Unhealthy lifestyles during the life course: association with physical decline in late life

Geriatric medicine and Olympic elite sports-parallels and philosophies

The 30th Olympiad took place in July 2024. At first glance, sports science and training of elite athletes may appear to be of little relevance to geriatric medicine. However, there are important parallels between the practice of geriatric medicine and elite sports and lessons that we can learn from our sports science colleagues. Elite athletes and older people are operating at the margins of physiological capacity. Both benefit from tailored, scientifically informed training programmes delivered and monitored by a multidisciplinary team. There are parallels between the comprehensive geriatric assessment and the philosophy of marginal gains pioneered by British Cycling. Insights into the biology of skeletal muscle function are beginning to translate into the development of clinical interventions and substances that offer an unfair advantage in sport by improving muscle strength and physical performance may be of therapeutic benefit in sarcopenia. The 2024 Olympics provide an opportunity for us to learn lessons for excellence in our research and provide an opportunity to promote exercise across the life course-important for healthy ageing.

Factors associated with handgrip strength across the life course: A systematic review

BACKGROUND

Muscle strength is essential for healthy ageing. Handgrip strength (HGS) has been recommended by expert bodies as the preferred measure of muscle strength, in addition to being considered a strong predictor of overall health. Cross-sectional studies have shown several potential factors associated with HGS, but a systematic review of factors predicting HGS over time has not previously been conducted. The aim of this study is to systematically review the literature on the factors associated with adult HGS [at follow-up(s) or its rate of change] across the life course.

METHODS

Searches were performed in MEDLINE via Ebsco, Embase and SPORTDiscus databases. Longitudinal studies assessing potential factors impacting adult HGS over time were included in the analyses. Based on previously established definitions of consistency of results, a semiquantitative analysis was conducted using the proportions of studies supporting correlations with HGS.

RESULTS

A total of 117 articles were included in this review. Factors associated with HGS were grouped into 11 domains: demographic, socioeconomic, genetic, early life, body composition, health markers/biomarkers, health conditions, psychosocial, lifestyle, reproductive and environmental determinants. Overall, 103 factors were identified, of which 10 showed consistent associations with HGS over time (i.e., in at least four studies with ≥60% agreement in the direction of association). Factors associated with greater declines in HGS included increasing age, male sex, higher levels of inflammatory markers and the presence of cardiovascular diseases. Education level, medication use, and self-rated health were not associated with the rate of change in HGS. Increased birth weight was associated with a stronger HGS over time, whereas depressive symptoms were linked to a weaker HGS, and smoking habits showed null associations.

CONCLUSIONS

Comparison between studies and estimation of effect sizes were limited due to the heterogeneity in methods. Although sex and age may be the main drivers of HGS decline, it is crucial to prioritize modifiable factors such as inflammation and cardiovascular diseases in health interventions to prevent greater losses. Interventions to improve birth weight and mental health are also likely to produce positive effects on muscle strength. Our results point to the complexity of processes involving muscle strength and suggest that the need to better understand the determinants of HGS remains.

Does physical activity attenuate the association between ambient PM2.5 and physical function?

BACKGROUND

Physical function (PF), such as muscle strength, performing daily activities, has gradually declined with the increase of age, causing the occurrence of disability and diseases burden. Air pollution exposure and physical activity (PA) were both linked to PF. We aimed to explore the individual and joint effects of particulate matter <2.5 μm (PM_2.5) and PA on PF.

METHODS

A total of 4537 participants and 12,011 observations aged ≥45 years old from the China Health and Retirement Longitudinal Study (CHARLS) cohort from 2011 to 2015 were included into the study. PF was assessed by a combined score of four tests, including grip strength, walking speed, sense of balance, and chair standing tests. Air pollution exposure data was from The ChinaHighAirPollutants (CHAP) dataset. The annual PM_2.5 exposure for each individual was estimated based on county-level resident addresses. We estimated the volume of moderate-to-vigorous physical activity (MVPA) by quoting metabolic equivalent (MET). Multivariate linear model was conducted for baseline analysis, and linear mixed model with random participant intercepts was constructed for cohort longitudinal analysis.

RESULTS

PM_2.5 was negatively associated with PF, while PA was positively associated with PF in baseline analysis. In cohort longitudinal analysis, a 10 μg/m³ increase in PM_2.5 was associated to a 0.025 point (95 % CI: -0.047, -0.003) decrease in PF score, and a 10-MET-h/week increase in PA was related to a 0.004 point (95 % CI: 0.001, 0.008) increase in PF score. The association between PM_2.5 and PF decreased by increased PA intensity, and PA reversed the detrimental effects between PM_2.5 and PF.

CONCLUSION

PA attenuated the association of air pollution with PF at both high and low levels of air pollution, implying that PA may be an effective behavior to reduce the adverse effects of poor air quality on PF.

Associations between physical activity levels with nutritional status, physical fitness and biochemical indicators in older adults

BACKGROUND & AIMS

A sedentary lifestyle is one of the major health concerns of all societies that is associated by an increased risk of cardiovascular diseases. In this regard, we compared the anthropometric parameters, physical fitness (PF), lipid profile, and nutritional status of older adults with different levels of physical activity (PA).

METHODS

In this cross sectional study, 220 older people (age: 67.39 ± 2.08 yrs) according to their PA levels had been categorized at high (n = 72), moderate (78) and low (n = 70) PA groups. The International Physical Activity Questionnaires and food frequency questionnaire has been used to determine the PA and nutritional status, respectively. Waist and hip circumference, height, weight, and body mass index of subjects were measured and calculated. Both lower and upper body strength, flexibility, static and dynamic balance, and endurance performance factors were used to determine the level of PF. To assess blood biochemical factors, subjects were asked to visit the laboratory after 12 h of fasting.

RESULTS

The results showed waist circumference, hip circumference, and body fat percent were significantly lower in the high PA group compared to the low PA group in both males and females (P ≤ 0.05). Upper body strength, lower body strength, static balance, dynamic balance flexibility and endurance were significantly better in the high PA group compared to the low PA group in both males and females (P ≤ 0.05). Moreover, triglyceride was significantly lower in the high PA group compared to the low PA group in both males and females (P ≤ 0.05). According to the post hoc results, high-density lipoprotein, low-density lipoprotein and fasting glucose were significantly better in the high PA group compared to the low PA group in both males and females (P ≤ 0.05). All participants regardless PA levels showed insufficient consumption of zinc, calcium, vitamin E, and vitamin D (P ≤ 0.05). On the other hand, carbohydrate, sodium, iron, vitamin C and niacin intake significantly above recommended dietary allowance (P ≤ 0.05).

CONCLUSIONS

The results of the current work showed that a higher level of PA improved anthropometric indicators, PF, and lipid profile in Iranian older adults. Moreover, older nutrition should be monitor to maintain their physical health and to prevent them from developing chronic diseases and their malnutrition complications.

Age-Related Changes in Physical Fitness Among Community-Living Middle-Aged and Older Japanese: A 12-Year Longitudinal Study

Physical fitness is one of the key factors in healthy aging. Although physical fitness is widely recognized to decline with age, age-related decreases in the individual dimensions of physical fitness in later life are less clear. Purpose: The purpose of the present study was to describe the age-related changes in six fitness components covering a variety of motor dimensions in men and women through a 12-year longitudinal epidemiological study. Method: Participants were randomly selected community-living men (n = 1,139) and women (n = 1,128) aged 40 to 79 years at baseline who were repeatedly tested over a mean (standard deviation) follow-up period of 9.8 (3.4) years with a mean of 4.9 (2.3) examinations. The six physical fitness tests were sit-and-reach, grip strength, sit-ups, one-leg standing, reaction time and leg extension power. The effect of age on each physical fitness task was analyzed using a mixed-effects model controlling for habitual physical activity level. Results: The fixed effect of the interaction of age and time in all fitness tests was significant in men. Higher age at baseline was significantly associated with a greater decrease over time except in one-leg standing. In women, no significant interaction effect of age and time was found in grip strength or reaction time. Age-related changes in grip strength and reaction time were constant with increasing age. Conclusion: Twelve-year longitudinal data showed that the age-related decrease in physical fitness over time, especially musculoskeletal fitness in men, was pronounced, whereas in women, the decrease was less pronounced.

Longitudinal associations between lifestyle, socio-economic position and physical functioning in women at different life stages

Women's physical functioning declines with age and the rate of decline increases with age, but substantial disparities exist in trajectories over time. To inform development of interventions to optimise physical functioning across the adult life span, the aim is to explore which lifestyle and socio-economic position (SEP) factors contribute to disparities in physical functioning across the adult life span in women. Younger (born 1973-1978, n = 14,247), middle-aged (born 1946-1951, n = 13,715) and older (born 1921-1926, n = 12,432) participants from the Australian Longitudinal Study on Women's Health completed six questionnaires between 1996 and 2012 at approximate 3-year intervals. Physical functioning was measured with a 10-item subscale of the Short-Form Health Survey (score 1-100). Relationships between age and physical functioning were modelled using spline regression, stratified by baseline categories of physical activity, alcohol intake, smoking status, level of education, managing on income and index of neighbourhood socio-economic disadvantage for area. Multivariable models excluding one of the six factors were compared with models including all six factors to examine the relative importance of each factor. Women with unhealthy lifestyles (inactive, smokers or risky alcohol intake) and lower SEP had lower levels of physical functioning and more rapid declines across the adult life span. The variables with the greatest relative contribution to the models for physical functioning differed by age cohort: i.e. education and physical activity in younger women, managing on income and physical activity in middle-aged women and physical activity in older women. For optimal physical functioning, socio-economic factors seemed particularly important in younger and middle-aged women, while physical activity seemed important at all ages.

Objectively measured physical activity and physical performance in old age

Background

physical performance is a key factor that determines how older people cope with daily tasks and maintain independency. There is strong evidence suggesting that physical activity (PA) is important in maintaining physical performance in old age. However, most studies have been done using self-reported PA. Our aim was to explore the association between objectively measured PA and physical performance in old age.

Methods

we studied 695 participants (mean age 70.7 years, SD 2.7) from the Helsinki Birth Cohort Study. Physical performance was assessed with the Senior Fitness Test (SFT) and PA with a multisensory activity monitor SenseWear Pro 3 Armband.

Results

total volume of PA was significantly associated with the overall SFT score (β = 0.08; 95% confidence interval: 0.07-0.10, P < 0.001). There were no significant differences between men and women. Both light and moderate to vigorous level of PA were positively associated with the overall SFT score, while sedentary time was negatively associated with the overall SFT score.

Conclusions

volume of objectively measured PA among older people was positively associated with the physical performance measured with a validated fitness test battery.

Associations of vitamin D status and vitamin D-related polymorphisms with sex hormones in older men

OBJECTIVE

Evidence regarding relationships of serum 25-hydroxyvitamin D (25(OH)D) with sex hormones and gonadotropin concentrations remains inconsistent. Polymorphisms in vitamin D-related genes may underly these relationships. Our aim was to examine the relationship of vitamin D status and polymorphisms in vitamin D-related genes with sex hormone and gonadotropin levels.

DESIGN AND MEASUREMENTS

We analysed data from the Longitudinal Aging Study Amsterdam, an ongoing population-based cohort study of older Dutch individuals (65-89 years). We included data of men with measurements of serum 25-hydroxyvitamin D (25(OH)D) (n=643) and determination of vitamin D-related gene polymorphisms (n=459). 25(OH)D concentrations were classified into four categories: <25, 25-50, 50-75 and >75nmol/L. Outcome measures were total testosterone, calculated bioavailable and free fraction testosterone, SHBG, estradiol, LH and FSH concentrations. Hypogonadism was defined as a total testosterone level <8.0nmol/L.

RESULTS

Serum 25(OH)D was positively associated with total and bioavailable testosterone levels. After adjustments for confounders, men with serum 25(OH)D less than 25 (n=56), 25-50 (n=199) and 50-75nmol/L (n=240) had lower total testosterone levels compared to men with serum 25(OH)D higher than 75nmol/L (n=148) (β (95% confidence interval): -2.1 (-3.7 to -0.4nmol/L), -0.8 (-1.9 to 0.4nmol/L) and -1.4 (-2.4 to -0.3nmol/L), respectively). For bioavailable testosterone the association was significant only for men with serum 25(OH)D less than 25nmol/L (-0.8 (-1.4 to -0.1nmol/L)) compared to men with serum 25(OH)D >75nmol/L. Serum 25(OH)D was not related to SHBG, estradiol or gonadotropin levels. Hypogonadism (n=29) was not associated with lower serum 25(OH)D. No significant differences were found in hormone levels between the different genotypes of the vitamin D-related gene polymorphisms. Also, the polymorphisms did not modify the relationships of serum 25(OH)D with sex hormones or gonadotropins.

CONCLUSION

Vitamin D status is positively associated with testosterone levels. No association was found between vitamin D-related gene polymorphisms and hormone levels.

Age-Related Change in Mobility: Perspectives From Life Course Epidemiology and Geroscience

Mobility is the most studied and most relevant physical ability affecting quality of life with strong prognostic value for disability and survival. Natural selection has built the "engine" of mobility with great robustness, redundancy, and functional reserve. Efficient patterns of mobility can be acquired during development even by children affected by severe impairments. Analogously, age-associated impairments in mobility-related physiological systems are compensated and overt limitations of mobility only occur when the severity can no longer be compensated. Mobility loss in older persons usually results from multiple impairments in the central nervous system, muscles, joints, and energetic and sensory physiological systems. Early preclinical changes in these physiological systems that precede mobility loss have been poorly studied. Peak performance, rate of decline, compensatory behaviors, or subclinical deterioration of physiological resources may cumulatively influence both timing of mobility loss and chances of recovery, but their role as risk factors has not been adequately characterized. Understanding the natural history of these early changes and intervening on them would likely be the most effective strategy to reduce the burden of disability in the population. For example, young women with low bone peak mass could be counseled to start strength resistance exercise to reduce their high risk of developing osteoporosis and fracture later in life. Expanding this approach to other physiological domains requires collecting and interpreting data from life course epidemiological studies, establishing normative measures of mobility, physical function, and physical activity, and connecting them with life course trajectories of the mobility-relevant physiological domains.

Noninvasive molecular screening for oral precancer in Fanconi anemia patients

LOH at chromosome arms 3p, 9p, 11q, and 17p are well-established oncogenetic aberrations in oral precancerous lesions and promising biomarkers to monitor the development of oral cancer. Noninvasive LOH screening of brushed oral cells is a preferable method for precancer detection in patients at increased risk for head and neck squamous cell carcinoma (HNSCC), such as patients with Fanconi anemia. We determined the prevalence of LOH in brushed samples of the oral epithelium of 141 patients with Fanconi anemia and 144 aged subjects, and studied the association between LOH and HNSCC. LOH was present in 14 (9.9%) nontransplanted patients with Fanconi anemia, whereas LOH was not detected in a low-risk group (n = 50, >58 years, nonsmoking/nonalcohol history) and a group with somewhat increased HNSCC risk (n = 94, >58 years, heavy smoking/excessive alcohol use); Fisher exact test, P = 0.023 and P = 0.001, respectively. Most frequent genetic alteration was LOH at 9p. Age was a significant predictor of LOH (OR, 1.13, P = 0.001). Five patients with Fanconi anemia developed HNSCC during the study at a median age of 39.6 years (range, 24.8-53.7). LOH was significantly associated with HNSCC (Fisher exact test, P = 0.000). Unexpectedly, the LOH assay could not be used for transplanted patients with Fanconi anemia because donor DNA in brushed oral epithelium, most likely from donor leukocytes present in the oral cavity, disturbed the analysis. Noninvasive screening using a LOH assay on brushed samples of the oral epithelium has a promising outlook in patients with Fanconi anemia. However, assays need to be adapted in case of stem cell transplantation, because of contaminating donor DNA.

Associations of serum 25-hydroxyvitamin D concentrations with quality of life and self-rated health in an older population

CONTEXT

Vitamin D deficiency has been associated with impaired physical functioning, depression, and several chronic diseases and might thereby affect quality of life and self-rated health.

OBJECTIVE

The aim of this study was to assess relationships of serum 25-hydroxyvitamin D [25(OH)D] with quality of life and self-rated health and to examine whether physical performance, depressive symptoms, and number of chronic diseases mediate these relationships.

DESIGN

We analyzed data from the Longitudinal Aging Study Amsterdam, an ongoing population-based cohort study of older Dutch individuals.

MAIN OUTCOME MEASURES

Serum 25(OH)D was classified into the following categories: less than 25, 25-50, and 50 nmol/L or greater. We assessed quality of life (QOL) using the Short Form-12 Health Survey (SF-12; n = 862) and self-rated health (SRH) with a single question, dichotomized into good vs poor SRH (n = 1248).

RESULTS

Individuals with serum 25(OH)D less than 25 nmol/L scored lower on the physical component score of the SF-12 and had a lower odds on good SRH score compared with individuals with serum 25(OH)D greater than 50 nmol/L (β (95% confidence interval) -3.9 (-6.5 to -1.3) for SF-12, and odds ratio [95% confidence interval) 0.50 (0.33-0.76) for SRH]. Physical performance, depressive symptoms, and the number of chronic diseases were associated with vitamin D status, QOL, and SRH. Adding all these potential mediators to regression models attenuated associations of 25(OH)D less than 25 nmol/L with QOL with 78% and SRH with 32%.

CONCLUSION

Lower 25(OH)D status is related to lower scores on QOL and SRH. A large part of the association with QOL can statistically be explained by physical performance, depressive symptoms, and the number of chronic diseases.

A biographical approach to studying individual change and continuity in walking and cycling over the life course

Most research studies seeking to understand walking and cycling behaviours have used cross-sectional data to explain inter-individual differences at a particular point in time. Investigations of individual walking and cycling over time are limited, despite the fact that insights on this could be valuable for informing policies to support life-long walking and cycling. The lack of existing longitudinal data, difficulties associated with its collection and scepticism towards retrospective methods as a means to reconstruct past behavioural developments have all contributed to this deficit in knowledge. This issue is heightened when the time frame extends to longer term periods, or the life course in its entirety. This paper proposes and details a retrospective qualitative methodology that was used to study individual change and stability in walking and cycling within a life course framework. Biographical interviews supported by a life history calendar were developed and conducted with two adult birth cohorts. Interpretive, visual biographies were produced from the interview materials. Analysis focused on identifying the occurrence, context and timing of behavioural change and stability over the life course. Typologies of behavioural development were generated to resolve common and distinct behavioural patterns over the life course. Whilst the validity of reconstructed biographies of walking and cycling cannot be proven, this is an approach which offers credible and confirmable insights on how these behaviours increase, diminish, persist, cease, are restored or adapted through the life course, and how behavioural trajectories of walking and cycling may be evolving through historical time.

A life-course perspective on physical functioning in women

OBJECTIVE

To validate Kalache & Kickbusch's model: namely, that functional capacity peaks in early adulthood, then declines at a rate dependent on fitness level until a "disability threshold" is reached.

METHODS

Data came from the Australian Longitudinal Study on Women's Health, which followed three cohorts from 1996 to 2011: a young, a mid-aged and an older cohort (born in 1973-78, 1946-51 and 1921-26, respectively). The Short Form (36) Health Survey was used to measure physical functioning (score 1-100). The disability threshold was the mean physical functioning score in older women requiring assistance with daily activities (62.8). The relationship between age and physical functioning was modelled using spline regression for the entire sample, and by baseline physical functioning quintile and physical activity level.

FINDINGS

PHYSICAL DECLINE QUICKENED WITH AGE: 0.05 annual units (95% confidence interval, CI: -0.13 to 0.22) at ages 18-23 years (i.e. no decline); -2.43 (95% CI: -2.64 to -2.23) at ages 82-90 years. Decline was faster in quintiles with lower baseline physical functioning in the younger and mid-age cohorts and in quintiles with higher baseline physical functioning in the older cohort. The disability threshold was reached at a mean age of 79 years, but the range was 45-88 years, depending on baseline physical functioning and physical activity.

CONCLUSION

Age and physical decline are not linearly related, as traditionally believed; decline accelerates with age. However, baseline physical functioning, but not physical activity, influences the rate of decline.

Smoking and physical inactivity patterns during midlife as predictors of all-cause mortality and disability: A 39-year prospective study

This study estimated the long-term mortality hazards and disability risks associated with various combinations of smoking and physical inactivity measured over time in a sample of middle-aged adults. Data came from a national sample of Swedish adults, originally interviewed in 1968 and followed until 2007 (N=1,682). Smoking and physical activity status were measured at baseline and 13 years later (1981). Different patterns of change and stability in smoking and physical inactivity over this 13 year period were used as predictors of mortality through 2007. Also, associations between different patterns of these health behaviors and the odds of disability (measured in 2004) were estimated among survivors (n=925). Results suggest that mortality rates were elevated among persistent (HR=1.7; 95% CI=1.5, 2.0) and new smokers (HR=2.5; 95% CI=1.6, 4.1), but not among discontinued smokers. However, mortality rates remained elevated among discontinued smokers who were also persistently inactive (HR=1.9; 95% CI=1.3, 2.6). Additional findings suggest that persistent physical inactivity during midlife was associated with increased odds of late-life disability (OR=1.8; 95% CI=1.1, 2.7), but that smoking had no clear additive or multiplicative effects on disability. As such, these findings indicate that while persistent smoking during midlife primarily impacts subsequent mortality, persistent physical inactivity during midlife appears to counteract the survival benefits of smoking cessation, while also imposing a long-term risk on late life disability among those who do survive to old age.

Adopting an active lifestyle during adulthood and health-related quality of life: the Doetinchem Cohort Study

OBJECTIVES

We examined health-related quality of life in adults who became physically active at recommended levels over a 10-year period compared with adults with different physical activity patterns. Methods. We examined men and women aged 26 to 70 years (mean [SD] = 47.4 [10.1]) in the Doetinchem Cohort Study 3 times between 1995 and 2009. We distinguished participants who became physically active (n = 618), remained active (n = 1286), remained inactive (n = 727), became physically inactive (n = 535), or with varying activity levels (n = 455) over 10 years. We used multivariable linear regression analyses to determine differences in health-related quality of life (survey similar to the 36-Item Short-Form Health Survey) at 10-year follow-up. Results. Adults who became physically active reported better physical functioning, vitality, and general health after 10 years than did persistently inactive adults and adults who became inactive. They also reported less bodily pain and better social functioning than adults who became inactive. No differences were observed with adults who remained active or with varying activity levels. Conclusions. Adopting a physically active lifestyle may result in a better health-related quality of life, comparable to remaining physically active over 10 years.

Use of virtual reality technique for the training of motor control in the elderly. Some theoretical considerations

Virtual augmented exercise, an emerging technology that can help to promote physical activity and combine the strengths of indoor and outdoor exercise, has recently been proposed as having the potential to increase exercise behavior in older adults. By creating a strong presence in a virtual, interactive environment, distraction can be taken to greater levels while maintaining the benefits of indoor exercises which may result in a shift from negative to positive thoughts about exercise. Recent findings on young participants show that virtual reality training enhances mood, thus, increasing enjoyment and energy. For older adults virtual, interactive environments can influence postural control and fall events by stimulating the sensory cues that are responsible in maintaining balance and orientation. However, the potential of virtual reality training has yet to be explored for older adults. This manuscript describes the potential of dance pad training protocols in the elderly and reports on the theoretical rationale of combining physical game-like exercises with sensory and cognitive challenges in a virtual environment.

[The Longitudinal Ageing Study Amsterdam: a survey of 17 years of research into changes in daily functioning]

In this article, a report is provided of results from the Longitudinal Aging Study Amsterdam (LASA). LASA is a study on determinants and consequences of changes in daily functioning. In this article, the focus is on changes in physical functioning. From longitudinal data, it is observed that many older people experience function loss, especially at higher ages. A host of factors are associated with function loss, such as chronic diseases, cognitive decline, depressive complaints, socio-economic status, and life style. A few of these factors are causal, others are characteristics of groups with raised chances of function loss. From trend analyses, it is apparent that the prevalence of functional limitations is not fixed, but varies over time. The LASA study shows that this prevalence is increasing. In view of the absolute and relative rise of the number of older people in the population, it is of great importance to realise a lower prevalence of function loss and a delay of function loss to older ages. Based on the findings presented, some suggestions for this are given. Also, some directions for future research are described.

Turning anti-ageing genes against cancer

Recent studies in diverse organisms implicate proto-oncogenic pathways, including insulin-like growth factor-I (IGF-I), Ras and AKT/protein kinase B in the ageing process. Although IGF-I is thought to contribute to cancer by promoting growth and preventing apoptosis, evidence from model organisms suggests that proto-oncogene homologues might contribute to the DNA mutations and chromosomal damage that are observed in tumour cells by increasing DNA damage, in both dividing and non-dividing cells, and involving error-prone systems in DNA repair. This raises the possibility that cancer can be reduced by chronic downregulation of pro-ageing pathways.

Physical activity and risk of cognitive impairment among older persons living in the community

BACKGROUND AND AIMS

Despite growing interest in the physical and environmental factors associated with the risk of cognitive decline, there is still a lack of information explaining whether they are related to each other. The aim of the present study was to evaluate the relationship of lifetime physical activity with cognitive performance in older persons aged 80 years or older.

METHODS

Data are from the baseline evaluation of the ilSIRENTE Study (n=364). Cognitive performance was assessed using a 6-item, 7-category scale [Cognitive Performance Scale (CPS)]. The questionnaire in the ilSIRENTE study form contained one item asking respondents about the frequency of light and high physical activity. Analysis of covariance (ANCOVA) was used to examine the effect of different levels of physical activity on cognitive performance, after adjustment for potential confounding variables.

RESULTS

The mean age of 364 subjects participating in the study was 85.9 (standard deviation [SD] 4.9) years, and 244 (67.0%) were women. Of the total sample, 158 subjects (43%) had a history of high intensity physical activity during young age; the rate of high intensity physical activity was lower during adult age and old age (125 and 67 subjects, respectively). After adjustment for potential confounders, individuals with a history of high intensity physical activity had a significantly lower CPS score (indicating better performance) than other participants, independently of the age period considered.

CONCLUSIONS

The present study suggests that, among old-old subjects living in the community, a history of high physical activity is associated with better cognitive performance.