-intensity PA (LPA), moderate-intensity PA (MPA), and vigorous-intensity PA (VPA) on overall cognition, episodic memory, and mental intactness. Random forest and XGBoost machine learning methods were employed to further validate the effects of PA. ARIMA models predicted future cognitive trends under the influence of PA.

RESULTS

MPA demonstrated significant advantages in preserving cognitive function, particularly in overall cognition and episodic memory. While LPA had some protective effects, they were less significant than those of MPA, and VPA did not show advantages. Machine learning methods confirmed these findings. ARIMA model predictions indicated that the protective effects of MPA on cognitive function are likely to persist in the future.

CONCLUSIONS

Moderate-intensity physical activity is associated with the preservation of cognitive ability in middle-aged and elderly individuals and may continue to provide this benefit in the future; however, further in-depth research is needed for confirmation.

The Hidden Dangers of Sedentary Living: Insights into Molecular, Cellular, and Systemic Mechanisms

With the aging of the global population, neurodegenerative diseases are emerging as a major public health issue. The adoption of a less sedentary lifestyle has been shown to have a beneficial effect on cognitive decline, but the molecular mechanisms responsible are less clear. Here we provide a detailed analysis of the complex molecular, cellular, and systemic mechanisms underlying age-related cognitive decline and how lifestyle choices influence these processes. A review of the evidence from animal models, human studies, and postmortem analyses emphasizes the importance of integrating physical exercise with cognitive, multisensory, and motor stimulation as part of a multifaceted approach to mitigating cognitive decline. We highlight the potential of these non-pharmacological interventions to address key aging hallmarks, such as genomic instability, telomere attrition, and neuroinflammation, and underscore the need for comprehensive and personalized strategies to promote cognitive resilience and healthy aging.

The Effects of Social Interaction Intervention on Cognitive Functions Among Older Adults Without Dementia: A Systematic Review and Meta-Analysis

Background and Objectives

Previous systemic reviews, predominantly including observational studies, have shown that participation in social activities is a protective factor against cognitive decline. However, this association is subject to potential reverse causality, creating a knowledge gap in our understanding of the effect of social interaction interventions on cognitive function. Therefore, this study aims to conduct a systematic review and meta-analysis of randomized controlled trials to examine the effects of social interaction interventions on cognitive decline among older adults without dementia.

Research Design and Methods

This systematic review, registered in PROSPERO (CRD42022367828), systematically searched 6 databases from inception to May 6, 2022, to identify relevant articles on the effects of activities with social interaction components on cognitive function in community-dwelling older adults without dementia aged above 60. Two independent reviewers conducted study selection, data extraction, and bias assessment, with RevMan5.3 used for meta-analysis. Subgroup analysis was conducted to assess variation in intervention effects among subgroups.

Results

We included 11 studies for qualitative analysis and 8 studies for the meta-analysis. The results showed that social interaction intervention had a significant effect on executive function (standardized mean difference [SMD] = 1.60; 95% CI, 0.50 to 2.70; p = .004), but not attention and memory. The subgroup analysis showed a greater cognitive benefit for healthy older adults, but not those with mild cognitive impairment. Moreover, in-person social interaction positively affected global cognition, whereas online interaction did not.

Discussion and Implications

Social interaction interventions have a limited impact on cognitive function in older adults without dementia but showed potential effects on executive function. This finding offers insights for implementing social intervention in the community.

Effects of different types of leisure activities on working memory across the adult lifespan

The aim of the present study was to contrast the potential influence of five independent types of leisure activities (physical, mental, social, cultural, and passive) on working memory in a lifespan sample and in specific stages of adulthood (young, middle-aged, and older adults). A sample of 1652 healthy adults between 21 and 80 years of age participated in the study. Leisure activities were assessed through a lifestyle questionnaire created for the study. Working memory was measured in the verbal and spatial domains using a computerized n-back task that allowed us to reliably measure discrimination and reaction times. Across adulthood, mental (computer use and hobbies) and social leisure activities predicted greater verbal and spatial working memory discrimination; mental (reading) and social activities predicted faster verbal working memory; and mental (computer use) and physical activities predicted faster spatial working memory. In young adults, mental (computer use) and social activities were associated with greater verbal and spatial working memory performance. In middle-aged adults, physical and mental activities (computer use) were associated with greater working memory performance. In older adults, physical, mental (hobbies), and social activities were associated with greater working memory performance. Leisure activities can enhance working memory discrimination and speed independent of individuals' age.

The impact of MIND diet consumption and physical activity on cognitive functioning in healthy aging older adults

Objective: Modifiable lifestyle factors evidence great promise in reducing cognitive decline in older adults. Greater consumption to the MIND diet (Morris et al.) and increased daily physical activity (Buchman et al.) are associated with higher cognitive functioning. The interactive effects of lifestyle factors on cognition in older adults has not been investigated extensively. The present study examined the interaction between MIND diet consumption and intensity of physical activity on cognition in community-dwelling older adults. Methods: The sample included 215 older adults (159 female, Mage=79.8; Medu=15.5) from the Memory and Aging Project (Bennet et al.). The measures included the food frequency questionnaire (FFQ, MIND diet consumption), a portable actigraph worn 24 h a day for ten days (activity intensity), and a neuropsychological battery (cognitive variables). Results: Controlling for age and education, multiple regression analyses revealed that MIND diet consumption significantly predicted global cognition (ps< .05). Physical activity significantly predicted global cognition (ps< .05), and processing speed (ps< .01). Interaction effects were significant in global cognition (ps< .05), and episodic memory (ps< .01) revealing a pattern that those with the lowest MIND diet consumption may experience greater cognitive benefits from physical activity in than those with higher diet consumption. Conclusions: Findings suggest that older adults who do not consume the MIND diet closely may experience greater benefit in cognitive functioning from exercise than individuals who more greatly consume the diet.

Changes in physical fitness and body build of women and men surveyed in 2004 and 2022-A longitudinal study

Physical fitness plays a crucial role in determining human health and overall well-being. The objective of the study was to assess the changes in body structure and physical fitness among individuals examined in 2004 and 2022 (persons aged 32-34 and 50-52). The research material consists of data from the Krakow Continuous Study (KCS) of somatic development and physical fitness of people born in 1970 and 1972, conducted in Krakow in the years 1976-2022. In total, in 2004, 103 women and 122 men took part in the study, and in 2022-47 women and 67 men. Of these participants, 37 women and 53 men were present for both measurements. The following measurements were performed-physical fitness tests: handgrip strength of left and right hand, standing broad jump, sit-and-reach test and overhead medicine ball throw (2 kg); anthropometric measurements: body height, body weight and tissue composition, circumferences of the chest (relaxed and in deep inspiration), waist, hips, thigh, mid-upper-arm (MUAC, relaxed and in deep inspiration), forearm and calf, thickness of biceps, triceps, subscapular, abdominal, suprailiac and calf skinfolds; width of shoulders and hips, depth and width of the chest. A comparative analysis of the two series showed that all fitness test scores deteriorated. The percentage decrease was greater in women than in men in the tests of right and left handgrip strength and overhead medicine ball throw than in men, in the standing broad jump test similar in both sexes, in the sit-and-reach test-lower in women than in men. The greatest decreases were observed in the standing broad jump (by 14%) and the 2 kg medicine ball throw (15-12%), both in women and men. In contrast, the level of development of most of the somatic characteristics studied in 2022 was higher compared to the previous study, and, apart from body height, elbow and knee width and calf skinfold in both sexes, the differences in arithmetic means between the 2004 and 2022 series were statistically significant. Furthermore, the absence of involutionary changes in body height can be highlighted. In conclusion, the decrease in physical fitness occurring in adulthood and the increase in most somatic characteristics between 32 and 34 year-olds and 50 and 52 year-olds were confirmed.

The influence of open-skill and closed-skill sports on executive functions: a systematic review

Aims/Background Open-skill sports are reportedly more effective than closed-skill sports in improving executive functions. However, it remains unclear as to its superiority in specific components of executive functions and specific populations. This review aims to explore the degree to which specific components of executive functions are affected by different sport types, open-skill sports and closed-skill sports, among different age groups. Methods Relevant articles published from 1st January 2000 to 31st December 2023 were searched and obtained from four databases, namely EBSCO, PubMed, Web of Science, and Science Direct. These studies were selected through a carefully established article-filtering workflow, governed by a set of inclusion and exclusion criteria, and the quality assessment was carried out independently by each researcher. Results Out of the 30 studies included for this systematic review, eight studies demonstrated the beneficial impacts of open-skill sports on adults by improving three executive functions subcomponents, as compared with closed-skill sports. Six studies found that open-skill sports are conducive to inhibitory control and cognitive flexibility among children and adolescents, while four studies showed that open-skill sports greatly enhance inhibitory control in elderly individuals. Conclusion Compared with closed-skill sports, open-skill sports have a favourable impact on inhibitory control and cognitive flexibility in children, adolescents, and adults, marked by shorter response time in inhibitory control tasks, as well as shorter response time and lower switch costs in cognitive flexibility tasks. In addition, relative to closed-skill sports, open-skill sports heightens accuracy in working memory tasks among adults.

Does resistance training in older adults lead to structural brain changes associated with a lower risk of Alzheimer's dementia? A narrative review

Dementia, particularly Alzheimer's Disease (AD), has links to several modifiable risk factors, especially physical inactivity. When considering the relationship between physcial activity and dementia risk, cognitive benefits are generally attributed to aerobic exercise, with resistance exercise (RE) receiving less attention. This review aims to address this gap by evaluating the impact of RE on brain structures and cognitive deficits associated with AD. Drawing insights from randomized controlled trials (RCTs) utilizing structural neuroimaging, the specific influence of RE on AD-affected brain structures and their correlation with cognitive function are discussed. Preliminary findings suggest that RE induces structural brain changes in older adults that could reduce the risk of AD or mitigate AD progression. Importantly, the impacts of RE appear to follow a dose-response effect, reversing pathological structural changes and improving associated cognitive functions if performed at least twice per week for at least six months, with greatest effects in those already experiencing some element of cognitive decline. While more research is eagerly awaited, this review contributes insights into the potential benefits of RE for cognitive health in the context of AD-related changes in brain structure and function.

Arthroscopic rotator cuff repair in active patients younger than 45 Years: a prospective analysis with a mean 5-year follow-up

Background

To report clinical and activity-specific outcomes after arthroscopic rotator cuff repair (ARCR) for full-thickness supraspinatus tears in active individuals aged less than or equal to 45 years. The pre hoc hypothesis was that patients in this age group would demonstrate significant improvements in clinical outcomes following ARCR along with a significant improvement of athletic abilities.

Methods

Patients were included in this study if they were (1) active individuals aged between 18 and 45 years at the time of surgery, (2) had a full-thickness rotator cuff tear of the supraspinatus tendon with or without anterior or posterior extension, and (3) underwent ARCR. Preoperative and postoperative patient-reported outcomes scores including the American Shoulder and Elbow Surgeons (ASES) score; Disabilities of Arm, Shoulder and Hand; Single Assessment Numeric Evaluation; and Short Form-12 Physical Component Summary were prospectively collected and postoperative patient satisfaction (scale of 1-10) was recorded at a minimum of 2 years postoperatively. Attainment of the minimal clinically important difference and patient acceptable symptom state for the ASES was calculated. Athletic activity-specific outcomes and return to activity were investigated prospectively via a custom-made comprehensive questionnaire.

Results

Between November 2005 and June 2020, of 1149 RCRs performed by the senior author, 54 patients (mean age 40.9 years, 13 female; follow-up 69.7 ± 35.2 months in a range of 24.6-179.6 months) were included into the outcomes analysis. Of those, 4 patients (7.4%) had progressed to revision RCR. At a follow-up of 5.8 years, outcome scores had significantly improved compared to preoperative baselines (ASES 55.6 ± 13.8 to 90.1 + 15.8; P < .001; Disabilities of Arm, Shoulder and Hand 38.9 ± 18.4 to 11.9 ± 17.1; P < .001, Single Assessment Numeric Evaluation 60.7 ± 22.7 to 79.3 ± 27.6; P = .001, Short Form-12 Physical Component Summary 41.6 ± 8.3 to 51.9 ± 9.0; P ≤ .001). Ninety three point six percent of the patients reached the minimal clinically important difference and 72.6% reached the patient acceptable symptom state. Median satisfaction was 9.5/10. Eighty six percent of the patients returned to sports, while 67% of the patients returned to a similar level compared to preoperatively. All sport-specific metrics such as shoulder strength and endurance (P < .001), intensity (P < .001), and impairments from pain affecting speed (P = .002), endurance (P = .002), and competition (P < .001) significantly improved postoperatively.

Conclusion

ARCR of full-thickness rotator cuff tear in active individuals aged 45 years or less results in a clinically relevant improvement of outcomes, function, and quality of life at a minimum of 2 years and mean 5.8-year follow-up with a low rate of revision. While 86% of patients were able to return to activity and sport-specific outcome metrics significantly and substantially improved compared to preoperatively, a return to preinjury levels was not reliably achieved in all patients, with particular limitations observed in overhead active individuals. The data support the hypothesis that patients in this age group demonstrate significant improvements in clinical outcomes following ARCR along with significant improvements in athletic abilities.

Effects of different types of physical exercise on executive function of older adults: a scoping review

Objective

This scoping review examined the impact of physical exercise on executive function (EF) in older adults and investigated the moderating effects of exercise types.

Methods

We systematically searched four electronic databases for randomized controlled trials (RCTs) investigating the effects of exercise on EF, published until November 26, 2023. The proportions of positive and null/negative effects across all studies were calculated.

Results

In total, 91 studies were included in the analysis. Among these, 27 (29.7%) studies employed aerobic exercise interventions for older adults' EF, with 19 (70.4%) studies reporting positive effects. Additionally, 18 (19.8%) studies utilized strength exercise interventions for older adults' EF, with 15 (83.3%) studies demonstrating positive benefits. Furthermore, 32 (35.2%) studies employed coordination exercise interventions for older adults' EF, with 25 (78.1%) studies showing positive benefits. Similarly, 30 (33%) studies applied mixed exercise interventions for older adults' EF, with 25 (83.3%) studies indicating positive benefits.

Conclusion

Overall, all four types of physical exercise enhance EF in older adults, with mixed exercises being the most effective.

Associations between cognitive function and lifestyle in community-living older people: a correlational study

BACKGROUND

Previous studies have examined relationship between cognitive function and lifestyle; however, the nature of this relationship is expected to vary in diverse cultural and low-income setting where lifestyle practices differ from those in high-income countries.

AIM

This study aims to investigate the correlation between lifestyle factors and cognitive function among individuals aged 60 years and older in 2021.

METHODS

This cross-sectional, Community-based study involved 300 older adults from comprehensive urban health centers in Khorramabad, Iran, selected through stratified cluster sampling. Data were collected using the demographic information questionnaire, Mini-Mental State Examination, and Lifestyle Questionnaire. Data management and analysis were performed using SPSS (version 22) and independent t-tests, Pearson's correlation coefficient, ANOVA, and multiple linear regression analysis were used. A p value < 0.05 was considered significant.

RESULTS

The study included 156 males (52%) and 144 females (48%). Findings revealed a significant correlation between cognitive function and lifestyle (P < 0.001). Multiple linear regression analysis indicated that physical health, environmental health, exercise, accident prevention, and avoidance of medication exerted the most significant positive effect on cognitive function. Conversely, social health exhibited a notable negative influence on cognitive function. (P < 0.001).

CONCLUSION

The results suggest that specific aspects of lifestyle, such as physical health, accident prevention, and avoidance of medication are associated with cognitive function in older adults. Consequently, lifestyle promotion programs may enhance cognitive function and improve the quality of life among older adults.

The Association Between Physical Activity and Cognition in a Racially/Ethnically Diverse Cohort of Older Adults: Results From the Kaiser Healthy Aging and Diverse Life Experiences Study

OBJECTIVE

Most prior research on physical activity (PA) and cognition is based on predominantly white cohorts and focused on associations of PA with mean (average) cognition versus the distribution of cognition. Quantile regression offers a novel way to quantify how PA affects cognition across the entire distribution.

METHODS

The Kaiser Healthy Aging and Diverse Life Experiences study includes 30% white, 19% black, 25% Asian, and 26% Latinx adults age 65+ living in Northern California (n = 1600). The frequency of light or heavy PA was summarized as 2 continuous variables. Outcomes were z-scored executive function, semantic memory, and verbal episodic memory. We tested associations of PA with mean cognition using linear regression and used quantile regression to estimate the association of PA with the 10th-90th percentiles of cognitive scores.

RESULTS

Higher levels of PA were associated with higher mean semantic memory (b = 0.10; 95% CI: 0.06, 0.14) and executive function (b = 0.05; 95% CI: 0.01, 0.09). Associations of PA across all 3 cognitive domains were stronger at low quantiles of cognition.

CONCLUSION

PA is associated with cognition in this racially/ethnically diverse sample and may have larger benefits for individuals with low cognitive scores, who are most vulnerable to dementia.

Impact of physical activity on disability-free and disabled life expectancies in middle-aged and older adults: Data from the healthy aging longitudinal study in Taiwan

AIM

Leisure-time physical activity (LTPA) promotes healthy aging; however, data on work-related physical activity (WPA) are inconsistent. This study was conducted to examine the disability-free life expectancy (DFLE) and disabled life expectancy (DLE) across physical activity levels, with a focus on WPA, in middle-aged and older adults.

METHODS

Data from 5663 community-dwelling participants aged ≥55 years and enrolled in the Healthy Aging Longitudinal Study in Taiwan were evaluated. Energy expenditures from LTPA and WPA were calculated from baseline questionnaires and categorized into sex-specific cutoffs. Disability was based on repeat measures of participants' activities of daily living and instrumental activities of daily living. Mortality was confirmed via data linkage with the Death Certificate database. DFLE and DLE were estimated from discrete-time multistate life-table models.

RESULTS

At age 65, women with low WPA had a DLE of 2.88 years (95% confidence interval [CI], 1.67-4.08), which was shorter than that of women without WPA (DLE, 5.24 years; 95% CI, 4.65-5.83) and with high WPA (DLE, 4.01 years; 95% CI, 2.69-5.34). DFLE and DLE were similar across WPA levels in men. DFLE tended to increase as the LTPA increased in men and women.

CONCLUSION

Women with low WPA had shorter DLE than did those with no or high WPA. To reduce the risks of disability associated with physical activity, public policy should advocate for older people to watch the type, amount, and intensity of their activities as these may go ignored during WPA. Geriatr Gerontol Int 2024; 24: 229-239.

Physical Activity and Cognitive Decline Among Older Adults: A Systematic Review and Meta-Analysis

Importance

Physical activity is associated with the risk for cognitive decline, but much of the evidence in this domain comes from studies with short follow-ups, which is prone to reverse causation bias.

Objective

To examine how length of follow-up, baseline age, physical activity amount, and study quality modify the longitudinal associations of physical activity with cognition.

Data Sources

Observational studies of adults with a prospective follow-up of at least 1 year, a valid baseline cognitive measure or midlife cohort, and an estimate of the association of baseline physical activity and follow-up cognition were sought from PsycInfo, Scopus, CINAHL, Web of Science, SPORTDiscus, and PubMed, with the final search conducted on November 2, 2022.

Study Selection

Two independent researchers screened titles with abstracts and full-text reports.

Data Extraction and Synthesis

Two reviewers independently assessed study quality and extracted data. Pooled estimates of association were calculated with random-effects meta-analyses. An extensive set of moderators, funnel plots, and scatter plots of physical activity amount were examined. This study is reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.

Main Outcomes and Measures

Pooled estimates of the associations between physical activity and global cognition, as well as specific cognitive domains, were examined.

Results

A total of 104 studies with 341 471 participants were assessed. Analysis of binary outcomes included 45 studies with 102 452 individuals, analysis of follow-up global cognition included 14 studies with 41 045 individuals, and analysis of change in global cognition included 25 studies with 67 463 individuals. Physical activity was associated with a decreased incidence of cognitive impairment or decline after correction for funnel plot asymmetry (pooled risk ratio, 0.97; 95% CI, 0.97-0.99), but there was no significant association in follow-ups longer than 10 years. Physical activity was associated with follow-up global cognition (standardized regression coefficient, 0.03; 95% CI, 0.02-0.03) and change in global cognition (standardized regression coefficient, 0.01; 95% CI, 0.01 to 0.02) from trim-and-fill analyses, with no clear dose-response or moderation by follow-up length, baseline age, study quality or adjustment for baseline cognition. The specific cognitive domains associated with physical activity were episodic memory (standardized regression coefficient, 0.03; 95% CI, 0.02-0.04) and verbal fluency (standardized regression coefficient, 0.05; 95% CI, 0.03-0.08).

Conclusions and Relevance

In this meta-analysis of the association of physical activity with cognitive decline, physical activity was associated with better late-life cognition, but the association was weak. However, even a weak association is important from a population health perspective.

Unexpected cognitive similarities between older adults and young people: Scores variability and cognitive performances

BACKGROUND

Increased interindividual variability in cognitive performance during aging has been proposed as an indicator of cognitive reserve.

OBJECTIVE

To determine if interindividual variability performance in episodic memory (PAL), working memory (SWM), reaction time (RTI), and sustained attention (RVP) could differentiate clusters of differential cognitive performance in healthy young and older adults and search for cognitive tests that most contribute to these differential performances.

METHODS

We employed hierarchical cluster and canonical discriminant function analyses of cognitive scores using the Cambridge Neuropsychological Test Automated Battery (CANTAB) to identify cognitive variability in older and young adults using the coefficient of variability of cognitive performances between and within groups. We also analyzed potential influences of age, education, and physical activity.

RESULTS

Cluster analysis distinguished groups with differential cognitive performance and correlation analysis revealed coefficient of variability and cognitive performance associations. The greater the coefficient of variability the poorer was cognitive performance in RTI but not in PAL and SWM. Older adults showed diverse trajectories of cognitive decline, and better education or higher percentage of physically active individuals exhibited better cognitive performance in both older and young adults.

CONCLUSION

PAL and SWM are the most sensitive tests to investigate the wide age range encompassing older and young adults. In older adults' intragroup analysis PAL showed greater discriminatory capacity, indicating its potential for clinical applications late in life. Our data underscore the importance of studying variability as a tool for early detection of subtle cognitive declines and for interpreting results that deviate from normality.

Association of step counts with cognitive function in apparently healthy middle-aged and older Japanese men

Background

Increasing physical activity may prevent cognitive decline. Previous studies primarily focused on older adults and used self-reported questionnaires to assess physical activity. We examined the relationship between step count, an objective measure of physical activity, and cognitive function in community-based middle-aged and older Japanese men.

Methods

The Shiga Epidemiological Study of Subclinical Atherosclerosis randomly recruited community-dwelling healthy men aged 40-79 years from Shiga, Japan, and measured their step counts over 7 consecutive days using a pedometer at baseline (2006-2008). Among men who returned for follow-up (2009-2014), we assessed their cognitive function using the Cognitive Abilities Screening Instrument (CASI) score. We restricted our analyses to those with valid 7-day average step counts at baseline and those who remained free of stroke at follow-up (n = 676). Using analysis of covariance, we calculated the adjusted means of the CASI score according to the quartiles of the average step counts.

Results

The mean (standard deviation) of age and unadjusted CASI score were 63.8 (9.1) years and 90.8 (5.8), respectively. The CASI score was elevated in higher quartiles of step counts (90.2, 90.4, 90.6, and 91.8 from the lowest to the highest quartile, respectively, [p for trend = 0.004]) in a model adjusted for age and education. Further adjustment for smoking, drinking, and other cardiovascular risk factors resulted in a similar pattern of association (p for trend = 0.005).

Conclusion

In apparently healthy middle-aged and older Japanese men, a greater 7-day average step count at baseline was associated with significantly higher cognitive function score.

Adherence to a healthy lifestyle and its association with cognitive impairment in community-dwelling older adults in Shanghai

Introduction

There is a growing body of recent literature linking the association of specific or multiple lifestyles with cognitive impairment, but most of these studies have been conducted in Western populations, and it is necessary to study multiple lifestyles and cognitive abilities in different populations, with the primary population of this study being a select group of community-dwelling older adults in Shanghai, China.

Methods

The sample included 2,390 community-dwelling Chinese participants. Their cognitive function was assessed using the Mini-Mental State Examination (MMSE). We defined a healthy lifestyle score on the basis of being non-smoking, performing ≥210 min/wk moderate/vigorous-intensity physical activity, having light to moderate alcohol consumption, eating vegetables and fruits daily, having a body mass index (BMI) of 18.5-23.9 kg/m2, and having a waist-to-hip ratio (WHR) <0.90 for men and <0.85 for women, for an overall score ranging from 0 to 6.

Results

Compared with participants with ≤2 healthy lifestyle factors, the adjusted odds ratio (OR) and 95% confidence interval (CI) for participants with 4, 5, and 6 healthy lifestyle factors were 0.53 (95% CI, 0.29-0.98), 0.40 (95% CI, 0.21-0.75), and 0.36 (95% CI, 0.16-0.79), respectively. Only WHR (OR = 0.54, 95% CI = 0.37-0.78) and physical activity (OR = 0.69, 95% CI = 0.51-0.92) were associated with cognitive impairment. A healthy lifestyle correlated with overall cognition (β = 0.066, orientation (β = 0.049), language ability (β = 0.060), delayed recall (β = 0.045) and executive function (β = 0.044) (P all < 0.05).

Conclusion

The study provides evidence on an inverse association between healthy lifestyles and cognitive impairment. We investigated whether healthy lifestyle was related to specific cognitive functions to provide a theoretical basis for accurate clinical prescription.

Physical activity interventions have a moderate effect in increasing physical activity in university students-a meta-analysis

INTRODUCTION

The transition to college is associated with changes in physical activity. This meta-analysis aims to quantify the effect of interventions on increasing physical activity in healthy university students.

METHODS

We conducted a literature search (up to 2/3/2020) to identify randomized controlled trials with healthy undergraduate or graduate students enrolled in a college degree program. Moderator analyses were conducted to examine the effects of intervention modality delivery (delivered in-person or remotely) and the type of outcome measure (self-report or objective measures).

RESULTS

18 publications were included. Interventions had a medium effect on physical activity (Cohen's d = 0.52). Moderator analyses revealed no differences.

CONCLUSION

Suggestions of how to improve the quality of physical activity intervention studies in college students are given. The moderate effect size of physical activity interventions in college students highlights the importance of developing and testing new interventions to promote physical activity in emerging adults.

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1998070 .

Audio-visual integration is more precise in older adults with a high level of long-term physical activity

It is well established that physical activity leads to numerous health, cognitive, and psychological benefits. However, to date, very few studies have investigated the impact of physical activity on multisensory perception, that is, the brain's capacity to integrate information across sensory modalities. Furthermore, it is unknown what level of long-term physical activity is associated with multisensory integration in adults. We explored the relationship between multisensory integration and a ten-year physical activity trajectory in 2,974 adults aged 50+ from The Irish Longitudinal Study on Ageing by measuring susceptibility to the Sound Induced Flash Illusion (SIFI) at multiple audio-visual temporal asynchronies. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ-SF) at 2 years intervals over ten years. We used latent class trajectory modelling to identify latent growth classes of individuals following a similar trajectory of physical activity over time. We analysed the association of this trajectory with performance accuracy to the illusion trials of the SIFI task with generalized logistic mixed effects regression models, adjusted for several covariates. Results showed that more precise integration (i.e., lower SIFI susceptibility with larger temporal asynchronies) was associated with a higher level of sustained physical activity across ten years. Although the use of self-reported physical activity and a short version of the SIFI task limit our conclusions to some extent, nonetheless, the results suggest that sustained physical activity is associated with more precise multisensory integration, which in turn is linked to better balance and a lower risk of falling in older adults.

Physical Activity in Community-Dwelling Older Adults: Which Real-World Accelerometry Measures Are Robust? A Systematic Review

Measurement of real-world physical activity (PA) data using accelerometry in older adults is informative and clinically relevant, but not without challenges. This review appraises the reliability and validity of accelerometry-based PA measures of older adults collected in real-world conditions. Eight electronic databases were systematically searched, with 13 manuscripts included. Intraclass correlation coefficient (ICC) for inter-rater reliability were: walking duration (0.94 to 0.95), lying duration (0.98 to 0.99), sitting duration (0.78 to 0.99) and standing duration (0.98 to 0.99). ICCs for relative reliability ranged from 0.24 to 0.82 for step counts and 0.48 to 0.86 for active calories. Absolute reliability ranged from 5864 to 10,832 steps and for active calories from 289 to 597 kcal. ICCs for responsiveness for step count were 0.02 to 0.41, and for active calories 0.07 to 0.93. Criterion validity for step count ranged from 0.83 to 0.98. Percentage of agreement for walking ranged from 63.6% to 94.5%; for lying 35.6% to 100%, sitting 79.2% to 100%, and standing 38.6% to 96.1%. Construct validity between step count and criteria for moderate-to-vigorous PA was rs = 0.68 and 0.72. Inter-rater reliability and criterion validity for walking, lying, sitting and standing duration are established. Criterion validity of step count is also established. Clinicians and researchers may use these measures with a limited degree of confidence. Further work is required to establish these properties and to extend the repertoire of PA measures beyond "volume" counts to include more nuanced outcomes such as intensity of movement and duration of postural transitions.

The relationship between physical activity and subjective cognitive decline: Evidence from the behavioral risk factor surveillance system (BRFSS)

BACKGROUND

Studies have shown that subjective cognitive decline (SCD) is a major risk factor for mild cognitive impairment or even dementia, but the relationship between physical activity (PA) and SCD is still unclear. The goal of current study is to address how various physical activities relate to SCD.

METHODS

216,593 adults from the Behavioral Risk Factor Surveillance System (BRFSS) were included in this study. We measured SCD and PA with participants' self-report. With the unconditional logistic regression model, the association between PA and SCD was investigated. We used a four-way decomposition method to explore the mediation roles of depression between PA and SCD. The nearest matching method of propensity score and multinomial propensity score were used to reduce the effects of confounding factors.

RESULTS

Compared with those inactive, the weighted adjusted odds ratios (AORs) of SCD among those who were physically active were <1 (p < 0.005), regardless of the type of PA. The top three PA in weighted AORs were: running (AOR: 0.51, 95 % CI: 0.50-0.52), aerobics exercise (AOR: 0.55, 95 % CI: 0.53-0.56), and weightlifting (AOR: 0.60, 95 % CI: 0.59-0.62). The dose-response relationship between PA and SCD was found. Participants who engaged in PA for 241-300 min per week (AOR: 0.61, 95 % CI: 0.59-0.62) or exercised metabolic equivalent of 801-1000 per week (AOR: 0.62, 95 % CI: 0.62-0.65) had the lowest risk of SCD.

CONCLUSIONS

Regardless of the specific PA types, engaging in PA is associated with a reduced risk of having SCD, and people who engage in running had the lowest risk of SCD. There was a dose-response relationship between PA and SCD, and PA-based interventions should be developed accordingly to prevent cognitive deterioration in older age.

Physical activity assessment with wearable devices in rheumatic diseases: a systematic review and meta-analysis

OBJECTIVES

In the management of rheumatic musculoskeletal disorders (RMDs), regular physical activity (PA) is an important recognized non-pharmacological intervention. This systematic review and meta-analysis aims to evaluate how the use of wearable devices (WDs) impacts physical activity in patients with noninflammatory and inflammatory rheumatic diseases.

METHODS

A comprehensive search of articles was performed in PubMed, Embase, CINAHL and Scopus. A random-effect meta-analysis was carried out on the number of steps and moderate-vigorous physical activity (MVPA). Univariable meta-regression models were computed to assess the possibility that the study characteristics may act as modifiers on the final meta-analysis estimate.

RESULTS

In the analysis, 51 articles were included, with a total of 7488 participants. Twenty-two studies considered MVPA outcome alone, 16 studies considered the number of steps alone, and 13 studies reported information on both outcomes. The recommended PA threshold was reached for MVPA (36.35, 95% CI 29.39, 43.31) but not for daily steps (-1092.60, -1640.42 to -544.77). Studies on patients with fibromyalgia report a higher number (6290, 5198.65-7381.62) of daily steps compared with other RMDs. Patients affected by chronic inflammatory arthropathies seemed to fare better in terms of daily steps than the other categories. Patients of younger age reported a higher overall level of PA than elderly individuals for both the number of steps and MVPA.

CONCLUSION

Physical activity can be lower than the recommended threshold in patients with RMDs when objectively measured using WD. WDs could be a useful and affordable instrument for daily monitoring physical activity in RMDs and may support an increase in activity levels.

PROSPERO TRIAL REGISTRATION

CRD42021227681, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227681.

Grip Strength and Sarcopenia Predict 2-Year Cognitive Impairment in Community-Dwelling Older Adults

OBJECTIVES

Using the Asian Working Group for Sarcopenia (AWGS2019) and the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, this study examined associations of sarcopenia and its components with specific domains of cognitive impairment over time.

DESIGN

A prospective cohort study with a 2-year follow-up.

SETTING AND PARTICIPANTS

This study is part of the Taiwan Initiatives for Geriatric Epidemiological Research (TIGER), which recruited participants aged 65 years old who attended the senior health checkup program at National Taiwan University Hospital (NTUH).

METHODS

Grip strength was measured using a handgrip dynamometer. Walking speed (m/s) was measured as the time required to walk 8 feet. Muscle mass was measured by performing a bioelectrical impedance analysis. Global cognition (assessed using the Taiwanese version of the Montreal Cognitive Assessment) and 4 cognitive domains (memory, executive function, verbal fluency, and attention) were assessed over time. Associations of sarcopenia and its components with cognitive impairment were evaluated after stratification by sex using generalized linear mixed models adjusted for essential covariates for cognitive impairment.

RESULTS

Compared with robust women, those with severe sarcopenia were more likely to have a global cognitive impairment over time (β = -0.87, P = .03 based on AWGS2019 criteria and β = -1.07, P = .02 based on the EWGSOP2 criteria). Among men, low grip strength was associated with poor scores on measures of global cognition (β = -0.80, P = .03), executive function (β = -0.35, P = .001), verbal fluency (β = -0.31, P = .02), and attention (β = -0.34, P = .008) over time.

CONCLUSIONS AND IMPLICATIONS

Severe sarcopenia predicted global and specific domains of cognitive impairment in older adults. Poor grip strength predicted cognitive impairment in men but not in women. A screen for sarcopenia severity and low muscle strength may be used to identify the risk of cognitive impairment.

INFLUENCE OF SEROLOGICAL MARKERS OF BLOOD GROUPS UPON THE DEVELOPMENT OF VISUAL MEMORY IN HIGH SCHOOLERS AND STUDENTS

OBJECTIVE

The aim: To investigate the influence of serological markers of blood groups of the AB0 system upon the development of short-term visual memory in high schoolers and students.

PATIENTS AND METHODS

Materials and methods: The research involved 13-16-year-old high schoolers (boys) (n = 139) who were involved in various sports: group A - speed and strength sports (n = 74); group B - endurance sports (n = 65). The control group consisted of 13-16-year-old high schoolers (n = 106) and 17-20-year-old students (n = 212) who were not engaged in sports. The study of short-term visual memory was conducted using the "Memory for geometric shapes" method.

RESULTS

Results: It was found that high schoolers and students with the 0(I) blood group have the best associative coupling with the properties of short-term visual memory.

CONCLUSION

Conclusions: The use of serological markers of blood groups according to the AB0 system is possible in the genetic prediction of the development of visual memory in high schoolers and students. Herewith, the associative coupling is more pronounced in juvenility than in adolescence.

A Decade Later on How to "Use It" So We Don't "Lose It": An Update on the Unanswered Questions about the Influence of Activity Participation on Cognitive Performance in Older Age

Activity engagement is a modifiable factor that has been widely-cited as being good for the aging brain and cognition and represents a valuable target for reducing dementia risk. However, specific issues about activity engagement (mental, social, and physical) and cognition in older adulthood remain, and Bielak [Gerontology 2010;56: 507-519] reviewed seven major methodological and theoretical questions about this relationship. We present an updated reflection on these key questions, focusing on research published in the last 10 years. For some questions, a significant amount of work has been done and conclusions have become clearer; for others, there have been few additions to the literature and our knowledge remains much the same as it was a decade ago. We review the issues identified in the 2010 paper including the directionality and temporal nature of the relationship; whether specific activity domains offer different benefits to cognition and what domain(s) of cognition are affected; variation in the relation by age, gender, or education; potential mechanisms involved; and how activity engagement is assessed. For each, we present the most up-to-date research, discuss remaining challenges and possible future directions. This formal unifying of the information in the field is intended as a guide to support continued progress by spurring on studies addressing specific questions while reminding researchers of critical issues. We conclude with recommendations that future studies investigating the link between activity engagement and cognitive performance in adulthood should consider.

Accelerometer-Measured Latent Physical Activity Profiles and Neurocognition Among Middle-Aged and Older Hispanic/Latino Adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

OBJECTIVES

Derive latent profiles of accelerometry-measured moderate-vigorous physical activity (MVPA) for Hispanic/Latino adults, examine associations between latent MVPA profiles and neurocognition, and describe profiles via self-reported MVPA.

METHODS

Complex survey design methods were applied to cross-sectional data from 7,672 adults ages 45-74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008-2011). MVPA was measured via hip-worn accelerometers. Latent profile analysis was applied to derive latent MVPA profiles (minutes/day of week). Neurocognition was assessed with the Brief-Spanish English Verbal Learning Test (B-SEVLT) Sum, B-SEVLT Recall, Controlled Oral Word Association Test (word fluency), and Digit Symbol Substitution (DSS) test. All tests were z-scored, and a global neurocognition score was generated by averaging across scores. Survey linear regression models were used to examine associations between latent MVPA profiles and neurocognitive measures. Self-reported MVPA domains were estimated (occupational, transportation, and recreational) for each latent profile.

RESULTS

Four latent MVPA profiles from the overall adult target population (18-74 years) were derived and putatively labeled: No MVPA, low, moderate, and high. Only the high MVPA profile (compared to moderate) was associated with lower global neurocognition. Sensitivity analyses using latent MVPA profiles with only participants aged 45-74 years showed similar profiles, but no associations between latent MVPA profiles and neurocognition. The occupational MVPA domain led in all latent MVPA profiles.

DISCUSSION

We found no consistent evidence to link accelerometry-measured MVPA profiles to neurocognitive function. Research to better characterize the role of high occupational MVPA in relation to neurocognition among Hispanic/Latino adults are needed.

Multi-Component Interventions in Older Adults Having Subjective Cognitive Decline (SCD)-A Review Article

Subjective cognitive decline (SCD) is one of those significant concerns faced by older individuals. Though it is predominantly self-reported, it is not an event that should be overlooked, considering its significant association with cognitive disorders like Alzheimer's disease, mild cognitive impairment, and so on. This makes it imperative to find ways to manage the event to enhance the cognitive performance of older adults and/or suppress the rate at which cognitive decline results in impairment. While multiple interventions have been used for SCD, multi-component non-pharmacological interventions are beginning to gain more attention among researchers. This is due to how such interventions have effectively contributed to improved cognitive performance across different outcome domains. Against this backdrop, this literature review has been conducted to explore the different multi-component non-pharmacological interventions utilized in managing SCD. Papers from databases such as PubMed, Scopus, and EBSCO were retrieved, with relevant data being extracted on the subject matter to address the objective of this review.

Effect of physical activity on the risk of frailty: A systematic review and meta-analysis

OBJECTIVE

The relationship between physical activity (PA) and the risk of frailty has not reached a conclusive result. This systematic review with meta-analysis aimed to evaluate the effect of PA on the onset of frailty in the community-dwelling middle and older age adults by pooling data from cohort studies.

METHODS

A systematic literature search was performed via PubMed, Embase, and Web of Science up to June 01, 2021. Pooled adjusted effect estimates (ES) with 95% confidence interval (CI) were calculated by using the random-effect model and by comparing the highest with lowest levels of PA. Heterogeneity was tested using the I2 statistic and Q-test. The quality of evidence was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

A total of ten cohort studies with 14 records were selected, and the GRADE approach classified the quality of evidence as low. In comparison with the lowest level of PA, the highest level of PA was associated with 41% decreased odds of frailty (ES: 0.59, 95% CI: 0.51-0.67; I2 = 70.0%, P-heterogeneity < 0.001) after pooling results from included studies. In stratified analysis by frailty assessment approach, the highest level of PA was significantly associated with 37% (ES 0.63, 95% CI: 0.52-0.77, 49% (ES: 0.51, 95% CI: 0.41-0.63), and 30% (ES: 0.70, 95% CI: 0.65-0.75) reduced odds of frailty when pooling studies using criteria of physical frailty, multidimensional model, and accumulation of disability, respectively. Stratified analyses further by PA indicators and PA assessment tools yielded similar protective effects in any subgroups.

CONCLUSIONS

This study with moderate-certainty evidence shows that a higher level of PA was associated with lower odds of frailty, and the benefits of PA for frailty prevention were independent of frailty assessment tools, PA indicators, and PA assessment methods. Findings from this study may help implement active exercise strategies to prevent frailty.

Brain insulin resistance and cognitive function: influence of exercise

Exercise has systemic health benefits in people, in part, through improving whole body insulin sensitivity. The brain is an insulin-sensitive organ that is often underdiscussed relative to skeletal muscle, liver, and adipose tissue. Although brain insulin action may have only subtle impacts on peripheral regulation of systemic glucose homeostasis, it is important for weight regulation as well as mental health. In fact, brain insulin signaling is also involved in processes that support healthy cognition. Furthermore, brain insulin resistance has been associated with age-related declines in memory and executive function as well as Alzheimer's disease pathology. Herein, we provide an overview of brain insulin sensitivity in relation to cognitive function from animal and human studies, with particular emphasis placed on the impact exercise may have on brain insulin sensitivity. Mechanisms discussed include mitochondrial function, brain growth factors, and neurogenesis, which collectively help combat obesity-related metabolic disease and Alzheimer's dementia.

Effects of exercise interventions on executive function in old adults with mild cognitive impairment: A systematic review and meta-analysis of randomized controlled trials

AIMS

To assess the effect of exercise interventions on subdomains of executive function (EF) in older adults with mild cognitive impairment (MCI).

METHODS

Nine electronic databases were comprehensively searched from their inception to February 2021. Randomized controlled trials examining the effect of exercise training on EF in MCI were included.

RESULTS

Twenty-four eligible articles involving 2278 participants were identified. The results showed that exercise interventions had positive benefits on working memory, switching and inhibition in MCI. Subgroup analysis based on exercise prescriptions revealed that both aerobatic exercise and mind-body exercise had similar positive effect size on working memory. However, only mind-body exercise had significant effect on switching. Exercise training with moderate frequency (3-4 times/week) had larger effect size than low frequency (1-2 times/week) and only moderate frequency had positive benefits on switching. Both short (4-12 weeks), medium (13-24 weeks) and long (more than 24 weeks) exercise duration significantly ameliorate working memory and switching, however with short duration having slight larger effect sizes than medium and long.

CONCLUSION

Exercise significantly improves three subdomains of EF in MCI, especially mind-body exercise. Exercise training sticking to at least 4 weeks with 3-4 times a week tends to have larger effect size.

Aerobic exercise training and neurocognitive function in cognitively normal older adults: A one-year randomized controlled trial

BACKGROUND

Current evidence is inconsistent on the benefits of aerobic exercise training for preventing or attenuating age-related cognitive decline in older adults.

OBJECTIVE

To investigate the effects of a 1-year progressive, moderate-to-high intensity aerobic exercise intervention on cognitive function, brain volume, and cortical thickness in sedentary but otherwise healthy older adults.

METHODS

We randomized 73 older adults to a 1-year aerobic exercise or stretching-and-toning (active control) program. The primary outcome was a cognitive composite score calculated from eight neuropsychological tests encompassing inductive reasoning, long-term and working memory, executive function, and processing speed. Secondary outcomes were brain volume and cortical thickness assessed by MRI, and cardiorespiratory fitness measured by peak oxygen uptake (VO2 ).

RESULTS

One-year aerobic exercise increased peak VO2 by ∼10% (p < 0.001) while it did not change with stretching (p = 0.241). Cognitive composite scores increased in both the aerobic and stretching groups (p < 0.001 for time effect), although no group difference was observed. Total brain volume (p < 0.001) and mean cortical thickness (p = 0.001) decreased in both groups over time, while the reduction in hippocampal volume was smaller in the stretching group compared with the aerobic group (p = 0.040 for interaction). Across all participants, improvement in peak VO2 was positively correlated with increases in cognitive composite score (r = 0.282, p = 0.042) and regional cortical thickness at the inferior parietal lobe (p = 0.016).

CONCLUSIONS

One-year aerobic exercise and stretching interventions improved cognitive performance but did not prevent age-related brain volume loss in sedentary healthy older adults. Cardiorespiratory fitness gain was positively correlated with cognitive performance and regional cortical thickness.

Effects of exercise intensity and frequency on improving cognitive performance in middle-aged and older adults with mild cognitive impairment: A pilot randomized controlled trial on the minimum physical activity recommendation from WHO

Background: The World Health Organization physical activity guidelines recommend adults and older adults to accumulate at least 150–300 min of moderate or 75–150 min of vigorous aerobic-type physical activity weekly for health benefits including improvements of cognitive performance. However, the optimal exercise intensity and frequency for maximizing the cognitive benefits remain unclear.

Purpose: We conducted a parallel, assessor-blinded, pilot randomized controlled trial to evaluate the effectiveness of different intensities and frequencies of the WHO-recommended minimal volume of aerobic-type physical activity on improving cognitive performance in middle-aged and older adults with mild cognitive impairment (MCI).

Methods: Participants were randomly allocated to the stretching exercise control group (CON), once-a-week and thrice-a-week moderate-intensity walking groups (M1 and M3), and once-a-week and thrice-a-week vigorous-intensity walking groups (V1 and V3). Intervention duration was 12 weeks. The primary outcome was global cognitive performance assessed by the Hong Kong version of Montreal Cognitive Assessment. Secondary outcomes were self-report and objective cognitive performances, mental health, sleep quality, and cardiorespiratory fitness.

Results: Thirty-seven participants completed the study (CON: n = 7, M1: n = 7, M3: n = 7, V1: n = 8, V3: n = 8). Participants in all four walking exercise groups demonstrated significant improvements in global cognitive performance assessed by the Hong Kong version of the Montreal Cognitive Assessment after the intervention when compared to CON (p < 0.001). The walking exercise interventions also significantly mitigated the anxiety severity (p < 0.005) and improved the cardiorespiratory fitness (p < 0.05) of the participants in the walking exercise groups.

Conclusion: 150-min moderate- or 75-min vigorous-intensity walking exercise performed once- or thrice-weekly showed similar effects on improving cognitive performance in middle-aged and older adults with MCI. The 12-week walking exercise interventions also reduced anxiety severity and improved cardiorespiratory fitness of the participants.

Clinical Trial Registration:clinicaltrials.gov, identifier NCT04515563

Physical activity, memory function, and hippocampal volume in adults with Down syndrome

Higher engagement in moderate-intensity physical activity (PA) is related to better cognitive functioning in neurotypical adults; however, little is known about the effect of PA on cognitive aging in adults with Down syndrome (DS). Individuals with DS have three copies of chromosome 21, which includes the gene involved in the production of the amyloid precursor protein, resulting in an increased risk for an earlier onset of Alzheimer’s disease (AD). The goal of this study was to understand the relationship between engagement in moderate PA, memory, and hippocampal volume in adults with DS. Adults with DS participated in an ancillary Lifestyle study linked to the Alzheimer’s Biomarkers Consortium for DS (ABC- DS; N = 71). A within-sample z-score memory composite was created from performance on the Cued Recall Test (CRT) and the Rivermead Picture Recognition Test. Participants wore a wrist-worn accelerometer (GT9X) to measure PA. Variables of interest included the average percentage of time spent in moderate PA and average daily steps. Structural MRI data were acquired within 18 months of actigraphy/cognitive data collection for a subset of participants (n = 54). Hippocampal volume was extracted using Freesurfer v5.3. Associations between moderate PA engagement, memory, and hippocampal volume were evaluated with hierarchical linear regressions controlling for relevant covariates [age, body mass index, intellectual disability level, sex, and intracranial volume]. Participants were 37.77 years old (SD = 8.21) and were 55.6% female. They spent 11.1% of their time engaged in moderate PA (SD = 7.5%) and took an average of 12,096.51 daily steps (SD = 4,315.66). After controlling for relevant covariates, higher memory composite score was associated with greater moderate PA engagement (β = 0.232, p = 0.027) and more daily steps (β = 0.209, p = 0.037). In a subset of participants, after controlling for relevant covariates, PA variables were not significantly associated with the hippocampal volume (all p-values ≥ 0.42). Greater hippocampal volume was associated with higher memory composite score after controlling for relevant covariates (β = 0.316, p = 0.017). More PA engagement was related to better memory function in adults with DS. While greater hippocampal volume was related to better memory performance, it was not associated with PA. Greater PA engagement may be a promising lifestyle behavior to preserve memory in adults with DS.

The effect of two multi-component behavior change interventions on cognitive functions

Background

We previously reported the effects of two cluster-randomized 6-month multi-component workplace interventions, targeting reducing sedentary behavior or increasing physical activity among office workers, on movement behaviors and cardiorespiratory fitness. The primary aim of this study was to investigate the effects of these interventions on cognitive functions compared to a wait-list control group. The secondary aims were to examine if changes in cognition were related to change in cardiorespiratory fitness or movement behaviors and if age, sex, or cardiorespiratory fitness moderated these associations.

Methods

Both interventions encompassed multi-components acting on the individual, environmental, and organizational levels and aimed to change physical activity patterns to improve mental health and cognitive function. Out of 263 included participants, 139 (mean age 43 years, 76% females) completed a neuropsychological test battery and wore accelerometers at baseline and 6-month follow-up. The intervention effect (aim 1) on cognitive composite scores (i.e., Executive Functions, Episodic Memory, Processing Speed, and Global Cognition) was investigated. Additionally, associations between changes in movement behaviors and cardiorespiratory fitness, and changes in cognition were examined (aim 2). Moreover, age, sex, and cardiorespiratory fitness level were investigated as possible moderators of change associations (aim 3).

Results

Overall, cognitive performance improved from baseline to follow-up, but the change did not differ between the intervention groups and the control group. Changes in cardiorespiratory fitness or any movement behavior category did not predict changes in cognitive functions. The association between changes in time in bed and changes in both Executive Function and Global Cognition were moderated by age, such that a more positive relation was seen with increasing age. A less positive association was seen between changes in sedentary behavior and Processing Speed for men vs. women, whereas higher cardiorespiratory fitness was related to a more positive association between changes in moderate-intensity physical activity and Global Cognition.

Conclusion

The lack of an intervention effect on cognitive functions was expected since the intervention did not change movement behavior or fitness. Age, sex, and cardiorespiratory fitness level might moderate the relationships between movement behaviors and cognitive functions changes.

Trial registration

ISRCTN92968402. Registered 09/04/2018.

Impact of physical activity on response to stress in people aged 65 and over during COVID-19 pandemic lockdown

BACKGROUND

The outbreak of the COVID-19 pandemic has negatively affected the lives of many people. In particular, restrictions of physical activity (PA) due to pandemic-related lockdown have impacted their psychological status. The aim of this work was to investigate the relationship between PA habits, before the pandemic and during the lockdown, and responses to stress due to home isolation during the lockdown, in older people.

METHODS

To this aim, an online survey addressed to people aged 65 years and over was conducted during the first pandemic wave in Italy (Study 1). To explore the effect of PA restrictions on responses to stress over time, the survey was replicated during the second wave (Study 2). A group of 72 and 43 participants, from 65 to 88 years, completed the two studies, respectively. The survey required the completion of the International Physical Activity Questionnaire, and of two questionnaires on stress response, namely, the Impact of Event Scale-Revised and the Perceived Stress Scale. The correlation between the questionnaires' scores was examined.

RESULTS

Study 1 demonstrated that higher levels of PA during the lockdown, related to working and walking activities, were associated with fewer stress-related symptoms and lower stress perception. In parallel, greater reduction of PA, during lockdown compared to the pre-pandemic period, was associated with more stress-related symptoms. People who spent more time at rest (sitting) before and during the pandemic lockdown were those who showed higher psychological impact. Study 2 confirmed the benefits of maintaining working activities during lockdown, but also showed that during the second pandemic wave people were more resilient to PA restrictions and home isolation, even if conducting a sedentary lifestyle.

CONCLUSIONS

Maintaining good levels of PA during lockdown was a protective factor against developing stress-related symptoms in older people. On the other hand, more resilient response to stress emerged in this population during the second wave.

Can exercise training teach us how to treat Alzheimer's disease?

Alzheimer's disease (AD) is the most common cause of dementia and there is currently no cure. Novel approaches to treat AD and curb the rapidly increasing worldwide prevalence and costs of dementia are needed. Physical inactivity is a significant modifiable risk factor for AD, estimated to contribute to 12.7% of AD cases worldwide. Exercise interventions in humans and animals have shown beneficial effects of exercise on brain plasticity and cognitive functions. In animal studies, exercise also improved AD pathology. The mechanisms underlying these effects of exercise seem to be associated mainly with exercise performance or cardiorespiratory fitness. In addition, exercise-induced molecules of peripheral origin seem to play an important role. Since exercise affects the whole body, there likely is no single therapeutic target that could mimic all the benefits of exercise. However, systemic strategies may be a viable means to convey broad therapeutic effects in AD patients. Here, we review the potential of physical activity and exercise training in AD prevention and treatment, shining light on recently discovered underlying mechanisms and concluding with a view on future development of exercise-free treatment strategies for AD.

Mid-Life Physical Activity and Late-Life Cognitive Performance among American Indians

INTRODUCTION

Research on factors associated with late-life cognitive performance in diverse racial/ethnic groups is increasingly important due to the growing size and racial diversity of the elder population.

METHODS

Using data on American Indians (AIs) from the Strong Heart Study, we measured associations between mid-life physical activity (PA), assessed by a questionnaire or pedometer, and performance on tests of general cognitive function, phonemic fluency, verbal learning and memory, and processing speed. Cognitive tests were administered 7-21 years after PA measurements. To estimate associations, we used regression models with and without inverse-probability weights to account for potential attrition bias in the cohort.

RESULTS

Questionnaire and pedometer measures of PA were positively associated with cognitive function. Participants in the top quartile of questionnaire-based PA had Modified Mini-Mental State examination scores 3.2 (95% CI: 1.5-4.9) points higher than participants in the lowest quartile. Phonemic fluency scores also trended higher for participants in the top compared to the bottom categories for both PA measures: top questionnaire quartile = 2.7 (95% CI: 0.6-4.8) points higher and top pedometry tertile = 6.7 (95% CI: 2.7-10.7) points higher. We observed no associations between PA and tests assessing verbal learning and memory, or processing speed. Weighted model results were similar, but less precise.

CONCLUSIONS

In this cohort of AIs with relatively low levels of PA, positive associations between mid-life PA and late-life cognitive performance were dose-dependent and of modest clinical significance.

Cognitive Aging and the Promise of Physical Activity

Is the field of cognitive aging irretrievably concerned with decline and deficits, or is it shifting to emphasize the hope of preservation and enhancement of cognitive function in late life? A fragment of an answer comes from research attempting to understand the reasons for individual variability in the extent and rate of cognitive decline. This body of work has created a sense of optimism based on evidence that there are some health behaviors that amplify cognitive performance or mitigate the rate of age-related cognitive decline. In this context, we discuss the role of physical activity on neurocognitive function in late adulthood and summarize how it can be conceptualized as a constructive approach both for the maintenance of cognitive function and as a therapeutic for enhancing or optimizing cognitive function in late life. In this way, physical activity research can be used to shape perceptions of cognitive aging. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Prevalência e incidência de deficit cognitivo em pessoas idosas: associações com atividade física no lazer

Resumo Objetivo Descrever a prevalência e a incidência de deficit cognitivo em pessoas idosas, considerando a presença isolada e conjunta de atividades físicas no lazer, hipertensão arterial sistêmica e obesidade. Igualmente analisar a presença isolada e simultânea de inatividade física, obesidade, hipertensão e deficit cognitivo em dois tempos de medida. Métodos Foi realizado um estudo observacional, analítico e de coorte, baseado nos registros dos bancos de dados da linha de base (2008-2009) e do seguimento (2016-2017) do Estudo Fibra Campinas. Foram realizadas medidas de rastreio de demência, de autorrelato de horas semanais de atividades físicas de no lazer de diferentes intensidades, de hipertensão arterial e de status nutricional, com base no Índice de Massa Corporal (IMC). Resultados Participaram 394 pessoas idosas, 71,8% das quais eram mulheres; 74,4% tinham escolaridade <4 anos; Midade =72,8±5,3 na linha de base e Midade =81,4±4,8 no seguimento. Na linha de base, as condições conjuntas mais prevalentes foram inatividade física e hipertensão (21,5%) e as menos prevalentes, inatividade física, obesidade, hipertensão e deficit cognitivo (0,6%). Foram observadas associações entre deficit cognitivo e inatividade física no seguimento. Idosos inativos na linha de base apresentaram maior razão de incidência de deficit cognitivo no seguimento, ajustada por sexo, idade, escolaridade, estado nutricional e hipertensão (RI=2,27; IC 95%: 1,49-3,45; p<0,001). Conclusão A prevalência e a incidência de deficit cognitivo em idosos refletem a influência de baixo nível de atividade física no lazer na linha de base e no seguimento.