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Rosenberg DE, Wu Y, Idu A, Greenwood-Hickman MA, McCurry SM, LaCroix AZ, Shaw PA. Historic Cognitive Function Trajectories as Predictors of Sedentary Behavior and Physical Activity in Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glae125. [PMID: 38747395 PMCID: PMC11176976 DOI: 10.1093/gerona/glae125] [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: 01/17/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND We examined whether trajectories of cognitive function over 10 years predict later-life physical activity (PA), sedentary time (ST), and sleep. METHODS Participants were from the Adult Changes in Thought (ACT) cohort study. We included 611 ACT participants who wore accelerometers and had 3+ measures of cognition in the 10 years prior to accelerometer wear. The Cognitive Assessment Screening Instrument (CASI) measured cognition and was scored using item-response theory (IRT). activPAL and ActiGraph accelerometers worn over 7 days measured ST and PA outcomes. Self-reported time in bed and sleep quality measured sleep outcomes. Analyses used growth mixture modeling to classify CASI-IRT scores into latent groups and examine associations with PA, ST, and sleep including demographic and health covariates. RESULTS Participants (Mean age = 80.3 (6.5) years, 90.3% White, 57.1% female, 29.3% had less than 16 years of education) fell into 3 latent trajectory groups: average stable CASI (56.1%), high stable CASI (34.0%), and declining CASI (9.8%). The declining group had 16 minutes less stepping time (95% confidence interval [95% CI]: 0.6, 31.4), 1 517 fewer steps per day (95% CI: 138, 2 896), and 16.3 minutes per day less moderate-to-vigorous PA (95% CI: 1.3, 31.3) compared to the average stable group. There were no associations between CASI trajectory and sedentary or sleep outcomes. CONCLUSIONS Declining cognition predicted lower PA providing some evidence of a reverse relationship between PA and cognition in older adults. However, this conclusion is limited by having outcomes at only one time point, a nonrepresentative sample, self-reported sleep outcomes, and using a global cognition measure.
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Affiliation(s)
- Dori E Rosenberg
- Investigative Sciences Division, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Yinxiang Wu
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Abisola Idu
- Biostatistics Division, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | | | - Susan M McCurry
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Andrea Z LaCroix
- Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Pamela A Shaw
- Biostatistics Division, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
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Falck RS, Hsu CL, Best JR, Boa Sorte Silva NC, Hall PA, Li LC, Liu-Ambrose T. Cross-sectional and longitudinal neural predictors of physical activity and sedentary behaviour from a 6-month randomized controlled trial. Sci Rep 2024; 14:919. [PMID: 38195673 PMCID: PMC10776740 DOI: 10.1038/s41598-023-48715-z] [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: 04/18/2023] [Accepted: 11/29/2023] [Indexed: 01/11/2024] Open
Abstract
A sedentary lifestyle offers immediate gratification, but at the expense of long-term health. It is thus critical to understand how the brain evaluates immediate rewards and long-term health effects in the context of deciding whether to engage in moderate-to-vigorous physical activity (MVPA) or sedentary behaviour (SB). In this secondary analysis of a 6-month randomized controlled trial to increase MVPA and reduce SB among community-dwelling adults, we explored how neural activity during an executive control task was associated with MVPA and SB levels. At baseline, a subset of participants (n = 26/61) underwent task-based functional magnetic resonance imaging (fMRI) to examine neural activity underlying executive control using the Now/Later task. MVPA and SB were measured objectively using the Sensewear Mini at baseline, and 2, 4, and 6 months follow-up. We then examined the associations of baseline neural activation underlying executive control with: (1) baseline MVPA or SB; and (2) changes in MVPA and SB over 6 months. Our results determined that there is a complex neurocognitive system associated with MVPA levels, while SB appears to lack any neurocognitive control. In other words, MVPA appears to require neurocognitive effort, while SB may be the default behavioural pattern in adults.
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Affiliation(s)
- Ryan Stanley Falck
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Chun Liang Hsu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - John R Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
| | - Narlon Cassio Boa Sorte Silva
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Peter A Hall
- School of Kinesiology, The University of Waterloo, Waterloo, ON, Canada
| | - Linda C Li
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada.
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada.
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, Vancouver Coastal Health Research Institute, Faculty of Medicine, University of British Columbia, 212-177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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Lin YK, Peters K, Chen IH. Television watching, reading, cognition, depression and life satisfaction among middle-aged and older populations: A group-based trajectory modelling analysis of national data. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5661-e5672. [PMID: 36057964 DOI: 10.1111/hsc.13993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/07/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
This retrospective cohort study aimed to identify heterogeneous cognition, depression, and life satisfaction trajectory groups, and to examine the independent contributions of watching television and reading to these trajectories among middle-aged and older adults. A sample was taken from the Taiwan Longitudinal Study on Aging (TLSA) with measures of cognition, depression, life satisfaction, watching television, and reading during 12 years of follow-up (N = 4440). Group-based trajectory models and multinomial logistic regressions were used. The findings showed that the cohort was separated into three global cognition groups of low-cognition (n = 376), declining-cognition (n = 805), and maintained-cognition (n = 2718); three episodic memory groups of high-declining (n = 540), middle-stable (n = 2066), and improving groups (n = 1293); three depression groups of low-to-low (n = 2571), median-to-high (n = 960), and high-to-high groups (n = 368); and three life satisfaction groups of low- (n = 1133), middle- (n = 977), and high-level groups (n = 1789). Also, the findings demonstrated that after adjusting for covariates, those who did not watch television or read at the baseline had independently significantly increased odds of having lower global cognitive function, higher depression, and lower life satisfaction over time versus those who watched television or read almost every day. Based on the findings obtained, group-based trajectories of cognition, depression, and life satisfaction scores identified distinct subgroups among TLSA participants. Moreover, the findings suggest that healthcare providers need to develop more targeted population interventions to ensure successful aging. Healthcare providers can encourage older adults, particularly new retirees, to participate in leisure activities (i.e., watching television and reading) to reduce prevalence rates of cognitive impairment and depression.
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Affiliation(s)
- Yen-Kuang Lin
- Biostatistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - I-Hui Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Roberts AL, Liu J, Lawn RB, Jha SC, Sumner JA, Kang JH, Rimm EB, Grodstein F, Kubzansky LD, Chibnik LB, Koenen KC. Association of Posttraumatic Stress Disorder With Accelerated Cognitive Decline in Middle-aged Women. JAMA Netw Open 2022; 5:e2217698. [PMID: 35771577 PMCID: PMC9247738 DOI: 10.1001/jamanetworkopen.2022.17698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Posttraumatic stress disorder (PTSD) has been hypothesized to lead to impaired cognitive function. However, no large-scale studies have assessed whether PTSD is prospectively associated with cognitive decline in middle-aged adults. OBJECTIVE To assess the association between PTSD and decline in cognitive function over time. DESIGN, SETTING, AND PARTICIPANTS This cohort study included participants from the Nurses' Health Study II, an ongoing longitudinal cohort study involving community-dwelling middle-aged female nurses residing in the US who had at least a 2-year nursing degree at the time of enrollment in 1989. The present study included 12 270 trauma-exposed women who were enrolled in the PTSD substudy of the Nurses' Health Study II and completed 1 to 5 cognitive assessments. Data were collected from March 1, 2008, to July 30, 2019. EXPOSURES Lifetime PTSD symptoms, assessed using a validated questionnaire between March 1, 2008, and February 28, 2010. MAIN OUTCOMES AND MEASURES The main outcome was evaluated using the Cogstate Brief Battery, a self-administered online cognitive battery. Cognitive function was measured by a psychomotor speed and attention composite score and a learning and working memory composite score. Women completed the Cogstate Brief Battery every 6 or 12 months (up to 24 months) from October 3, 2014, to July 30, 2019. Linear mixed-effects models were used to evaluate the association of PTSD symptoms with the rate of change in cognition over follow-up, considering a broad range of relevant covariates, including the presence of depression symptoms and history of clinician-diagnosed depression. The rate of cognitive change was adjusted for potential practice effects (ie, potential changes in test results that occur when a test is taken more than once) by including indicators for the number of previous tests taken. RESULTS Among 12 270 women, the mean (SD) age at the baseline cognitive assessment was 61.1 (4.6) years; 125 women (1.0%) were Asian, 75 (0.6%) were Black, 156 (1.3%) were Hispanic, 11 767 (95.9%) were non-Hispanic White, and 147 (1.2%) were of other race and/or ethnicity. A higher number of PTSD symptoms was associated with worse cognitive trajectories. Compared with women with no PTSD symptoms, women with the highest symptom level (6-7 symptoms) had a significantly worse rate of change in both learning and working memory (β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and psychomotor speed and attention (β = -0.05 SD/y; 95% CI, -0.09 to -0.01 SD/y; P = .02), adjusted for demographic characteristics. Associations were unchanged when additionally adjusted for behavioral factors (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and health conditions (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.08 SD/y; 95% CI, -0.11 to -0.04 SD/y; P < .001) and were partially attenuated but still evident when further adjusted for practice effects (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.07 SD/y; 95% CI, -0.10 to -0.03 SD/y; P < .001) and comorbid depression (eg, 6-7 symptoms in the analysis of learning and working memory: β = -0.07 SD/y; 95% CI, -0.11 to -0.03 SD/y; P < .001). CONCLUSIONS AND RELEVANCE In this large-scale prospective cohort study, PTSD was associated with accelerated cognitive decline in middle-aged women, suggesting that earlier cognitive screening among women with PTSD may be warranted. Given that cognitive decline is strongly associated with subsequent Alzheimer disease and related dementias, better understanding of this association may be important to promote healthy aging.
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Affiliation(s)
- Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jiaxuan Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rebecca B. Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shaili C. Jha
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Jae H. Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eric B. Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lori B. Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Neurology, Massachusetts General Hospital, Boston
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston
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Associations of Objectively-Measured Sedentary Time and Patterns with Cognitive Function in Non-Demented Japanese Older Adults: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041999. [PMID: 35206188 PMCID: PMC8871939 DOI: 10.3390/ijerph19041999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 02/01/2023]
Abstract
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.
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Haslam-Larmer L, Shum L, Chu CH, McGilton K, McArthur C, Flint AJ, Khan S, Iaboni A. Real-time location systems technology in the care of older adults with cognitive impairment living in residential care: A scoping review. Front Psychiatry 2022; 13:1038008. [PMID: 36440422 PMCID: PMC9685159 DOI: 10.3389/fpsyt.2022.1038008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION There has been growing interest in using real-time location systems (RTLS) in residential care settings. This technology has clinical applications for locating residents within a care unit and as a nurse call system, and can also be used to gather information about movement, location, and activity over time. RTLS thus provides health data to track markers of health and wellbeing and augment healthcare decisions. To date, no reviews have examined the potential use of RTLS data in caring for older adults with cognitive impairment living in a residential care setting. OBJECTIVE This scoping review aims to explore the use of data from real-time locating systems (RTLS) technology to inform clinical measures and augment healthcare decision-making in the care of older adults with cognitive impairment who live in residential care settings. METHODS Embase (Ovid), CINAHL (EBSCO), APA PsycINFO (Ovid) and IEEE Xplore databases were searched for published English-language articles that reported the results of studies that investigated RTLS technologies in persons aged 50 years or older with cognitive impairment who were living in a residential care setting. Included studies were summarized, compared and synthesized according to the study outcomes. RESULTS A total of 27 studies were included. RTLS data were used to assess activity levels, characterization of wandering, cognition, social interaction, and to monitor a resident's health and wellbeing. These RTLS-based measures were not consistently validated against clinical measurements or clinically important outcomes, and no studies have examined their effectiveness or impact on decision-making. CONCLUSION This scoping review describes how data from RTLS technology has been used to support clinical care of older adults with dementia. Research efforts have progressed from using the data to track activity levels to, most recently, using the data to inform clinical decision-making and as a predictor of delirium. Future studies are needed to validate RTLS-based health indices and examine how these indices can be used to inform decision-making.
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Affiliation(s)
- Lynn Haslam-Larmer
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Leia Shum
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Charlene H Chu
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Kathy McGilton
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Caitlin McArthur
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | - Alastair J Flint
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, Canada
| | - Shehroz Khan
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Andrea Iaboni
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, Canada
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