Sedentary behaviours, cognitive function, and possible mechanisms in older adults: a systematic review

Nonlinear Associations of Accelerometer-Based Sedentary Time With Cognitive Functions in the UK Biobank

OBJECTIVES

Device-based sedentary time shows a nonlinear association with incident dementia among older adults. However, associations between sedentary time and cognitive performance have been inconsistent. We examined potential nonlinear associations between sedentary time and performance on cognitive tests among older adults.

METHODS

We used data from the UK Biobank and included 32,875 adults aged 60-79. Sedentary time was estimated from a machine learning-based analysis of 1 week of wrist-worn accelerometer data. The primary outcomes were performance on 6 cognitive tests completed online (fluid intelligence test, short-term numeric memory test, symbol substitution test, visual-spatial memory test, alphanumeric, and numeric trail making tests), as well as a composite cognitive score.

RESULTS

Except for the visual-spatial memory test, nonlinear approaches provided a better fit than linear methods to model the associations of sedentary time with other cognitive outcomes. For these outcomes, segmented regression models showed that, although effect sizes were small, higher sedentary time was associated with better cognitive performance up to a threshold of sedentary time that varied from 9.7 to 12.3 hr per day. Above this threshold, the association between sedentary time and cognitive performance was attenuated toward the null or became negative (for the symbol substitution test only).

DISCUSSION

As accounted by our nonlinear approach, the association between sedentary time and cognitive performance may shift from positive to null or negative above a 10-12-hr threshold among older adults. A combination of device-based and self-report assessments of sedentary behavior is needed to better understand these nonlinear associations.

Weekend sedentary behaviour and cognition three months after stroke based on the exploratory analysis of the CANVAS study

Stroke survivors experience high levels of sedentary behaviour. However, less is known about the variability in weekday-weekend patterns of sedentary behaviour and whether it is linked to cognitive performance. We examined whether there was a difference in weekend and weekday amount of time spent in sedentary and moderate-to-vigorous physical activity (MVPA) at three months post-stroke and whether there was an association between these patterns and cognitive performance at three months. We included ischaemic stroke survivors from the Cognition And Neocortical Volume After Stroke (CANVAS) cohort, with objective physical activity data estimated using the SenseWear® Armband. We compared physical activity levels between 97 stroke survivors (minor severity) and 37 control participants on weekends and weekdays in sedentary and MVPA zones. We then linked these outcomes to cognitive functioning at three months. While both stroke and control groups had a comparable decrease in MVPA on weekends compared to weekdays, we observed a significant increase in sedentary activity [55 min on average (95% Confidence Interval 77 - 33) with a small effect size - partial eta squared = 0.036)] on weekends in the stroke group but not in controls. When we compared two groups of stroke participants 'more sedentary' vs. 'less sedentary'-based on weekend activity, we observed a higher proportion of stroke survivors classified as cognitively impaired vs. cognitively normal in the 'more sedentary' group. Further analysis showed the groups differed significantly on their cognitive performance, especially in the memory domain. There is a significant difference in the amount of sedentary behaviour, but not MVPA, on weekends vs. weekdays in the stroke group. Furthermore, we demonstrate that a higher amount of sedentary activity on the weekend is associated with worse cognitive performance at three months, especially on memory tasks. These results are exploratory but suggest that decreasing sedentary behaviour, especially on the weekend, could be specifically investigated as a therapeutic target to maintain better cognition after stroke.

Rest-activity rhythm and cognitive function in older adults: A scoping review and integrative framework

Rest-activity rhythm (RAR) encompasses sleep, activity, and rest across a 24-hour cycle and over time (i.e., peak activity timing, mean activity level, activity amplitude, and rhythmicity). While the link between sleep, exercise, and cognitive function is established, the specific relationship between RAR and cognitive function in older adults remains unclear. This review synthesizes the literature on RAR and cognition, identifying 26 eligible studies from databases including PubMed, CINAHL, PsycINFO, and Web of Science. Although it was difficult to draw definitive conclusions due to the limited number of available studies focusing on each of cognitive domain and methodological heterogeneity among them, the collective findings broadly indicate that later peak activity timing, higher mean activity levels, higher activity amplitude, and more stable rhythmicity were associated with better global cognition. Future research with larger, diverse samples, more accurate RAR and cognition measurements, and incorporating biomarkers will provide deeper insights into these relationships.

Effects of Physical Exercise Breaks on Executive Function in a Simulated Classroom Setting: Uncovering a Window into the Brain

Acknowledging the detrimental effects of prolonged sitting, this study examined the effects of an acute exercise break during prolonged sitting on executive function, cortical hemodynamics, and microvascular status. In this randomized crossover study, 71 college students completed three conditions: (i) uninterrupted sitting (SIT); (ii) SIT with a 15 min moderate-intensity cycling break (MIC); and (iii) SIT with a 15 min vigorous-intensity cycling break (VIC). Behavioral outcomes, retinal vessel diameters (central retinal artery equivalents [CRAE], retinal vein equivalents [CRVE], arteriovenous ratio [AVR]), cortical activation, and effective connectivity were evaluated. Linear mixed models identified significant positive effects of exercise conditions on behavioral reaction time (RT), error rate, and inverse efficiency score (β = -2.62, -0.19, -3.04: ps < 0.05). MIC and VIC conditions produced pre-to-post-intervention increases in CRAE and CRVE (β = 4.46, 6.34), frontal activation, and resting-state and task-state causal density (β = 0.37, 0.06) (ps < 0.05) compared to SIT; VIC was more beneficial for executive function and neurobiological parameters. The effect of AVR on average RT was mediated through task-based causal density (indirect effect: -0.82). Acutely interrupting prolonged sitting improves executive function, microvascular status, and cortical activation and connectivity, with causal density mediating the microvascular-executive function link.

Effects of reducing sedentary behaviour by increasing physical activity, on cognitive function, brain function and structure across the lifespan: a systematic review and meta-analysis

OBJECTIVE

To examine the acute and chronic effects of reducing prolonged sedentary time (ST) with physical activity (PA) on cognitive and brain health.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed, Scopus, CINAHL, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertation and Theses.

ELIGIBILITY CRITERIA

Randomised controlled trials (RCTs) published from inception to 17 June 2024, with healthy participants without cognitive impairment or neurological conditions that affect cognitive functioning, aged ≥4 years, testing acute and chronic effects of reducing ST and/or prolonged ST by reallocating ST to PA on cognitive function, brain function, and structure.

RESULTS

We included 25 RCTs (n=1289) investigating acute (21 studies) and chronic (4 studies) effects on cognitive function (acute: n=20, chronic: n=4) and brain function (acute: n=7, chronic: n=1); there were no studies on brain structure. Acutely interrupting continuous ST with either multiple or a single PA bout improved cognitive function measured from 3 hours to three consecutive days based on 91 effect sizes (g=0.17, 95% CI: 0.05 to 0.29, p=0.005, I 2=45.5%). When comparing single versus multiple PA bouts, only multiple PA bouts yielded a positive effect on cognitive function based on 72 effect sizes (g=0.20, 95% CI: 0.06 to 0.35, p=0.006; I 2=48.8%). Chronic studies reported null findings on cognitive function (n=4), with some evidence of improved neural efficiency of the hippocampus (n=1).

CONCLUSION

Interrupting ST with PA acutely improves cognitive function. The evidence from chronic studies remains inconclusive.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020200998.

The Combined Impact of Physical Activity and Sedentary Behavior on Executive Functions in Older Adults: A Cross-Sectional Study

Background

The interplay between physical activity (PA) and sedentary behavior (SB) significantly influences cognitive health in older adults, with executive functions (EFs) being particularly vulnerable to lifestyle factors. However, previous research on older adults focused mainly on PA and is limited due to the lack of comprehensive consideration of other factors that influence EFs. Current guidelines suggest an association between sedentary behavior (SB) and EFs, yet few studies have examined the combined effects of PA and SB on EFs.

Objective

This cross-sectional study aimed to explore the relationship between PA, SB, and EFs in older adults.

Methods

A total of 116 healthy older adults aged ≥65 years were recruited and categorized into four groups based on activity lifestyles: higher PA and higher SB (PHSH); higher PA and lower SB (PHSL); lower PA and higher SB (PLSH); and lower PA and lower SB (PLSL). EFs were assessed using the Tower of London (TOL) task and the Stroop test, which measure high-order EFs (planning and problem-solving) and core EFs (inhibitory control), respectively.

Results

The PHSL group performed better on the TOL task, with lower total move scores and shorter total problem-solving times, compared to the PLSH group. The total move score of the PLSL group was better, and the total problem-solving time of the PHSH group was shorter than those of the PLSH group. However, the Stroop test scores did not differ between the four groups.

Conclusion

These findings suggest that increasing PA or reducing SB selectively enhances executive functions, particularly in planning and problem-solving, while less impacting inhibitory control in older adults. This highlights the importance of considering the nuanced effects of PA and SB on different aspects of executing functioning in older adults.

Associations of Cognitively Active Versus Passive Sedentary Behaviors and Cognition in Older Adults

BACKGROUND

Cognitively stimulating sedentary behavior (SB) may positively impact cognition. This study aimed to (1) describe participation across types of SB among older adults with and without cognitive impairment and (2) examine how baseline SB participation impacts cognition, longitudinally.

METHODS

We used National Health and Aging Trends Study data from rounds 6 to 11 for cross-sectional and longitudinal analyses. Participants were 2244 community-dwelling older adults who were selected for the SB module in round 6. The SBs were categorized as active (eg, hobbies) and passive (eg, television). Participants were also categorized as having intact or impaired orientation, memory, and executive function based on tests of orientation, recall, and the clock-drawing test. We calculated descriptive statistics characterizing SB by cognitive status. Aim 2 involved competing risks proportional hazard models of participants with intact cognition (n = 1574) to identify associations between baseline SB and changes in cognition, moves to institutional care, and death over 6 years.

RESULTS

Participants (40% ≥ 80 years, 55% female, 77% White non-Hispanic) averaged 8.75 (SD = 4.42) hours of daily SB, including 4.05 (SD = 2.32) hours of passive SB and 4.75 (SD = 3.13) hours of active SB. Active SB >3 hours per day was associated with a lower risk of impaired orientation (subdistribution hazard models = 0.60; P = .048) and memory (subdistribution hazard models = 0.62; P = .02). Baseline participation in passive SB did not impact the risk of having a change in cognition during rounds 7 to 11.

CONCLUSION

Cognitive decline was lower among older adults who participated in more active SB. Thus, type of SB should be considered in examining the impact on cognition.

Association of 24-Hour movement behavior and cognitive function in older Taiwanese adults

OBJECTIVES

This study investigates how 24-hour movement behaviors (physical activity, sedentary time, sleep) relate to cognitive performance in older adults.

METHODS

213 adults (aged 65+) wore accelerometers to track activity. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Isotemporal substitution analysis examined how replacing one behavior with another affected cognition.

RESULTS

Increased light physical activity was linked to better cognitive function, whereas longer sleep had a negative impact. Replacing 30 min of sedentary behavior or sleep with light physical activity improved orientation, attention, language, and short-term memory. Substituting moderate-to-vigorous physical activity did not have the same cognitive benefit.

CONCLUSION

Encouraging older adults to replace sedentary time or excess sleep with light physical activity could support cognitive health and potentially help prevent dementia. These findings have implications for public health strategies promoting cognitive well-being in aging populations.

Can physical activity counteract the negative effects of sedentary behavior on the physical and mental health of children and adolescents? A narrative review

Background

The increase in sedentary behavior (SB) in children and adolescents is one of the major threats to global public health, and the relationship between physical activity (PA) and SB has always been a key topic.

Methods

The literature search was conducted through PubMed, Web of Science, CNKI, Wanfang, and Scopus, and 121 pieces of literature were included in this study after screening and evaluation.

Results

(1) SB caused by screen time such as mobile phones and TVs has varying degrees of negative impact on obesity, cardiovascular metabolism, skeletal muscle development, and cognitive, and psychological disorders in children and adolescents. (2) Regular physical activity could effectively prevent, offset, or improve the harm of SB to the physical and mental health of children and adolescents, mainly by reducing the incidence of obesity, and cardiovascular and metabolic risks, promoting skeletal muscle development, and improving cognitive function and mental health. (3) The mechanism of physical activity to prevent or ameliorate the harm of SB was relatively complex, mainly involving the inhibition or activation of neurobiomolecules, the improvement of blood and cell metabolic factors, and the enhancement of brain functional connectivity.

Conclusions

Children and adolescents should avoid excessive SB, and through a variety of moderate to vigorous physical activity (MVPA) to replace or intermittent SB, which could effectively prevent or improve the harm of SB to physical and mental health.

Sit less and move more! A cross-sectional study of the associations between physical activity and sedentary behaviors with inhibitory control in Brazilian adults

OBJECTIVE

To investigate the independent and joint associations between sedentary behaviors (SB) and physical activity (PA) with inhibitory control (IC) in adults.

METHODS

A total of 111 participants (median age = 30 years; 60% women), completed the Stroop Color-Words test to assess IC. They also wore accelerometers for seven days to measure SB, light PA, moderate-to-vigorous PA (MVPA), and daily steps. We previously set cutoff points for SB and PA measurements and tested them to determine their association with IC. All analyses were adjusted for potential confounding factors including age, gender, post-secondary education, income, body mass index, and accelerometer wear time.

RESULTS

Low SB, high MVPA, and high daily steps were independently associated with a better IC compared to their respective counterparts. Adults with low levels of SB and light PA demonstrated better IC performance (β = -227.67, 95%CI = -434.14 to -21.20) compared to those with high SB and low light PA. Conversely, individuals with high SB and high light PA exhibited worse performance (β = 126.80, 95%CI = 2.11 to 251.50) than those in the high SB and low light PA group. Furthermore, the joint association of low SB with high MVPA (β = -491.12, 95%CI = -689.23 to -293.01) or low SB with high daily steps (β = -254.29, 95%CI = -416.41 to -92.16) demonstrated better IC performance compared to those with high SB and low MVPA or low daily steps.

CONCLUSION

Our findings highlight independent and joint associations between low SB, high MVPA, and high daily steps with enhanced IC in adults.

Physical activity, sedentary behaviour, and cognitive function among older adults: A bibliometric analysis from 2004 to 2024

Because of population ageing, there will be a vast increase in the prevalence of cognitive decline and dementia. Physical activity and sedentary behaviour have been identified as modifiable lifestyle behaviours associated with these cognitive conditions. Therefore, the aim of this bibliometric analysis is to reveal the knowledge structure of the field of physical activity, sedentary behaviour, and cognitive function among older adults from 2004 to 2024, and to predict emerging research trends. A total of 1290 publications were retrieved from the Web of Science Core Collection. CiteSpace and VOSviewer were applied to conduct performance analysis, science mapping, and enrichment. T. Liu-Ambrose was the most prolific author (39 publications), and the University of British Columbia was the most prolific institution (48 publications). The USA, China, and Canada were the three most productive countries with 392, 174, and 136 publications respectively. Two research trends revealed the knowledge structure of this field, including the shift from evaluating the effectiveness of interventions on cognitive function to evaluating the effectiveness of interventions on other health-related outcomes, as well as an expansion of research on the role of physical activity and sedentary behaviour in the context of healthy ageing. Sleep, sedentary behaviour, and virtual reality may be emerging research trends and may predict directions for future research. Collectively, this bibliometric analysis provides a one-step overview of the knowledge structure in this field for researchers and other stakeholders, as well as a reference for future research.

From "online brains" to "online lives": understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions

In response to the mass adoption and extensive usage of Internet-enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the "online brain". Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued to grow. Furthermore, the research evidence on the ways in which Internet usage affects the human mind has advanced considerably. In this paper, we sought to draw upon the latest data from large-scale epidemiological studies and systematic reviews, along with randomized controlled trials and qualitative research recently emerging on this topic, in order to now provide a multi-dimensional overview of the impacts of Internet usage across psychological, cognitive and societal outcomes. Within this, we detail the empirical evidence on how effects differ according to various factors such as age, gender, and usage types. We also draw from new research examining more experiential aspects of individuals' online lives, to understand how the specifics of their interactions with the Internet, and the impact on their lifestyle, determine the benefits or drawbacks of online time. Additionally, we explore how the nascent but intriguing areas of culturomics, artificial intelligence, virtual reality, and augmented reality are changing our understanding of how the Internet can interact with brain and behavior. Overall, the importance of taking an individualized and multi-dimensional approach to how the Internet affects mental health, cognition and social functioning is clear. Furthermore, we emphasize the need for guidelines, policies and initiatives around Internet usage to make full use of the evidence available from neuroscientific, behavioral and societal levels of research presented herein.

Sedentary behavior and lifespan brain health

Higher levels of physical activity are known to benefit aspects of brain health across the lifespan. However, the role of sedentary behavior (SB) is less well understood. In this review we summarize and discuss evidence on the role of SB on brain health (including cognitive performance, structural or functional brain measures, and dementia risk) for different age groups, critically compare assessment approaches to capture SB, and offer insights into emerging opportunities to assess SB via digital technologies. Across the lifespan, specific characteristics of SB (particularly whether they are cognitively active or cognitively passive) potentially act as moderators influencing the associations between SB and specific brain health outcomes. We outline challenges and opportunities for future research aiming to provide more robust empirical evidence on these observations.

Cross-sectional associations between 24-hour time-use composition, grey matter volume and cognitive function in healthy older adults

BACKGROUND

Increasing physical activity (PA) is an effective strategy to slow reductions in cortical volume and maintain cognitive function in older adulthood. However, PA does not exist in isolation, but coexists with sleep and sedentary behaviour to make up the 24-hour day. We investigated how the balance of all three behaviours (24-hour time-use composition) is associated with grey matter volume in healthy older adults, and whether grey matter volume influences the relationship between 24-hour time-use composition and cognitive function.

METHODS

This cross-sectional study included 378 older adults (65.6 ± 3.0 years old, 123 male) from the ACTIVate study across two Australian sites (Adelaide and Newcastle). Time-use composition was captured using 7-day accelerometry, and T1-weighted magnetic resonance imaging was used to measure grey matter volume both globally and across regions of interest (ROI: frontal lobe, temporal lobe, hippocampi, and lateral ventricles). Pairwise correlations were used to explore univariate associations between time-use variables, grey matter volumes and cognitive outcomes. Compositional data analysis linear regression models were used to quantify associations between ROI volumes and time-use composition, and explore potential associations between the interaction between ROI volumes and time-use composition with cognitive outcomes.

RESULTS

After adjusting for covariates (age, sex, education), there were no significant associations between time-use composition and any volumetric outcomes. There were significant interactions between time-use composition and frontal lobe volume for long-term memory (p = 0.018) and executive function (p = 0.018), and between time-use composition and total grey matter volume for executive function (p = 0.028). Spending more time in moderate-vigorous PA was associated with better long-term memory scores, but only for those with smaller frontal lobe volume (below the sample mean). Conversely, spending more time in sleep and less time in sedentary behaviour was associated with better executive function in those with smaller total grey matter volume.

CONCLUSIONS

Although 24-hour time use was not associated with total or regional grey matter independently, total grey matter and frontal lobe grey matter volume moderated the relationship between time-use composition and several cognitive outcomes. Future studies should investigate these relationships longitudinally to assess whether changes in time-use composition correspond to changes in grey matter volume and cognition.

Association between accelerometry measured patterns of sedentary behaviors and functional status in older adults

BACKGROUND

Older adults are highly sedentary, and too much sedentary behavior (SB) is associated with negative health effects, but little is known about SB patterns and their associations with functional status.

AIMS

To examine the association between objectively measured sedentary behavior time (SBT) and sedentary behavior fragmentation (SBF) and functional status in older adults using the National Health Aging Trends Study (NHATS) dataset, a nationally representative sample from 2021.

METHODS

Data from NHATS were analyzed using weighted linear regressions to examine the association between objective measures of SBT (mean hours spent in SB/day during waking hours) and SBF, and six functional variables (difficulties with activities of daily living [ADL], short physical performance battery, hand grip strength, immediate word recall, delayed word recall, and mental health), accounting for sociodemographic, body mass index, and the number of chronic conditions.

RESULTS

A total of 738 individuals from the NHATS were included. Higher SBT was associated with greater difficulties with ADL, poorer short physical performance battery and hand grip strength, lower scores in both immediate and delayed word recall, and poorer mental health. Higher SBF was associated with fewer difficulties with ADL, better short physical performance battery and hand grip strength, a higher score in immediate word recall, and better mental health.

DISCUSSIONAND CONCLUSIONS

Greater fragmentation of SB was associated with better function, and increasing SBF may be a useful strategy for mitigating the effects of SB in older adults, but prospective research is needed to support this approach.

Changes in physical activity, sedentary behavior, and self-reported cognitive function in cancer survivors before and during the COVID-19 pandemic: A cross-sectional study

BACKGROUND

Physical activity (PA) and reductions in sedentary behavior (SED) may mitigate cancer-related cognitive impairment. The purpose of this study was to examine (a) the associations between changes in PA, SED, and cognitive function in cancer survivors before and during the coronavirus disease 2019 (COVID-19) pandemic; and (b) clinical subgroups that moderate this association.

METHODS

A cross-sectional survey was administered online to adult cancer survivors globally between July and November of 2020. This was a secondary analysis of a cross-sectional survey examining changes in self-reported PA and quality of life in cancer survivors before and during the COVID-19 pandemic. Self-reported Questionnaires assessed moderate-to-vigorous PA (MVPA) using the modified Godin Leisure Time Exercise Questionnaire, cognitive function using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) scale, and SED using the Domain-specific Sitting Time questionnaire. Cancer survivors were classified into no change in behavior, desirable change (i.e., increase MVPA to meet PA guidelines or decrease SED by ≥60 min/day), and undesirable change (i.e., decrease MVPA to <150 min/week or increase SED by ≥60 min/day). Analysis of covariance examined differences in FACT-Cog scores across the activity change categories. Planned contrasts compared differences in FACT-Cog scores between cancer survivors with (a) no meaningful change vs. any change, and (b) a desirable change vs. an undesirable change.

RESULTS

There were no significant differences in FACT-Cog scores across activity-change categories in the full sample of cancer survivors (n = 371; age = 48.6 ± 15.3 years (mean ± SD)). However, cancer survivors who were diagnosed ≥5 years ago (t(160) = -2.15, p = 0.03) or who received treatment ≥5 years ago (t(102) = -2.23, p = 0.03) and who had a desirable change in activity reported better perceived cognitive abilities than those who had an undesirable change.

CONCLUSION

PA promotion efforts should consider reducing SED in addition to maintaining MVPA in long-term cancer survivors to mitigate cancer-related cognitive impairment during the COVID-19 pandemic.

Association between napping and cognitive impairment: A systematic review and meta-analysis

STUDY OBJECTIVES

Increasing evidence suggests that napping is associated with cognitive impairment and dementia, but the conclusions are inconsistent. Moreover, the extent of the risk is uncertain. We therefore conducted a systematic review and meta-analysis to quantify the connection between napping and cognitive impairment.

METHODS

We performed a systematic search of PubMed, EMBASE, Web of Science, and Cochrane Library for studies that were published up to June 2023, and assessed associations between napping and cognitive impairment. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as the effect sizes for all studies. Heterogeneity and potential publication biases were assessed.

RESULTS

A total of 4535 papers were retrieved, with 20 reports assessing the relationships between napping and cognitive impairment. Pooled analysis indicated that napping was associated with dementia (OR = 1.14; 95% CI: 1.07-1.21). Importantly, we found that those napping longer than 30, 45, and 60 min/day were 35%, 41%, and 40%, respectively, more likely to have an increased risk of cognitive impairment (30 min: OR = 1.35; 95% CI: 1.24-1.48; 45 min: OR = 1.41; 95% CI: 1.27-1.58; 60 min: OR = 1.40; 95% CI: 1.26-1.56). North America and Europe showed that associations existed between napping and cognitive impairment (North America: OR = 1.15; 95% CI: 1.04-1.27; Europe: OR = 1.13; 95% CI: 1.08-1.18).

CONCLUSIONS

This meta-analysis indicated associations between long napping durations and cognitive impairment or dementia, suggesting that longer napping might be a potential risk factor of adverse cognitive outcomes.

Domains of Sedentary Behavior and Cognitive Function: The Health, Aging, and Body Composition Study, 1999/2000 to 2006/2007

BACKGROUND

This study examines the relationship between various domains of sedentary behavior and subsequent cognitive function to evaluate whether different sedentary activities have specific associations with future cognitive performance.

METHODS

Data were from 1 261 older adults participating in the Health, Aging, and Body Composition (Health ABC) Study between 1999/2000 and 2006/2007. Total sitting time (hours/day), reading time (hours/week), and TV time (≤27/≥28 h/wk) were self-reported at baseline and 3 years later. At follow-up, cognitive function was evaluated using the Teng Mini-Mental State Examination (3MS) and the Digit Symbol Substitution Test (DSST). Multivariable linear regression modeling examined the independent associations of baseline sedentary behaviors and 3-year change in those behaviors with cognitive function scores at follow-up, adjusting for important covariables.

RESULTS

Baseline total sitting time was positively associated with 3MS (β = 0.14 ± 0.07; p < .05) and DSST (β = 0.20 ± 0.10; p < .05) scores at follow-up, as was reading time (β = 0.09 ± 0.03; p < .05 for 3MS score and β = 0.14 ± 0.04; p < 0.01 for DSST score). Participants who increased their TV watching time over 3 years had a significantly lower 3MS score (β = -1.45 ± 0.71; p < .05) at follow-up, compared with those who maintained a low level of TV time (referent). These findings were independent of age, sex, race, education level, health status, depressive symptoms, and physical activity.

CONCLUSION

Some types of sedentary behavior may have benefits for cognitive function in older age, thus highlighting the importance of measuring different domains of sitting time.

Differentiating the influence of sedentary behavior and physical activity on brain health in late adulthood

Public health messaging calls for individuals to be more physically active and less sedentary, yet these lifestyle behaviors have been historically studied independently. Both physical activity (PA) and sedentary behavior (SB) are linked through time-use in a 24-hour day and are related to health outcomes, such as neurocognition. While the benefits of PA on brain health in late adulthood have been well-documented, the influence of SB remains to be understood. The purpose of this paper was to critically review the evolving work on SB and brain health in late adulthood and emphasize key areas of consideration to inform potential research. Overall, the existing literature studying the impact of SB on the components and mechanisms of brain health are mixed and inconclusive, provided largely by cross-sectional and observational work employing a variety of measurement techniques of SB and brain health outcomes. Further, many studies did not conceptually or statistically account for the role of PA in the proposed relationships. Therefore, our understanding of the way in which SB may influence neurocognition in late adulthood is limited. Future efforts should include more prospective longitudinal and randomized clinical trials with intentional methodological approaches to better understand the relationships between SB and the brain in late adulthood, and how these potential links are differentiated from PA.

The Quiet Epidemic: An Overview of Emerging Qualitative Research Trends on Sedentary Behavior in Aging Populations

Sedentary behavior poses a significant health risk to older adults. The purpose of this scoping review is to summarize key findings from qualitative research (since 2012), with a focus on explaining prevailing research trends and patterns within the field. This review included 25 studies that met the strict inclusion criteria. Five key research themes have emerged: (1) defining and shaping perspectives of sedentary behavior, (2) understanding the dynamics of daily routines and contexts, (3) raising awareness of older adults' perceived advantages and disadvantages of sedentary behavior, (4) identifying its determinants and discouraging factors, and (5) exploring interventions to promote active behaviors and reduce sedentary behavior. These themes highlight the multifaceted nature of SB and underscore the importance of tailoring interventions to address individual, social, and environmental issues. A comprehensive understanding of SB is critical to developing effective strategies to promote active lifestyles and reduce SB in older adults. Further qualitative research is needed to deepen our understanding and develop targeted interventions and strategies.

Sociodemographic, Behavioural, and Health Factors Associated with Sedentary Behaviour in Community-Dwelling Older Adults: A Nationwide Cross-Sectional Study

Few studies have focused on factors associated with sedentary behaviour among older Asian adults. This study aimed to identify factors independently associated with prolonged sedentary times in Korean older adults. We included 8273 community-dwelling older adults aged ≥65 years who participated in the Korean National Health and Nutrition Examination Survey. Self-reported sedentary times were assessed via the Global Physical Activity Questionnaire, and sedentary times of ≥420 min/day were considered 'long'. Complex-sample multivariable-adjusted logistic regression analyses were conducted to investigate the factors associated with long sedentary times. Among the participants, 4610 (55.72%) had long sedentary times that were associated with advanced age (odds ratio [OR], 2.49; 95% confidence interval [CI], 2.05-3.01), female sex (OR, 1.32; 95% CI, 1.11-1.57), unemployment (OR, 1.23; 95% CI, 1.09-1.38), living alone (OR, 1.24; 95% CI, 1.08-1.43), urban residence (OR, 1.35; 95% CI, 1.14-1.61), and insufficient aerobic exercise (OR, 1.80; 95% CI, 1.60-2.02). Among health factors, obesity (OR, 1.27; 95% CI, 1.12-1.45), diabetes (OR, 1.17; 95% CI, 1.04-1.32), cardiovascular diseases (OR, 1.30; 95% CI, 1.11-1.52), and arthritis (OR, 1.26; 95% CI, 1.11-1.43) had positive associations with long sedentary times. A tailored approach that considered various sociodemographic, behavioural, and health factors is needed to reduce sedentary behaviour in this population.

Analysis of the 24-h activity cycle: An illustration examining the association with cognitive function in the Adult Changes in Thought study

The 24-h activity cycle (24HAC) is a new paradigm for studying activity behaviors in relation to health outcomes. This approach inherently captures the interrelatedness of the daily time spent in physical activity (PA), sedentary behavior (SB), and sleep. We describe three popular approaches for modeling outcome associations with the 24HAC exposure. We apply these approaches to assess an association with a cognitive outcome in a cohort of older adults, discuss statistical challenges, and provide guidance on interpretation and selecting an appropriate approach. We compare the use of the isotemporal substitution model (ISM), compositional data analysis (CoDA), and latent profile analysis (LPA) to analyze 24HAC. We illustrate each method by exploring cross-sectional associations with cognition in 1,034 older adults (Mean age = 77; Age range = 65-100; 55.8% female; 90% White) who were part of the Adult Changes in Thought (ACT) Activity Monitoring (ACT-AM) sub-study. PA and SB were assessed with thigh-worn activPAL accelerometers for 7-days. For each method, we fit a multivariable regression model to examine the cross-sectional association between the 24HAC and Cognitive Abilities Screening Instrument item response theory (CASI-IRT) score, adjusting for baseline characteristics. We highlight differences in assumptions and the scientific questions addressable by each approach. ISM is easiest to apply and interpret; however, the typical ISM assumes a linear association. CoDA uses an isometric log-ratio transformation to directly model the compositional exposure but can be more challenging to apply and interpret. LPA can serve as an exploratory analysis tool to classify individuals into groups with similar time-use patterns. Inference on associations of latent profiles with health outcomes need to account for the uncertainty of the LPA classifications, which is often ignored. Analyses using the three methods did not suggest that less time spent on SB and more in PA was associated with better cognitive function. The three standard analytical approaches for 24HAC each have advantages and limitations, and selection of the most appropriate method should be guided by the scientific questions of interest and applicability of each model's assumptions. Further research is needed into the health implications of the distinct 24HAC patterns identified in this cohort.

Associations between Sedentary Duration and Cognitive Function in Older Adults: A Longitudinal Study with 2-Year Follow-Up

OBJECTIVES

This study aimed to investigate the association between different forms of sedentary behavior and cognitive function in Chinese community-dwelling older adults.

DESIGN

A longitudinal study with a 2-year follow-up.

SETTING AND PARTICIPANTS

Data from 5356 participants at baseline and 956 participants at the follow-up of the Anhui Healthy Longevity Survey (AHLS) were analysed.

MEASUREMENTS

Cognitive function was evaluated by the Mini-Mental State Examination (MMSE), and mild cognitive impairment (MCI) was classified according to education-specific criteria. Self-report questionnaires were used to assess the sedentary behavior of the participants.

RESULTS

The participants who reported longer screen-watching sedentary duration had higher MMSE scores (1-2 hours: β=0.758, 95% CI: 0.450, 1.066; > 2 hours: β=1.240, 95% CI: 0.917, 1.562) and lower likelihoods of MCI (1-2 hours: OR= 0.787, 95% CI: 0.677, 0.914; >2 hours: OR=0.617, 95% CI: 0.524, 0.726). The participants who had played cards (or mahjong) sedentary had higher MMSE scores (β= 1.132, 95% CI: 0.788, 1.476) and lower likelihoods of MCI (OR=0.572, 95% CI: 0.476, 0.687). However, the participants who reported longer other forms of sedentary duration had lower MMSE scores (1-2 hours: β=-0.409, 95% CI: -0.735, -0.082; > 2 hours: β=-1.391, 95% CI: -1.696, -1.087) and higher likelihoods of MCI (1-2 hours: OR=1.271, 95% CI: 1.081, 1.496; > 2 hours: OR=1.632, 95% CI: 1.409, 1.889). No significant association was detected between sedentary duration and MCI incidence.

CONCLUSION

Variations in the impact of diverse sedentary behaviors on the cognitive function were detected in Chinese older adults. However, such associations were cross-sectional and longitudinal associations were not found in the current study.

Association between Sedentary Behavior and Cognitive Performance in Middle-Aged and Elderly Adults: Cross-Sectional Results from ELSA-Brasil

BACKGROUND

This study aimed to verify the association between Sedentary Behavior (SB) and performance on cognitive function tests in middle-aged and elderly adults.

METHODS

This cross-sectional study included 6505 participants (55.2% women) of ELSA-Brasil, with a median age of 61 years. The different types of SB considered were sitting time and screen time. The scores obtained in the memory, language, and executive function tests were used to assess cognitive performance (CP). The association between SB and CP was assessed using linear regression.

RESULTS

For men, sitting time was associated with better performance in memory, language, and executive function tests. Screen time on the weekend, showed a favorable association with performance in the executive function test. Occupational screen time on weekdays was positively associated with language test performance. For women, sitting time and occupational screen time were positively associated with performance on memory tests. SB was favorably associated with performance in language tests and executive function tests.

CONCLUSIONS

SB seems to favor CP in this population without evident dementia and with a high level of education. The type of SB (mentally active or passive) and the schooling seem to be of particular interest for cognitive performance.

Effects of reducing sedentary behaviour duration by increasing physical activity, on cognitive function, brain function and structure across the lifespan: a systematic review protocol

INTRODUCTION

Greater engagement in sedentary behaviours has been related to poorer cognitive functions in epidemiological research. However, the effects of reducing sedentary behaviour duration on cognitive function, brain function, and structure remain poorly understood. This systematic review aims to synthesise the evidence on the effects of reducing sedentary behaviour duration by increasing time spent in physical activity on cognitive function, brain structure and function in apparently healthy children, adolescents and adults.

METHODS AND ANALYSIS

The protocol follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search will be conducted (search dates: August-September 2022) across six databases: PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (via EBSCO Host), PsycINFO (via ProQuest), SPORTDiscus and Web of Science (Science and Social Science Citation Index). The inclusion criteria are as follows: randomised and non-randomised experimental studies as defined by the Cochrane Handbook, published in English, in peer-reviewed journals, and as theses or dissertations. References of included papers will be screened for additional studies. Acute and chronic interventions targeting children (≥ 4 years), adolescents, younger adults (≥ 18-40 years), middle-aged (40-64 years) and older adults (65+ years) will be eligible. Methodological quality will be assessed with the Effective Public Health Practice Project quality assessment tool for quantitative studies. Qualitative synthesis will be stratified by intervention type (acute vs chronic), intervention content (reducing sedentary time or interrupting prolonged sitting) and outcome (cognitive, brain structure and function).

ETHICS AND DISSEMINATION

No primary data collection will be conducted as part of this systematic review. Study findings will be disseminated through peer-reviewed publications, conference presentations and social media.

PROSPERO REGISTRATION NUMBER

CRD42020200998.

Total Sedentary Time and Cognitive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-analysis

Background

An estimated 47 million people have dementia globally, and around 10 million new cases are diagnosed each year. Many lifestyle factors have been linked to cognitive impairment; one emerging modifiable lifestyle factor is sedentary time.

Objective

To conduct a systematic review and meta-analysis of peer-reviewed literature examining the association between total sedentary time with cognitive function in middle-aged and older adults under the moderating conditions of (a) type of sedentary time measurement; (b) the cognitive domain being assessed; (c) looking at sedentary time using categorical variables (i.e., high versus low sedentary time); and (d) the pattern of sedentary time accumulation (e.g., longer versus shorter bouts). We also aimed to examine the prevalence of sedentary time in healthy versus cognitively impaired populations and to explore how experimental studies reducing or breaking up sedentary time affect cognitive function. Lastly, we aimed to conduct a quantitative pooled analysis of all individual studies through meta-analysis procedures to derive conclusions about these relationships.

Methods

Eight electronic databases (EMBASE; Web of Science; PsycINFO; CINAHL; SciELO; SPORTDiscus; PubMed; and Scopus) were searched from inception to February 2021. Our search included terms related to the exposure (i.e., sedentary time), the population (i.e., middle-aged and older adults), and the outcome of interest (i.e., cognitive function). PICOS framework used middle-aged and older adults where there was an intervention or exposure of any sedentary time compared to any or no comparison, where cognitive function and/or cognitive impairment was measured, and all types of quantitative, empirical, observational data published in any year were included that were published in English. Risk of bias was assessed using QualSyst.

Results

Fifty-three studies including 83,137 participants met the inclusion criteria of which 23 studies had appropriate data for inclusion in the main meta-analysis. The overall meta-analysis suggested that total sedentary time has no association with cognitive function (r = −0.012 [95% CI − 0.035, 0.011], p = 0.296) with marked heterogeneity (I² = 89%). Subgroup analyses demonstrated a significant negative association for studies using a device to capture sedentary time r = −0.035 [95% CI − 0.063, − 0.008], p = 0.012). Specifically, the domains of global cognitive function (r = −0.061 [95% CI − 0.100, − 0.022], p = 0.002) and processing speed (r = −0.067, [95% CI − 0.103, − 0.030], p < 0.001). A significant positive association was found for studies using self-report (r = 0.037 [95% CI − 0.019, 0.054], p < 0.001). Specifically, the domain of processing speed showed a significant positive association (r = 0.057 [95% CI 0.045, 0.069], p < 0.001). For prevalence, populations diagnosed with cognitive impairment spent significantly more time sedentary compared to populations with no known cognitive impairments (standard difference in mean = −0.219 [95% CI − 0.310, − 0.128], p < 0.001).

Conclusions

The association of total sedentary time with cognitive function is weak and varies based on measurement of sedentary time and domain being assessed. Future research is needed to better categorize domains of sedentary behaviour with both a validated self-report and device-based measure in order to improve the strength of this relationship. PROSPERO registration number: CRD42018082384.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-022-00507-x.

Psychological-health correlates of physical activity and sedentary behaviour during the COVID pandemic

BACKGROUND

While physical inactivity is associated with adverse psychological outcomes, less is known about the psychological outcomes associated with sedentary behaviour, and specifically, its mentally active and passive forms. The COVID-19 pandemic represents a unique opportunity to study associations between these variables in light of widespread stay-at-home mandates and restrictions on outdoor exercise/social activities. Using a cross-sectional dataset acquired during the COVID-19 pandemic in Australia, we examined whether physical activity and sedentary behaviour were associated with subjective quality of life (sQoL) and subjective cognitive dysfunction, and whether these associations were mediated by depressive symptoms.

METHODS

658 participants (males = 169, females = 489) self-reported data on physical activity and sedentary behaviour in an online survey during May 2020-May 2021. Data on physical activity and sedentary behaviour (both mentally active and passive types) was compared according to whether it was collected during or out of a lockdown period. Regression models were used to test associations of physical activity and sedentary behaviour with sQoL and subjective cognitive dysfunction, and whether these associations were mediated by depression severity.

RESULTS

Physical activity was beneficially associated with sQoL, whereas sedentary behaviour (both total hours and the reduction of mentally active/increase in mentally passive behaviour) was detrimentally associated with sQoL. These associations were mediated by depression severity. Physical activity and sedentary behaviour were also indirectly associated with subjective cognitive dysfunction by virtue of their associations with depression severity.

CONCLUSIONS

There are important differences in the psychological correlates of mentally passive and active sedentary behaviours. Our findings suggest that health promotion strategies should focus on not only increasing physical activity but also reducing passive sedentary behaviours as a means of maintaining good psychological health.

Leisure-time sedentary behaviors are differentially associated with all-cause dementia regardless of engagement in physical activity

Sedentary behavior (SB) is associated with cardiometabolic disease and mortality, but its association with dementia is currently unclear. This study investigates whether SB is associated with incident dementia regardless of engagement in physical activity (PA). A total of 146,651 participants from the UK Biobank who were 60 years or older and did not have a diagnosis of dementia (mean [SD] age: 64.59 [2.84] years) were included. Self-reported leisure-time SBs were divided into two domains: time spent watching television (TV) or time spent using a computer. A total of 3,507 individuals were diagnosed with all-cause dementia over a mean follow-up of 11.87 (±1.17) years. In models adjusted for a wide range of covariates, including time spent in PA, time spent watching TV was associated with increased risk of incident dementia (HR [95% CI] = 1.24 [1.15 to 1.32]) and time spent using a computer was associated with decreased risk of incident dementia (HR [95% CI] = 0.85 [0.81 to 0.90]). In joint associations with PA, TV time and computer time remained significantly associated with dementia risk at all PA levels. Reducing time spent in cognitively passive SB (i.e., TV time) and increasing time spent in cognitively active SB (i.e., computer time) may be effective behavioral modification targets for reducing risk of dementia regardless of engagement in PA.

Sedentary behaviour and brain health in middle-aged and older adults: a systematic review

Sedentary behaviour may increase the risk of dementia. Studying physiological effects of sedentary behaviour on cerebral health may provide new insights into the nature of this association. Accordingly, we reviewed if and how acute and habitual sedentary behaviour relate to brain health factors in middle-aged and older adults (≥45 years). Four databases were searched. Twenty-nine studies were included, with mainly cross-sectional designs. Nine studies examined neurotrophic factors and six studied functional brain measures, with the majority of these studies finding no associations with sedentary behaviour. The results from studies on sedentary behaviour and cerebrovascular measures were inconclusive. There was a tentative association between habitual sedentary behaviour and structural white matter health. An explanatory pathway for this effect might relate to the immediate vascular effects of sitting, such as elevation of blood pressure. Nevertheless, due to the foremost cross-sectional nature of the available evidence, reverse causality could also be a possible explanation. More prospective studies are needed to understand the potential of sedentary behaviour as a target for brain health.

The role of socio-demographic factors and physical functioning in the intra- and interpersonal variability of older adults' sedentary time: an observational two-country study

BACKGROUND

Insight into the variability of older adults' sedentary time is needed to inform future interventions. The aim of this study was to examine the intra- and interpersonal variability in sedentary time, and the moderating role of socio-demographics, physical functioning and geographical location in this variability.

METHODS

Cross-sectional data from 818 community-dwelling older adults (mean age: 74.8 years; 61.1%women) of the Active Lifestyle and the Environment in Chinese Seniors and Belgian Environmental Physical Activity Study in Seniors were used. An interview questionnaire was administered to collect socio-demographic information. The Short Physical Performance Battery was performed to evaluate physical functioning, and Actigraph GT3X( +) accelerometers were used to estimate sedentary time. Linear mixed models with random intercepts at the neighborhood, person and day levels examined the variability in sedentary time, and the moderating role of socio-demographics, physical functioning and geographical location within this variability.

RESULTS

Most of the variance in accelerometry-assessed sedentary time was due to intrapersonal variability across periods of the day (72.4%) followed by interpersonal variability within neighborhoods (25.6%). Those who were older, men, lived in Hong Kong, and experienced a lower level of physical functioning were more sedentary than their counterparts. Sedentary time increased throughout the day, with highest levels of sedentary time observed between 6:00 and 9:00 pm. The patterns of sedentary time across times of the day differed by gender, educational attainment, age, physical functioning and/or geographical location. No significant differences were detected between week and weekend day sedentary time.

CONCLUSIONS

The oldest old, men, and those with functional limitations are important target groups for sedentary behavior interventions. As sedentary time was the highest in the evening future sedentary behavior intervention should pay particular attention to the evening hours. The variations in diurnal patterns of sedentary time between population subgroups suggest that personalized just-in-time adaptive interventions might be a promising strategy to reduce older adults' sedentary time.

Is Sedentary Behavior Associated With Executive Function in Children and Adolescents? A Systematic Review

Background

Prolonged time on sedentary behavior, especially screen-based sitting time, is associated with unfavorable health indicators in children and adolescents. However, the effects of sedentary behavior on cognitive function remain to be elucidated.

Objective

The purpose of this systematic review was to synthesize the evidence on the associations of sedentary behavior with executive function in children and adolescents.

Methods

Four electronic databases (i.e., PubMed, Web of Science, PsycINFO, and SPORTDiscus) were searched for studies examining the associations between sedentary behavior and executive function in children and adolescents. Study quality was assessed by the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results

A total of 1,151 records were initially identified through database searches and other searches. Twelve cross-sectional and four longitudinal studies met the inclusion criteria. Of the 16 studies, seven studies found significant negative associations between sedentary behavior and executive function, and two studies presented positive associations. Eight studies measured sedentary time using accelerometers and showed varied associations between objectively measured sedentary time and executive function. Nine studies measured screen-based sedentary behavior, of which five studies found negative associations of sedentary time with executive function.

Conclusion

The available evidence on the associations between sedentary behavior and executive function is not conclusive in children and adolescents. However, screen-based sedentary behavior may be negatively associated with executive function.

Prevalence of Physical Activity and Sedentary Behavior Patterns in Generally Healthy European Adults Aged 70 Years and Older—Baseline Results From the DO-HEALTH Clinical Trial

Background

Physical activity (PA) is important for healthy aging and disease prevention whereas sedentary behavior (SB) accelerates health deterioration.

Aim

To investigate activity profiles regarding PA and SB among generally healthy European older adults.

Methods

Meeting PA recommendations was defined as ≥150 min/week of moderate and/or ≥75 min/week of vigorous PA. A cut-off of ≥5.5 h/day was used to define time spent with SB. We present prevalence of PA and SB overall and by sex, age, BMI, and country. We examined correlates with multivariate logistic regression models.

Results

Two thousand one hundred and fifty-five DO-HEALTH participants completed baseline information on activity profiles [mean age 74.9 years (SD 4.5), 61.8% women]. Overall, 62.2% met PA recommendations and overall, 37.1% spent ≥5.5 h/day with SB. Younger participants (70–74 years), men, and those with BMI <25 kg/m² met PA recommendations more often. Per country, prevalence of meeting PA recommendations were: Austria 74.4%, France 51.0%, Germany 65.6%, Portugal 46.5%, and Switzerland 66.7%. Regarding SB, prevalence did not differ in all subgroups. In multivariate logistic regression analyses, being male, younger age, lower MoCA scores, and higher SPPB score were associated with greater odds, whereas higher BMI, more years of education, higher GDS score, and residing in Portugal were associated with lower odds of meeting PA recommendations. High BMI and higher MoCA scores were associated with greater odds of high SB.

Conclusion

Individualized public health efforts may be warranted even in active older adults, as profiles were less favorable in subgroups of older age, female sex and higher BMI.

Associations of Objectively-Measured Sedentary Time and Patterns with Cognitive Function in Non-Demented Japanese Older Adults: A Cross-Sectional Study

This study aimed to investigate the cross-sectional associations of objectively-measured sedentary time and patterns with cognitive function in Japanese older adults. A total of 1681 non-demented community-dwelling older adults (aged 73 ± 6, 62.1% women) were included. Total sedentary time, prolonged sedentary time (accumulated in ≥30 min bouts) and mean sedentary bout length were assessed using a tri-axial accelerometer. Global and domain-specific cognitive functions were measured using the Montreal Cognitive Assessment. The average of total sedentary time and prolonged sedentary time were 462 ± 125 and 186 ± 111 min/day, respectively. Greater prolonged sedentary time, but not total sedentary time, was significantly associated with poorer performance in the orientation domain even after controlling for moderate-to-vigorous physical activity (p for trend = 0.002). A significant inverse association was also observed between mean sedentary bout length and the orientation domain (p for trend = 0.009). No significant associations were observed for global cognitive function or other cognitive domains. Sedentary time accumulated in prolonged bouts, but not total sedentary time, was inversely associated with orientation ability among older adults. Our results encourage further researches to confirm the role of prolonged sedentary time in changes to cognitive domains over time among older adults.

Deducing the Impact of Physical Activity, Sedentary Behavior, and Physical Performance on Cognitive Function in Healthy Older Adults

Objectives: Participating in physical activity and maintaining physical performance as well as reducing sedentary behavior are discussed to be beneficially associated with cognitive function in older adults. The purpose of this cross-sectional analysis was to differentiate the relevance of objectively measured physical activity, physical performance, and sedentary behavior on cognitive function in healthy older adults (n = 56, age = 76 ± 7 yrs, gender = 30 female). Methods: Accelerometer based physical activity and sedentary behavior were analyzed as minutes per week spent sedentary and physically active with light or moderate to vigorous intensity. Participants' physical performance was assessed via cardiopulmonary exercise testing and analyzed as maximal workload and heart rate, heart rate reserve and peak oxygen uptake. The assessment of cognitive function included working memory, attention, executive function, and verbal memory. Data was analyzed with Spearman and partial correlations. Trial registration: NCT02343029. Results: Light physical activity was moderately associated with executive function (r = -0.339, p = 0.015). Attention was significantly associated with maximal workload (r = -0.286, p = 0.042) and peak oxygen uptake (r = -0.337, p = 0.015). Working memory was associated with maximal workload (r = 0.329, p = 0.017). Conclusion: Whereas a broad range of cognitive function were beneficially linked to physical performance, light intensity activities in particular showed an impact on executive function. Our research underlines the need to separate the impact of physical performance and physical activity on cognitive function and highlights the relevance of light physical activity.

Comportamento sedentário e associação com multimorbidade e padrões de multimorbidade em idosos brasileiros: dados da Pesquisa Nacional de Saúde de 2019

Resumo: O comportamento sedentário emerge como um importante determinante da saúde da pessoa idosa, no entanto, sua relação com a multimorbidade e seus padrões de acometimento em estudos epidemiológicos têm sido pouco explorados na população brasileira. Tais associações poderão auxiliar na elaboração de políticas públicas visando à modificação desse comportamento. Assim, o objetivo deste estudo foi avaliar a associação entre comportamento sedentário com multimorbidade e seus padrões em idosos brasileiros. Estudo transversal, com 43.554 idosos da Pesquisa Nacional de Saúde de 2019. O comportamento sedentário autorreferido foi categorizado em < 3; 3-6; e > 6 horas por dia. A presença de multimorbidade e seus padrões foram analisados pelo autorrelato da coexistência de duas ou mais doenças crônicas, sendo que os três padrões estabelecidos consideraram as doenças com características clínicas similares: (1) cardiopulmonar; (2) vascular-metabólico; e (3) mental-musculoesquelético. As associações foram realizadas pela regressão logística binária. Os idosos que despendiam 3-6 horas/dia em comportamento sedentário tiveram maiores chances (OR = 1,39; IC95%: 1,29; 1,50) de apresentar multimorbidade, padrão vascular-metabólico (OR = 1,39; IC95%: 1,29; 1,50) e mental-musculoesquelético (OR = 1,11; IC95%: 1,00; 1,24). Quando o comportamento sedentário foi > 6 horas/dia, houve maiores chances de multimorbidade (OR = 1,58; IC95%: 1,43; 1,74) e dos padrões cardiopulmonar (OR = 1,73; IC95%: 1,33; 2,27), vascular-metabólico (OR = 1,49; IC95%: 1,35; 1,64) e mental-musculoesquelético (OR = 1,15; IC95%: 1,01; 1,31), quando comparados àqueles que ficavam até 3 horas/dia. Dessa forma, evidenciou-se que tempos elevados em comportamento sedentário são fatores de risco relevantes para a ocorrência de multimorbidade e seus padrões em idosos.

Learning From Human Responses to Deconditioning Environments: Improved Understanding of the "Use It or Lose It" Principle

Physical activity, mobility or patterned mobility (i.e., exercise) is intrinsic to the functioning of Homo sapiens, and required for maintenance of health. Thus, systems such as the musculoskeletal and cardiovascular systems appear to require constant reinforcement or conditioning to maintain integrity. Loss of conditioning or development of chronic deconditioning can have multiple consequences. The study of different types of deconditioning and their prevention or reversal can offer a number of clues to the regulation of these systems and point to how deconditioning poses risk for disease development and progression. From the study of deconditioning associated with spaceflight, a condition not predicted by evolution, prolonged bedrest, protracted sedentary behavior, as well as menopause and obesity and their consequences, provide a background to better understand human heterogeneity and how physical fitness may impact the risks for chronic conditions subsequent to the deconditioning. The effectiveness of optimized physical activity and exercise protocols likely depend on the nature of the deconditioning, the sex and genetics of the individual, whether one is addressing prevention of deconditioning-associated disease or disease-associated progression, and whether it is focused on acute or chronic deconditioning associated with different forms of deconditioning. While considerable research effort has gone into preventing deconditioning, the study of the process of deconditioning and its endpoints can provide clues to the regulation of the affected systems and their contributions to human heterogeneity that have been framed by the boundary conditions of Earth during evolution and the "use it or lose it" principle of regulation. Such information regarding heterogeneity that is elaborated by the study of deconditioning environments could enhance the effectiveness of individualized interventions to prevent deconditions or rescue those who have become deconditioned.

Emerging Qualitative Research Trends (2010-2021) on Sedentary Behaviour among Older Adults: A Systematic Literature Review Protocol

In recent years, research on sedentary behaviour has increased. In this regard, there is a need for theoretical reviews that allow us to determine the past, analyse the present, and prepare the future of research in this field. The purpose of this review paper was to analyse and organise the emerging qualitative research trends (2010-2021) on the sedentary behaviour of older adults. A systematic literature search strategy was developed in various electronic scientific databases (e.g., PubMed, Web of Science, ScienceDirect, Scielo, and Scopus). The included studies were required to have different qualitative methodological approaches in terms of data collection and methods of data analysis. Studies conducted in any country and published in a peer-reviewed journal in English, Spanish, and Portuguese were considered. A thematic analysis approach was used for data extraction and synthesis, and confidence in the results was assessed using the GRADE-CERQual approach. This study may enable accurate guidelines to be established for future primary qualitative research related to sedentary behaviour.

Is there a bidirectional association between sedentary behaviour and cognitive decline in older adults? Findings from the Irish Longitudinal Study on Ageing

Research on whether sedentary behaviour (SB) is related to cognitive decline in older individuals is conflicting, potentially caused by methodological differences in previous studies. To inform public health policies, we analysed both the forward and reverse association across four-years between subjective TV time and objectively-measured SB and four cognitive outcome measures in older adults. The Irish Longitudinal Study on Ageing (TILDA) quantified time spent watching TV using a questionnaire and objective physical activity patterns with a GENEActiv accelerometer. Mixed model analysis examined whether these two measures of SB related to changes in cognitive function (immediate and delayed recall, MMSE, and animal naming task) during a four-year follow-up period. Furthermore, the reverse association between changes in cognition over the preceding four years and SB was investigated. We included 1,276 participants (67 ± 9 years). Longitudinally, every hour of objective SB per day was associated with a -0.01 (95%CI = -0.03;-0.00) lower MMSE score per year. Reversely, a worse decline in immediate and delayed recall over the preceding waves was related to slightly more objective SB (B = -0.24 (95%CI = -0.41;-0.07)) and TV time (B = -0.25 (95%CI = -0.48;-0.03)) at the end of those four years. To conclude, in healthy older individuals, higher levels of objective SB are related to cognitive decline across a four-year follow-up, although the magnitude and clinical relevance are questionable. As preceding cognitive decline is associated with more SB across follow-up, this suggests that a bidirectional association is plausible.

Sitting Time, Physical Activity, and Cognitive Impairment in Midlife and Older Adults

This study cross-sectionally examines the relations of sitting and physical activity (PA) with cognitive impairment in community-dwelling adults aged 55-87 years (n = 3,780). Multivariable logistic regression assessed independent and joint relations of sitting and PA with Montreal Cognitive Assessment scores adjusting for covariates. Sitting ≥75% of the time and not meeting PA guidelines were related to 60% (95% confidence interval [CI] [1.19, 2.17]) and 27% (95% CI [1.06, 1.53]) higher odds for cognitive impairment, respectively. Stratification by age showed that sitting ≥75% of the time was associated with higher cognitive impairment odds in midlife (odds ratio [OR] = 1.86; 95% CI [1.31, 2.65]), but not older adults (OR = 1.06; 95% CI [0.57, 1.95]). Joint association analysis revealed that, overall, the highest odds for cognitive impairment were in those sitting ≥75% of the time while meeting or not meeting PA guidelines (OR = 1.69, 95% CI [1.13, 2.53]; and OR = 1.66, 95% CI [1.19, 2.32], respectively). In conclusion, prolonged sitting and insufficient PA are independent risk markers for cognitive impairment.

Longitudinal Association of Total Tau Concentrations and Physical Activity With Cognitive Decline in a Population Sample

IMPORTANCE

Tau is a brain protein located in neurons and develops abnormally in individuals with Alzheimer disease. New technology is convenient for measuring blood total tau concentrations and provides a unique and increased opportunity for early intervention to slow cognitive decline.

OBJECTIVE

To evaluate the association of physical activity and total tau concentrations with cognitive decline at baseline and over time.

DESIGN, SETTING, AND PARTICIPANTS

The Chicago Health and Aging Project is a population-based cohort study conducted in 4 Chicago communities. Data collection occurred in 3-year cycles between 1993 and 2012. Participants completed in-home interviews. Clinical evaluations, which included blood samples, were performed with a stratified random sample of 1159 participants. Statistical analyses were conducted from October 30, 2020, to May 25, 2021.

EXPOSURES

Physical activity and total serum tau concentrations. Data on physical activity were obtained through self-report items, and a sum of minutes per week was calculated. Little physical activity was defined as no participation in a minimum of 4 of the items on the physical activity measure. Medium activity was defined as participating in less than 150 minutes of physical activity per week, and high activity was defined as participating in 150 minutes or more of physical activity per week.

MAIN OUTCOMES AND MEASURES

The main outcome for this study is global cognitive function, measured through a battery of cognitive tests. The study hypothesis was developed after data were collected.

RESULTS

Of the 1159 participants in the study, 728 were women (63%), and 696 were African American (60%); the mean (SD) age was 77.4 (6.0) years, and the mean (SD) educational level was 12.6 (3.5) years. Participants with high total tau concentrations with medium physical activity had a 58% slower rate of cognitive decline (estimate, -0.028 standard deviation unit [SDU] per year [95% CI, -0.057 to 0.002 SDU per year]; difference, 0.038 SDU per year [95% CI, 0.011-0.065 SDU per year]), and those with high physical activity had a 41% slower rate of cognitive decline (estimate, -0.038 SDU per year [95% CI, -0.068 to -0.009 SDU per year]; difference, 0.027 SDU per year [95% CI, -0.002 to 0.056 SDU per year]), compared with those with little physical activity. Among participants with low total tau concentrations, medium physical activity was associated with a 2% slower rate of cognitive decline (estimate, -0.050 SDU per year [95% CI, -0.069 to -0.031 SDU per year]; difference, 0.001 SDU per year [95% CI, -0.019 to 0.021 SDU per year]), and high physical activity was associated with a 27% slower rate of cognitive decline (estimate, -0.037 SDU per year [95% CI, -0.055 to -0.019 SDU per year]; difference, 0.014 SDU per year [95% CI, -0.007 to 0.034 SDU per year]), compared with little physical activity. Individual tests of cognitive function showed similar results.

CONCLUSIONS AND RELEVANCE

This study suggests that, among participants with both high and low total tau concentrations, physical activity was associated with slower cognitive decline. Results support the potential utility of blood biomarkers in measuring the benefits associated with health behaviors and may contribute to specifying target populations or informing interventions for trials that focus on improving physical activity behavior. Future work should examine the association of total tau concentrations with other health behaviors and physical activity types.

Otago exercise programme for physical function and mental health among older adults with cognitive frailty during COVID-19: A randomised controlled trial

AIMS AND OBJECTIVES

Quarantine during the COVID-19 pandemic resulted in longer-term sedentary behaviours and mental health problems. Our study aimed to evaluate the impact of the Otago exercise programme (OEP) on physical function and mental health among elderly with cognitive frailty during COVID-19.

BACKGROUND

Lockdowns and restrictions during the COVID-19 pandemic result in longer-term sedentary behaviours related disease and mental problem. Older people with cognitive frailty are more vulnerable to be influenced. Timely intervention may achieve better outcomes, OEP exercise was designed as a balance and muscle-strengthening programme for elderly people.

DESIGN

A parallel-group, assessor-blinded randomised controlled trial was performed according to CONSORT guidelines.

METHODS

This study was conducted from July 2020 to October 2020 among 62 elderly people with cognitive frailty from a nursing home. Participants were randomly divided into an OEP group (n = 31) or a control group (n = 31). Both groups received sleep- and diet-related health education. The OEP group also received a 12-week group exercise programme. The Five Times Sit to Stand Test (FTSST), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT) were used to assess physical function. The Geriatric Depression Scale-15 (GDS-15) and the 12-Item Short Form Health Survey Mental Component Summary (SF-12 MCS) were used to assess mental health. Outcomes were measured at 6 and 12 weeks.

RESULTS

Physical function and mental health were similar in the two groups at baseline. At 12 weeks, the OEP group (difference in change from baseline: FTSST, -2.78; TUGT, -3.73; BBS, 2.17; GDS-15, -0.72; SF-12 MCS, 2.58; all p < .001) exhibited significantly greater improvements than the control group (difference in change from baseline: FTSST, 1.55; TUGT, 1.66; BBS, -0.10; GDS-15, 1.07; SF-12 MCS, -5.95; all p < .001).

CONCLUSION

Our findings showed the OEP group had better physical function and mental health outcomes than the control group. OEP can be used to improve the physical and mental function among elderly people with cognitive frailty during the COVID-19 pandemic.

RELEVANCE TO CLINICAL PRACTICE

Otago exercise program intervention programmes should be implemented to improve physical function for cognitive frailty elderly to reduce the harm of longer-term sedentary behaviours, and to ruduce depression symptom and improve mental health, particularly during COVID-19 pandemic period.

Objectively assessed physical activity and sedentary behavior and global cognitive function in older adults: a systematic review

BACKGROUND

Both physical activity (PA) and sedentary behavior (SB) are important factors for healthy ageing. This systematic review aimed to determine the association of objectively assessed (instrumented) PA and SB with global cognitive function in older adults.

METHODS

PubMed, Embase, the Cochrane Library (via Wiley), CINAHL, PsychINFO, and SPORTDiscus (via EBSCO) were searched from inception to June 21, 2020 for articles that described associations of objectively assessed PA/SB with global cognitive function in older adults aged 60 years and older. Results were synthesized using an effect direction heat map and albatross plots portrayed estimated effect sizes (standardized regression coefficients (βs)), which were summarized in boxplots.

RESULTS

In total, 45 articles were included representing a total of 15,817 older adults (mean/median age ranged from 65 to 88 years; 49.5% female). Longitudinal studies (n = 7) showed that higher moderate-to-vigorous and light PA (MVPA and LPA, respectively) and lower SB were associated with better global cognitive function. Standardized βs of cross-sectional studies (n = 38) showed that lower SB (median [IQR], β = 0.078 [0.004-0.184] and higher LPA (β = 0.096 [0.046-0.188]), activity counts (β = 0.131 [0.049-0.224]), number of steps (β = 0.155 [0.096-0.246]), MVPA (β = 0.163 [0.069-0.285]) and total PA (TPA) (β = 0.174 [0.147-0.255]) were associated with better global cognitive function.

CONCLUSIONS

Higher PA and lower SB are associated with better global cognitive function in older adults. The greatest estimated effect sizes were found for moderate-to-vigorous and TPA, suggesting that greater duration of any PA, and high intensity PA could be most beneficial for global cognitive function.

Relationships between changes in self-reported physical activity, sedentary behaviour and health during the coronavirus (COVID-19) pandemic in France and Switzerland

To assess whether changes in physical activity and sedentary behaviour during the COVID-19 lockdown are associated with changes in mental and physical health. Observational longitudinal study. Participants living in France or Switzerland responded to online questionnaires measuring physical activity, physical and mental health, anxiety, and depressive symptoms. Paired sample t-tests were used to assess differences in physical activity and sedentary behaviour before and during lockdown. Multiple linear regressions were used to investigate associations between changes in physical activity and changes in mental and physical health during lockdown. 267 (wave1) and 110 participants (wave2; 2 weeks later) were recruited. Lockdown resulted in higher time spent in walking and moderate physical activity (~10min/day) and in sedentary behaviour (~75min/day), compared to pre COVID-19. Increased physical activity during leisure time from week 2 to week 4 of lockdown was associated with improved physical health (β=.24, p=.002). Additionally, an increase in sedentary behaviour during leisure time was associated with poorer physical health (β=-.35, p=.002), mental health (β=-.25, p=.003), and subjective vitality (β=-.30, p=.004). Ensuring sufficient levels of physical activity and reducing sedentary time can play a vital role in helping people to cope with a major stressful event, such as the COVID-19 pandemic.

Effects of Progressive Resistance Training on Cognition and IGF-1 Levels in Elder Women Who Live in Areas with High Air Pollution

The aim of this study was to determine the effects of a muscular strength programme on the levels of insulin-like growth factor-1 (IGF-1) and cognitive status in elder women with mild cognitive impairment who lived in areas of high air pollution. A total of 157 women participated in the study, distributed in four groups: Active/Clean (AC n = 38) and Active/Pollution (AP n = 37), who carried out a progressive resistance training programme for 24 months, and Sedentary/Clean (SC n = 40) and Sedentary/Pollution (SP n = 42). Maximum strength in the upper and lower limbs (1RM), cognition (Mini-Mental Scale Examination (MMSE)) and blood IGF-1 were evaluated. At the beginning of the intervention, there were no differences between the groups in the assessed variables. The active groups which carried out the resistance training programme (AC and AP), registered better results in IGF-1 than the sedentary groups. These differences were statistically significant in AC vs. SC (p < 0.01) and AP vs. SC (p < 0.05). Regarding MMSE, group AC registered the highest score increases (+8.2%) (significantly better than the other groups), while group SP worsened (−7%) significantly compared to the other three groups. In conclusion, resistance training had a positive effect on IGF-1, while sedentary behaviour and air pollution had a negative effect on cognitive status.

The Mediation Effect of Self-Report Physical Activity Patterns in the Relationship between Educational Level and Cognitive Impairment in Elderly: A Cross-Sectional Analysis of Chilean Health National Survey 2016-2017

The aims of this cross-sectional study were (i) to determine the association of educational level attained with cognitive impairment and (ii) to investigate the mediating effect of different self-report physical activity (PA) patterns in a large sample of older Chileans. A sample of 1571 older adults from the National Chilean Survey (2016-2017) was included. The educational level attained, PA levels, mode of commuting, sedentary time, and leisure-time PA were self-reported through validated questionnaires. Cognitive impairment was determined by Mini-Mental State Examination (modified version). Association between educational level attained and cognitive impairment was examined using logistic regression models. Counterfactual mediation models were used to test the mediating effect of self-reported PA patterns. A lower educational level was consistently associated with higher odds of cognitive impairment (OR range 2.846 to 2.266, all p < 0.001), while leisure-time PA was the only PA pattern that partially mediated this association (proportion mediated 8.0%). In conclusion, leisure-time PA was the solely PA pattern that partially mediated the association between the educational level and cognitive impairment. The rest self-reported PA patterns did not modify this association.