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Luzum G, Gunnes M, Lydersen S, Saltvedt I, Tan X, Thingstad P, Thrane G, Askim T. Physical Activity Behavior and Its Association With Global Cognitive Function Three Months After Stroke: The Nor-COAST Study†. Phys Ther 2023; 103:pzad092. [PMID: 37440440 PMCID: PMC10733132 DOI: 10.1093/ptj/pzad092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 03/15/2023] [Accepted: 05/22/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE The purposes of this study were to determine the association between physical activity (PA) behavior and global cognitive function 3 months after stroke and to explore the role of physical capacity as a mediating factor. METHODS Participants with stroke were successively recruited at 5 different hospitals in Norway. PA was measured using accelerometers, with a follow-up period of 7 consecutive days, and global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). The general pattern of PA and the percentage of participants adhering to World Health Organization PA recommendations (at least 150 minutes of moderate-intensity aerobic PA per week) were investigated using descriptive statistics. Multiple regression and mediator analyses were used to examine the relationship between PA behavior and MoCA scores; physical capacity, measured with the Short Physical Performance Battery, served as the mediating variable. RESULTS A total of 193 women (42.6%) and 260 men (57.4%) with a median age of 73.7 years (25th and 75th percentiles = 65.8 and 80.4, respectively) and a median MoCA score of 25 points (25th and 75th percentiles = 22 and 27, respectively) were included. Mean total time spent walking at moderate intensity was 251.7 (SD = 164.6) min/wk (mean bout length = 20.9 [SD = 7.3] seconds), which indicated 69.3% adherence to World Health Organization guidelines. With each point decrease in the MoCA score, there was an expected 8.6% increase in the odds of nonadherence to PA recommendations. Physical capacity was identified as an important mediating factor, explaining the strength of the association between cognition and PA behavior. CONCLUSIONS In contrast to previous research, in the present study, most participants adhered to the updated global PA guidelines. However, people who had survived stroke and had reduced cognitive function were at higher risk of inactivity, an association mediated by physical capacity. IMPACT A better understanding of the association between cognition and PA behavior after stroke might help for developing more targeted early-onset interventions.
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Affiliation(s)
- Geske Luzum
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Mari Gunnes
- Department of Health Research, SINTEF, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingvild Saltvedt
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Department of Geriatric Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Xiangchun Tan
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health and Welfare Services, City of Trondheim, Trondheim, Norway
| | - Gyrd Thrane
- Department of Health and Care Science, Faculty of Health, The Arctic University of Norway, Tromsø, Norway
| | - Torunn Askim
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
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Boquete-Pumar C, Álvarez-Salvago F, Martínez-Amat A, Molina-García C, De Diego-Moreno M, Jiménez-García JD. Influence of Nutritional Status and Physical Fitness on Cognitive Domains among Older Adults: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2963. [PMID: 37998454 PMCID: PMC10671636 DOI: 10.3390/healthcare11222963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The health issues presented by the aging population can result in reduced muscle mass, poorer physical function, and cognitive impairment. The goal of this study was to determine how nutritional status and physical fitness relate to cognitive impairment in older adults. METHODS A cross-sectional descriptive and analytical study involving 100 participants was carried out to analyze the impact of nutritional status and physical fitness on cognitive impairment. Nutritional status was assessed with the Eating Assessment Tool (EAT-10) and The Mini Nutritional Assessment-Short Form (MNA-SF); physical fitness via the implementation of manual grip evaluation, the 4-m walking test (4-MWT), and the Timed Up and Go (TUG) test; and cognitive impairment evaluation was conducted using the Mini-Mental State Examination (MMSE), the Boston Naming Test (BNT) and the Controlled Oral Word Association Test (COWAT). RESULTS Data analysis revealed that higher malnutrition status was associated with fewer correct responses in the COWAT (R2 = 0.421), while a correlation between higher MMSE and BNT scores, faster completion times for the 4-m walking and TUG tests, and an increase in handgrip strength load was also observed. CONCLUSION The analysis of the data revealed that those individuals with superior nutritional status and greater levels of physical fitness outperformed others on the cognitive evaluation.
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Affiliation(s)
- Carmen Boquete-Pumar
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
| | - Francisco Álvarez-Salvago
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, 46010 Valencia, Spain
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
| | - Cristina Molina-García
- Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos nº135, 30107 Guadalupe, Spain;
| | - Manuel De Diego-Moreno
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
| | - José Daniel Jiménez-García
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
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Luna MG, Pahlen S, Corley RP, Wadsworth SJ, Reynolds CA. Frailty and Processing Speed Performance at the Cusp of Midlife in CATSLife. J Gerontol B Psychol Sci Soc Sci 2023; 78:1834-1842. [PMID: 37480567 PMCID: PMC10645312 DOI: 10.1093/geronb/gbad102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVES Frailty is not an end state of aging, but rather represents physiological vulnerability across multiple systems that unfolds across adulthood. However, examinations of frailty at the midlife transition, and how frailty may impact other age-sensitive traits, such as processing speed (PS), remain scarce. Our research aims were to examine frailty and frailty-speed associations before midlife, a ripe developmental period for healthy aging interventions. METHODS Using data from the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (N = 1,215; Mage = 33.23 years; standard deviation = 4.98), we constructed 25-item (FI25) and 30-item (FI30) frailty indices. PS was measured using the Colorado Perceptual Speed task and WAIS-III Digit Symbol (DS) subtest. Multilevel models accounted for clustering among siblings and adjusted for sex, race, ethnicity, adoption status, educational attainment, and age. RESULTS Reliability of FI measures was apparent from strong intraclass correlations (ICCs) among identical twin siblings, although ICC patterns across all siblings suggested that FI variability may include nonadditive genetic contributions. Higher FI was associated with poorer PS performance but was significant for DS only (BFI25 = -1.17, p = .001, d = -0.12; BFI30 = -1.21, p = .001, d = -0.12). Furthermore, the negative frailty-DS association was moderated by age (BFI25×age = -0.14, p = .042; BFI30×age=-0.19, p = .008) where increasingly worse performance with higher frailty emerged at older ages. DISCUSSION Frailty is evident before midlife and associated with poorer PS, an association that magnifies with age. These findings help elucidate the interrelationship between indicators of frailty and cognitive performance for adults approaching midlife, an understudied period within life-span development.
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Affiliation(s)
- Maria G Luna
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Shandell Pahlen
- Department of Psychology, University of California, Riverside, Riverside, California, USA
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, Boulder, Colorado, USA
| | - Sally J Wadsworth
- Institute for Behavioral Genetics, University of Colorado, Boulder, Boulder, Colorado, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California, Riverside, Riverside, California, USA
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Ladang A, Kovacs S, Lengelé L, Locquet M, Beaudart C, Reginster JY, Bruyère O, Cavalier E. Neurofilament-light chains (NF-L), a biomarker of neuronal damage, is increased in patients with severe sarcopenia: results of the SarcoPhAge study. Aging Clin Exp Res 2023; 35:2029-2037. [PMID: 37581861 PMCID: PMC10520189 DOI: 10.1007/s40520-023-02521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND As clinical tests, such as gait speed, require nervous system integrity to be performed properly, sarcopenia shares features with neurological diseases. Neurofilament light chains (NF-L) are now used as a blood-biomarker of neuronal damage, and its expression might be altered in sarcopenia. We aimed to assess NF-L concentrations in a large cohort of older individuals screened for sarcopenia. METHODS The SarcoPhAge cohort is a Belgian cohort of 534 community-dwelling older adults with an ongoing 10-year follow-up. Sarcopenia diagnosis was established at inclusion according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle strength was evaluated with a hydraulic hand dynamometer, appendicular lean mass by Dual-Energy X-ray Absorptiometry (DXA) and physical performance by the Short Physical Performance Battery (SPPB). NF-L was measured on all available sera collected at the time of inclusion (n = 409) using SiMoA technology (Quanterix°). RESULTS In the multivariate model, NF-L was associated with performance tests such as gait speed (p < 0.0001) and SPPB scores (p = 0.0004). An association was also observed with muscle strength (p = 0.0123) and lean mass (p = 0.0279). In the logistic regression model, NF-L was an independent predictor of severe sarcopenia (p = 0.0338; OR = 20.0; 95% CI 1.39-287.7) with satisfactory diagnostic accuracy (AUC: 0.828) and subjects with an SPPB score ≤ 8 had higher odds of having increased NF-L (p < 0.0001; OR = 23.9; 95% CI 5.5-104). CONCLUSIONS These data highlight the potential for using NF-L to investigate the pathophysiology of sarcopenia severity and the neurological features associated with performance tests. However, these results need to be confirmed with other cohorts in different settings.
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Affiliation(s)
- Aurélie Ladang
- Clinical Chemistry Department, CHU de Liège, University of Liège, Avenue de L'Hopital, 1, 4000, Liège, Belgium.
| | - Stéphanie Kovacs
- Clinical Chemistry Department, CHU de Liège, University of Liège, Avenue de L'Hopital, 1, 4000, Liège, Belgium
| | - Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium
- Physical, Rehabilitation Medicine and Sports Traumatology, SportS2, CHU de Liège, University of Liège, 4000, Liège, Belgium
| | - Etienne Cavalier
- Clinical Chemistry Department, CHU de Liège, University of Liège, Avenue de L'Hopital, 1, 4000, Liège, Belgium
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Mahapatra G, Gao Z, Bateman JR, Lockhart SN, Bergstrom J, DeWitt AR, Piloso JE, Kramer PA, Gonzalez-Armenta JL, Amick A, Casanova R, Craft S, Molina AJA. Blood-based bioenergetic profiling reveals differences in mitochondrial function associated with cognitive performance and Alzheimer's disease. Alzheimers Dement 2023; 19:1466-1478. [PMID: 35870133 PMCID: PMC9868193 DOI: 10.1002/alz.12731] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/26/2022] [Accepted: 06/01/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Despite evidence for systemic mitochondrial dysfunction early in Alzheimer's disease (AD) pathogenesis, reliable approaches monitoring these key bioenergetic alterations are lacking. We used peripheral blood mononuclear cells (PBMCs) and platelets as reporters of mitochondrial function in the context of cognitive impairment and AD. METHODS Mitochondrial function was analyzed using complementary respirometric approaches in intact and permeabilized cells from older adults with normal cognition, mild cognitive impairment (MCI), and dementia due to probable AD. Clinical outcomes included measures of cognitive function and brain morphology. RESULTS PBMC and platelet bioenergetic parameters were lowest in dementia participants. MCI platelets exhibited higher maximal respiration than normocognitives. PBMC and platelet respiration positively associated with cognitive ability and hippocampal volume, and negatively associated with white matter hyperintensities. DISCUSSION Our findings indicate blood-based bioenergetic profiling can be used as a minimally invasive approach for measuring systemic bioenergetic differences associated with dementia, and may be used to monitor bioenergetic changes associated with AD risk and progression. HIGHLIGHTS Peripheral cell bioenergetic alterations accompanied cognitive decline in older adults with mild cognitive impairment (MCI) and Alzheimer's disease (AD) and related dementia (DEM). Peripheral blood mononuclear cells (PBMC) and platelet glucose-mediated respiration decreased in participants with dementia compared to normocognitive controls (NC). PBMC fatty-acid oxidation (FAO)-mediated respiration progressively declined in MCI and AD compared to NC participants, while platelet FAO-mediated respiration exhibited an inverse-Warburg effect in MCI compared to NC participants. Positive associations were observed between bioenergetics and Modified Preclinical Alzheimer's Cognitive Composite, and bioenergetics and hippocampal volume %, while a negative association was observed between bioenergetics and white matter hyperintensities. Systemic mitochondrial dysfunction is associated with cognitive decline.
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Affiliation(s)
- Gargi Mahapatra
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Zhengrong Gao
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - James R. Bateman
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
- Department of Neurology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Samuel Neal Lockhart
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Jaclyn Bergstrom
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Amber Renee DeWitt
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Jemima Elizabeth Piloso
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Philip Adam Kramer
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Jenny L. Gonzalez-Armenta
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Allison Amick
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Ramon Casanova
- Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA
| | - Suzanne Craft
- Section on Gerontology and Geriatrics, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
| | - Anthony J. A. Molina
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California, USA
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Bracco L, Cornaro C, Pinto-Carral A, Koch SC, Mourey F. Tango-Therapy Intervention for Older Adults with Cognitive Impairment Living in Nursing Homes: Effects on Quality of Life, Physical Abilities and Gait. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3521. [PMID: 36834217 PMCID: PMC9963458 DOI: 10.3390/ijerph20043521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
Cognitive impairment in older adults is associated with poor gait performance, physical decline, falls and poor quality of life. This paper analyzes the feasibility and efficacy of tango-based intervention in older people living in nursing homes with and without cognitive impairment. A multicenter study, with pre- and post-test, was carried out. Intervention attendance, well-being, physical abilities (short physical performance battery), walking performance, functional capacities (Katz Index) and quality of life (quality of life in Alzheimer's disease) were assessed. Fifty-four participants (84.9 ± 6.7 years, mini mental state examination 14.5 ± 7.4) completed the protocol. Intervention attendance was 92%, and the mean subjective well-being after each session was 4.5 ± 0.5 (on a five-point scale). A statistically significant improvement was found in the quality of life (p = 0.030). Non-statistically significant changes were found in walking performance (p = 0.159), physical abilities (p = 0.876) and in functional capacities (p = 0.253). This study shows feasibility and suggests evidence for the effects of tango therapy on well-being and quality of life. Further studies are necessary to contrast these findings and to support the role of tango interventions as a holistic approach to prevent functional decline in older people with cognitive impairment.
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Affiliation(s)
- Lucía Bracco
- Inserm U1093-Cognition, Action and Sensorimotor Plasticity, Faculty of Sport Sciences, University of Burgundy, 21078 Dijon, France
| | - Clara Cornaro
- Research Institute for Creative Arts Therapies (RIArT), Alanus University of Arts and Social Science, 53347 Alfter, Germany
| | - Arrate Pinto-Carral
- SALBIS Research Group, Faculty of Health Sciences, Nursing and Physiotherapy Department, Universidad de León, 24401 Ponferrada, Spain
| | - Sabine C. Koch
- Research Institute for Creative Arts Therapies (RIArT), Alanus University of Arts and Social Science, 53347 Alfter, Germany
- Department of Therapy Sciences, SRH University Heidelberg, 69123 Heidelberg, Germany
| | - France Mourey
- Inserm U1093-Cognition, Action and Sensorimotor Plasticity, Faculty of Sport Sciences, University of Burgundy, 21078 Dijon, France
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Li C, Ge S, Yin Y, Tian C, Mei Y, Han P. Frailty is associated with worse cognitive functioning in older adults. Front Psychiatry 2023; 14:1108902. [PMID: 36816402 PMCID: PMC9928943 DOI: 10.3389/fpsyt.2023.1108902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 01/12/2023] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Frailty and impaired cognitive functioning often co-occur in older adults and are associated with adverse health outcomes. However, their relationship is unclear. This study sought to examine the association of frailty status with cognitive functioning in older adults. METHOD The study population consisted of 2,296 older adults aged ≥60 from the National Health and Nutrition Examination Survey 2011-2014. Frailty status was measured based on the Fried Phenotype and the participants were categorized into three groups- robust, pre-frailty, and frailty. Cognitive functioning was measured using the Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD-WL) immediate and delayed recall tests, the Animal Fluency test (AFT), and the Digit Symbol Substitution Test (DSST). Test-specific and global cognition z-scores were calculated. Multinomial linear regression models were constructed to examine the association between frailty status (reference: robust) and test-specific and global cognition z-scores. Multiple linear regression models were used to examine the relationship between the number of frailty dimensions and test-specific and global cognition z-scores. All models controlled for age, race/ethnicity, education, total cholesterol level, and systolic blood pressure. RESULTS About half of the participants (median age 68 years) were female (49.9%) and non-Hispanic White (48.7%). A quarter (23.3%) of the participants completed some college and above. Multinominal linear regression showed that compared with participants who were robust, those with frailty had worse DSST [β = -0.234, 95% confidence interval (CI): -0.391, -0.078, P = 0.003] and global cognition z scores (β = -0.129, 95% CI -0.233, -0.025, P = 0.02). Multiple linear regression model showed that the number of frailty dimensions was significantly associated with decreased the DSST (β = -0.065, 95% CI -0.103, -0.026, P = 0.001) and global cognition z-scores (β= -0.034, 95% CI -0.06, -0.009, P = 0.009). CONCLUSION Frailty is associated with worse processing speed, sustained attention, working memory, and global cognition in older adults. Prevention and treatment of frailty in older adults may help protect their cognitive functioning. Further, clinicians should consider assessing cognitive functioning, especially processing speed, sustained attention, and working memory, among frail older patients, which may allow early identification and interventions of cognitive impairment.
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Affiliation(s)
- Chunmei Li
- Infection Clinic, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Song Ge
- Department of Natural Sciences, University of Houston-Downtown, Houston, TX, United States
| | - Yueheng Yin
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongxia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Peijin Han
- Department of Computational Medicine and Bioinformatics, Medical School, University of Michigan, Ann Arbor, MI, United States
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Carson RG, Holton E. Deficits in rate of force production during multifinger tasks are associated with cognitive status. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5732. [PMID: 35586946 PMCID: PMC9321751 DOI: 10.1002/gps.5732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/27/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The multifinger force deficit (MFFD) is the decline in force generated by an individual finger as the number of fingers contributing to the action is increased. It has been proposed that as a measure of neural sufficiency rather than muscle status, it provides a means of detecting individuals at risk of cognitive decline. Age-related deficits in central neural drive exert a disproportionate impact on the rate at which force can be generated. We examined whether a MFFD derived from the maximum rate at which force is generated, is more sensitive to individual differences in cognitive status, than one calculated using the maximum level of force. METHODS Monotonic associations between each of two variants of the MFFD, and cognition (measured with the Montreal Cognitive Assessment), were estimated cross sectionally using generalized partial rank correlations, in which age, level of education and degree of handedness were included as covariates. The participants (n=26) were community dwelling adults aged 66-87. RESULTS The MFFD derived using the maximum rate of force development was negatively associated with cognitive status. The association for the MFFD based on the maximum level of force, was not statistically reliable. The associations with cognitive status obtained for both variants of the MFFD were of greater magnitude than those reported previously for standard grip strength dynamometry. CONCLUSION The sensitivity with which the MFFD detects risk of cognitive decline may be enhanced by using the maximum rate of force developed by each finger, rather than the maximum force generated by each finger.
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Affiliation(s)
- Richard G. Carson
- Trinity College Institute of Neuroscience and School of PsychologyTrinity College DublinDublin 2Ireland,School of PsychologyQueen's University BelfastBelfastNorthern IrelandUK
| | - Eimíle Holton
- Trinity College Institute of Neuroscience and School of PsychologyTrinity College DublinDublin 2Ireland
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Hernandez HHC, Ong EH, Heyzer L, Tan CN, Ghazali F, Yang DZ, Jung HW, Ismail NH, Lim WS. Validation of a multi-sensor-based kiosk for short physical performance battery in older adults attending a falls and balance clinic. Ann Geriatr Med Res 2022; 26:125-133. [PMID: 35399043 PMCID: PMC9271393 DOI: 10.4235/agmr.22.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/31/2022] [Indexed: 11/27/2022] Open
Abstract
Background The Short Physical Performance Battery (SPPB) is a well-established functional assessment tool used for the screening and assessment of frailty and sarcopenia. However, the SPPB requires trained staff experienced in conducting the standardized protocol, which may limit its widespread use in clinical settings. The automated SPPB (eSPPB) was developed to address this potential barrier; however, its validity among frail older adults remains to be established. Therefore, this exploratory study compared the eSPPB and manual SPPB in patients attending a tertiary fall clinic in relation to their construct validity, reliability, and agreement. Methods We studied 37 community-dwelling older adults (mean age, 78.5±6.8 years; mean FRAIL score, 1.2±1.0; 65% pre-frail) attending a tertiary falls clinic. The participants used the mSPPB and eSPPB simultaneously. We evaluated the convergent validity, discriminatory ability, reliability, and agreement using partial correlation adjusted for age and sex, an SPPB cutoff of ≤8 to denote sarcopenia, intraclass correlation coefficients (ICC), and Bland-Altman plots, respectively. Results The eSPPB showed strong correlations with the mSPPB (r=0.933, p<0.01) and Berg Balance Scale (r=0.869, p<0.01), good discriminatory ability for frailty and balance, and good to excellent reliability (ICC=0.94; 95% confidence interval, 0.88–0.97). The Bland-Altman plots indicated good agreement with the mSPPB (mean difference, -0.2; 95% confidence interval, -3.2–2.9) without evidence of systematic or proportional biases. Conclusion The results of our exploratory study corroborated the construct validity, reliability, and agreement of the eSPPB with the mSPPB in a small sample of predominantly pre-frail older adults with increased fall risk. Future studies should examine the scalability and feasibility of the widespread use of the eSPPB for frailty and sarcopenia assessment.
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Affiliation(s)
| | - Eng Hui Ong
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Department of Geriatric Medicine, Woodlands Health Campus, Singapore
| | - Louise Heyzer
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Department of Geriatric Medicine, Woodlands Health Campus, Singapore
| | - Cai Ning Tan
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
| | - Faezah Ghazali
- Department of Physiotherapy, Tan Tock Seng Hospital, Singapore
| | | | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Noor Hafizah Ismail
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Department of Continuing and Community Care, Tan Tock Seng Hospital, Singapore
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
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10
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Nilsson E, Igelström H, Vikman I, Larsson A, Pauelsen M. Positive Self-Perceptions of Aging Play a Significant Role in Predicting Physical Performance among Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111151. [PMID: 34769667 PMCID: PMC8583078 DOI: 10.3390/ijerph182111151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/02/2022]
Abstract
Self-perceptions of aging (SPA) is associated with various health-related outcomes, including physical performance. No previous study has investigated the potential predictive influence of SPA on physical performance among Swedish community-dwelling older adults. This was a cross-sectional study using a random sample of 153 Swedish community-dwelling individuals aged 70 and older. Multiple logistic regression analysis was performed, using the subscale “Attitude Towards Own Aging” of the Philadelphia Geriatric Center Morale Scale, as a measure of SPA. The Short Physical Performance Battery (SPPB) was dichotomized and used as the outcome variable. SPA was a significant predictor (OR = 1.546, CI = 1.066–2.243) of physical performance, adjusted for age, cognitive function, and life-space mobility. Further analyses revealed significant sex differences, with SPA not being included in the model for the men whilst it was still a significant predictor (OR = 1.689, CI = 1.031–2.765) of physical performance in the group of women. SPA plays a significant role in predicting physical performance among Swedish community-dwelling older adults. To further clarify this relationship and its consequences, future longitudinal research should focus on the relationship between SPA, physical performance, and fall risk.
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Affiliation(s)
- Emma Nilsson
- Department of Health, Education and Technology, Luleå University of Technology, SE 971 87 Luleå, Sweden; (E.N.); (I.V.); (A.L.)
| | - Helena Igelström
- Department of Neuroscience, Physiotherapy, Uppsala University, SE 752 37 Uppsala, Sweden;
| | - Irene Vikman
- Department of Health, Education and Technology, Luleå University of Technology, SE 971 87 Luleå, Sweden; (E.N.); (I.V.); (A.L.)
| | - Agneta Larsson
- Department of Health, Education and Technology, Luleå University of Technology, SE 971 87 Luleå, Sweden; (E.N.); (I.V.); (A.L.)
| | - Mascha Pauelsen
- Department of Health, Education and Technology, Luleå University of Technology, SE 971 87 Luleå, Sweden; (E.N.); (I.V.); (A.L.)
- Correspondence:
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11
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Gabriel A, Lehner CT, Höhler C, Schneider T, Pfeiffer TPT, Diehl-Schmid J, Hermsdörfer J. Anticipatory and Reactive Grip Force Control in Patients with Alzheimer's Disease: A Pilot Study. J Alzheimers Dis 2021; 82:1651-1665. [PMID: 34219727 DOI: 10.3233/jad-210387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) affects several cognitive functions and causes altered motor function. Fine motor deficits during object manipulation are evident in other neurological conditions, but have not been assessed in dementia patients yet. OBJECTIVE Investigate reactive and anticipatory grip force control in response to unexpected and expected load force perturbation in AD. METHODS Reactive and anticipatory grip force was investigated using a grip-device with force sensors. In this pilot study, fifteen AD patients and fourteen healthy controls performed a catching task. They held the device with one hand while a sandbag was dropped into an attached receptacle either by the experimenter or by the participant. RESULTS In contrast to studies of other neurological conditions, the majority of AD patients exerted lower static grip force levels than controls. Interestingly, patients who were slow in the Luria's three-step test produced normal grip forces. The timing and magnitude of reactive grip force control were largely preserved in patients. In contrast, timing and extent of anticipatory grip forces were impaired in patients, although anticipatory control was generally preserved. These deficits were correlated with decreasing Mini-Mental State Examination scores. Apraxia scores, assessed by pantomime of tool-use, did not correlate with performance in the catching task. CONCLUSION We interpreted the decreased grip force in AD in the context of loss of strength and lethargy, typical for patients with AD. The lower static grip force during object manipulation may emerge as a potential biomarker for early stages of AD, but more studies with larger sample sizes are necessary.
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Affiliation(s)
- Anna Gabriel
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Carolin T Lehner
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Chiara Höhler
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Thomas Schneider
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Department of Neurology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
| | - Tessa P T Pfeiffer
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Joachim Hermsdörfer
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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