Relationships of Physical Activity, Depression, and Sleep with Cognitive Function in Community-Dwelling Older Adults

Prospective association of depression symptoms with exceptional longevity among older women

Older women may experience elevated depression symptoms, which have been associated with morbidity and mortality. Yet, few studies have examined associations of depression symptoms with longevity. We examined associations among older women of depression symptoms with survival to ages 90, 95, and 100, and survival to age 90 with intact mobility and cognitive functioning. Participants were 70,560 women enrolled in the Women's Health Initiative with potential, due to birth year, to reach age ≥ 90 as of February 2022. Depression symptoms were assessed at baseline (1993-1998) using the Burnam screen, which comprises the 6-item Center for Epidemiologic Studies Depression Scale and 2 items from the Diagnostic Interview Schedule. Depression symptoms were classified as elevated (vs. not) using an established cut point of ≥ 0.06 for detecting depressive disorders. Survival (vs. death) to ages 90, 95, and 100 years was assessed. Among women surviving to age ≥ 90, maintenance of mobility and cognitive function were assessed in relation to depression symptoms. A total of 37,460 women (53.1%) survived to age ≥ 90. Women with (vs. without) elevated depression symptoms had 15% lower odds of surviving to age 90, 18% lower odds of surviving to age 95, and 23% lower odds of surviving to age 100. Among women surviving to 90, those with (vs. without) elevated depression symptoms had 46% lower odds of surviving with intact mobility and cognition. Depression symptoms associated with lower odds of healthy longevity. Findings underscore importance of depression intervention to increase women's odds of healthy longevity.

Cross-sectional and longitudinal association between accelerometer-measured light-intensity physical activity and cognitive function in older adults

Objectives

Regarding the methods of improving cognitive function in older adults, it is well-established that moderate-to-vigorous physical activity (MVPA) is beneficial. Considering the safety and mobility of older adults, recent research has focused on the benefits of light-intensity physical activity (LPA) on cognitive function. However, limited research has utilized the different domains of cognitive examination scales [such as the Mini-Mental State Examination (MMSE)] to analyze the relationship between LPA and different domains of cognitive function and compare the cross-sectional and longitudinal results. Thus, this study aimed to investigate the cross-sectional and longitudinal association between LPA and both overall and domain-specific cognitive function in older Taiwanese adults.

Methods

This longitudinal study recruited participants in an outpatient department of geriatrics and gerontology in a medical center in Taipei City, Taiwan. Data was collected from September 2020 to 2021; the follow-up data were collected until December 2022. Participants were community-dwelling older adults aged ≥ 65 years who could walk independently. Baseline physical activity (any bodily movement produced by skeletal muscles that requires energy expenditure) and sedentary behavior (any waking behavior while in a sitting, reclining or lying posture with low energy expenditure) were measured with a GT3X+ triaxial accelerometer, categorized as sedentary behavior (< 100 counts/min), LPA (100-2,019 counts/min) and MVPA (≥ 2,020 counts/min). Cognitive functions were measured using the Chinese version of MMSE for the baseline and follow-up data. Binary logistic regression analysis was used to examine the association between 3 h/day of LPA and cognitive functions. Baseline dependent variables were whether participants had overall cognitive impairment and whether scores of domain-specific MMSE were at the maximum level; in the follow-up analysis, the dependent variables were whether overall and domain-specific scores of MMSE maintained or increased (obtained by subtracting the baseline from the follow-up overall and individual domain MMSE scores).

Results

A total of 167 participants were included (52.10% female; 76.11 ± 6.47 years). The cross-sectional analysis results indicated that in the adjusted model (adjusted for age, sex, educational degree, wear time, MVPA time, and sedentary behavior time), both overall and domain-specific cognitive functions were not significantly associated with ≥ 3 h/day of LPA. The longitudinal analysis results indicated that in the adjusted model, ≥ 3 h/day of LPA was significantly negatively associated with the maintenance or increase of language [odds ratio (OR): 0.88; 95% confidence interval (CI): 0.01-0.99; P = 0.049], and significantly positively associated with the maintenance or increase of orientation (OR: 3.83; 95% CI: 1.01-14.46; P = 0.048).

Conclusion

The cross-sectional and longitudinal impacts of engaging in ≥ 3 h/day of LPA on cognitive functions differed. While engaging in ≥ 3 h/day of LPA has no significant short-term benefits, performing ≥ 3 h/day of LPA is beneficial for maintaining or improving orientation cognitive function in long term. Further studies should explore the longitudinal relationship between LPA and orientation cognitive function to provide a more comprehensive understanding of their potential interactions.

Sex differences in the associations of accelerometer-determined physical activity with physical and cognitive function in older adults living in long-term care

Older adults residing in long-term care often experience declines in physical and cognitive functions despite the access to in-house physical activity (PA) programs. This study aimed to evaluate the associations of PA with physical function and global cognitive function in older adults living in long-term care, while examining potential sex differences. A cross-sectional analysis of baseline data from a two-arm cluster randomized controlled trial was conducted, involving 67 participants (34 men, 33 women). PA levels were assessed using tri-axial accelerometers. Physical function, including muscular strength, postural sway, and Short Physical Performance Battery (SPPB) and cognitive function were measured. Spearman correlation analysis revealed no significant associations between PA metrics and muscular strength, postural sway, or global cognitive function across the entire samples (p ≥ 0.091). Multiple linear regression models were developed for the entire sample, males, and females to examine the associations between PA and physical function measures and global cognitive function. After adjustments for confounders, light PA was significantly associated with higher SPPB sub-scores (gait: β = 0.600, p < 0.001; sit-to-stand: β = 0.574, p < 0.001), faster usual gait speed (β = 0.659, p = 0.012), and shorter sit-to-stand times (β = -0.305, p = 0.041) across the whole sample. Similar significant associations were observed in males between light PA and SPPB scores (total: β = 0.319, p = 0.040; gait: β = 0.532, p < 0.001; sit-to-stand: β = 0.417, p = 0.009), usual gait speed (β = 0.762, p = 0.017), and sit-to-stand times (β = -0.677, p < 0.001). In females, a significant association was found between light PA and global cognitive function (β = 0.319, p = 0.012) after adjusting for confounders. This study highlights sex differences in the association of accelerometer-determined PA with physical and cognitive function in older adults living in long-term care, with LPA showing beneficial effects, especially for physical function in males and for cognitive function in females.

The Association Study on Physical Activity Intensity, Sleep Quality, and Depression among College Students in the Central Plains Region

This investigation sought to understand how physical activity, sleep quality, and depression interrelate among university students in a particular region of China. It involved a diverse group of 2363 students from three institutions, using a cross-sectional approach with well-established measurement tools. These tools demonstrated strong reliability and validity, with Cronbach's alpha values indicating robust internal consistency. The data revealed that higher levels of physical activity were inversely related to depression and directly related to better sleep quality, highlighting the potential of exercise and sleep improvement to reduce depressive symptoms among this demographic.

Latent profile analysis of depressive symptoms in college students and its relationship with physical activity

OBJECTIVE

To explore the classification of depressive symptoms in college students and the relationship between those symptoms and physical activity.

METHODS

A convenience sampling method was employed to enlist college students from Songjiang University Town in Shanghai to complete in the General Information Questionnaire, Patient Health Questionnaire-9, and Physical Activity Scale-3.

RESULTS

A total of 3541 students were analyzed, averaging 19.34 years of age with a male composition of 53 %. The participants can be classified into four categories, namely: Group 1, which exhibits the most severe depressive symptoms, including suicidal ideation and cognitive symptoms (11.07 %); Group 2, which only manifests cognitive symptoms without suicidal ideation (14.35 %); Group 3, which presents mild depressive symptoms (23.61 %); and Group 4, consisting of normal college students (50.97 %). Students with strained family and interpersonal relationships, high levels of academic stress, and low frequency of social activities were at higher risk for detecting suicidal intention and cognitive symptoms. The level of physical activity was significantly higher in the normal group than in the other groups (all P < 0.001), and only the frequency of exercise was significantly different among the remaining three groups (χ2 = 14.716, P = 0.005). The detection rate of cognitive symptoms was significantly lower when exercising >3 times per week for 30-59 min (OR = 0.740, 95 % CI: 0.590-0.928; OR = 0.596, 95 % CI: 0.427-0.831).The detection rate of suicidal thoughts was significantly lower when exercising 2 times per month to 2 times per week or >3 times per week (OR = 0.585, 95 % CI: 0.404-0.847; OR = 0.392, 95 % CI: 0.258-0.595).

CONCLUSION

Suicidal ideation and cognitive symptoms can differentiate between various categories of depressive symptoms among college students. Engaging in physical activity serves as a protective factor against depressive symptoms among college students.

Association of subclinical depressive symptoms and sleep with cognition in the community-dwelling older adults

BACKGROUND

/Purpose: This study aimed to explore the association of subclinical depressive symptoms and sleep with cognition in community-dwelling Taiwanese older adults.

METHODS

This four-year prospective cohort study (2015-2019) included 379 participants aged 65 years or older from the annual senior health checkup program at National Taiwan University Hospital who were followed up two years later. Global and domain cognitive functions were assessed using validated neuropsychological tests. Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression (CES-D) Scale. Sleep quality was evaluated using the Pittsburg Sleep Quality Index (PSQI). Excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Generalized linear mixed models were used to explore the associations of subclinical depressive symptoms and sleep variables with cognition, adjusting for important covariates. Stratification analyses were performed using the sleep variables.

RESULTS

Over time, depressive symptoms were associated with poor performance of memory (βˆ = 0.24, P = 0.04) and executive function (βˆ = -0.24, P = 0.03). Poor sleep quality (elevated PSQI score) was associated with poor memory performance (βˆ = -0.04 to -0.03, P < 0.05). Excessive daytime sleepiness (elevated ESS score) was associated with poor performance of memory (βˆ = -0.02, P < 0.05) and executive function (βˆ = -0.02, P = 0.001). At baseline, better sleep quality and no excessive daytime sleepiness were associated with better memory performance over time.

CONCLUSION

Subclinical depressive symptoms, worse sleep quality, and excessive daytime sleepiness were differentially associated with impairment of cognitive domains (mainly memory and executive function).

Cognitive Function, and Its Relationships with Comorbidities, Physical Activity, and Muscular Strength in Korean Older Adults

Background: Little is known regarding how much physical activity (PA) and lower-body muscle strength (LBMS) together can help to reduce the negative effect of comorbidities on cognitive function. This study examined the moderating effects of PA and LBMS in determining the relationship between comorbidities and cognitive function in older Korean adults. Materials and Methods: This is a population-based cross-sectional study. Data for this study were taken from the 2020 Korea Longitudinal Study on Aging (KLoSA) in South Korea using a computer-assisted personal interview. The 2020 KLoSA survey included a total of 10,097 older individuals aged 65 and older (6062 females and 4035 men). Comorbidities were determined based on physician-diagnosed chronic conditions. PA and LBMS were measured with a self-reported questionnaire and a sit-to-stand test, respectively. Cognitive function was assessed using the Korean version of the Mini-Mental Status Examination for dementia screening. Results: Multimorbidity was correlated with an increased risk (odds ratio, OR = 1.415, p < 0.001) of cognitive impairment. Insufficient PA and weak LBMS were correlated with an increased risk of cognitive impairment (OR = 1.340, p < 0.001; OR = 1.719, p < 0.001, respectively). Particularly, PA modulates the negative impact of comorbidities on cognitive function (β = −0.3833; 95% CI = −0.4743 to −0.2023) independent of all measured covariates. Weak LBMS was found to be an independent predictor of cognitive function (β = −2.5078, p < 0.001) regardless of comorbidities. Conclusions: The study findings suggest that a lifestyle intervention targeting regular PA and muscular fitness should be a therapeutic means against cognitive decline associated with normal aging and/or chronic diseases.