Development of a Conceptual Model for Smoking Cessation: Physical Activity, Neurocognition, and Executive Functioning

Association between habitual physical activity on episodic memory strategy use and memory controllability

Background: The primary objective of this study was to evaluate the association between habitual physical activity engagement and perceived controllability of memory function. Secondary objectives included the evaluation of physical activity on memory strategy use, and whether the latter mediates the relationship between physical activity on memory controllability. Methods: Two-hundred and nine young adults (M_age=25 y) completed a brief survey evaluating physical activity (Physical Activity Vital Signs Questionnaire), memory strategy use (Memory Functioning Questionnaire), and memory controllability (Memory Controllability Inventory). Results: Physical activity was not associated with memory strategy use (β=0.68; 95% CI: -1.25,2.62; P=0.48), nor was memory strategy use associated with memory controllability. Physical activity was consistently associated with various attributes of memory controllability, including Present Ability (β=1.10; 95% CI: 0.07, 2.12; P=0.03), Potential Improvement (β=0.84; 95% CI:0.05, 1.63; P=0.03), Effort Utility (β=0.87; 95% CI: 0.11, 1.61; P=0.02), Inevitable Decrement (β=-1.19; 95% CI: -2.19, -0.19; P=0.02) and Alzheimer's likelihood (β=-1.21; 95% CI: -2.29,-0.12; P=0.02). Conclusion: Physical activity is consistently associated with greater perceptions of memory controllability. Future longitudinal and experimental work on this topic is warranted to evaluate if physical activity can foster an individual's ability to modify their behavior and cognitions to enhance and preserve memory function.

The Prospective Association Between the Five Factor Personality Model With Health Behaviors and Health Behavior Clusters

To examine the prospective association of personality with individual behavior, multibehavior and clustered health behavior profiles. A prospective study design was employed. Two hundred young adults provided baseline data and 126 (mean age: 21.6 yrs) provide complete data for a 5-month follow-up assessment (63% response rate). Personality and health behaviors (and covariates) were assessed via validated questionnaires. A multibehavior index variable was created ranging from 0-5; two separate health behavior cluster indices were created, including high (4-5 behaviors) vs. low (2 or fewer) behavior adoption and an energy balance cluster (MVPA and diet). When examining MVPA as a continuous variable, the personality trait conscientiousness was prospectively associated with MVPA and a healthy diet. Extraversion was prospectively associated with high (vs. low) behavioral clustering (OR = 1.18; 95% CI: 1.00-1.40) and conscientiousness was prospectively associated with energy balance clustering (OR = 1.09; 95% CI: 1.01-1.17). Extraversion, conscientiousness, openness to experience, and agreeableness were associated with select health-related behaviors. Further, extraversion and conscientiousness were associated with health behavior clustering.

Harnessing centred identity transformation to reduce executive function burden for maintenance of health behaviour change: the Maintain IT model

The inability to produce sustainable lifestyle modifications (e.g., physical activity, healthy diet) remains a major barrier to reducing morbidity and mortality from prevalent, preventable conditions. The objective of this paper is to present a model that builds on and extends foundational theory and research to suggest novel approaches that may help to produce lasting behaviour change. The model aims to integrate factors not typically examined together in order to elucidate potential processes underlying a shift from behaviour initiation to long-term maintenance. The central premise of the Maintain IT model builds on approaches demonstrating that in-tact executive function (EF) is critical for health behaviour initiation, for more complex behaviours beyond initiation, and in unsupportive environments and circumstances, but successful recruitment of EF is effortful and prone to error. Enduring changes are more likely if the underlying cognitive processes can become less effortful (non-conscious, automatic). The Maintain IT model posits that a centred identity transformation is one path leading to less effortful processing and facilitating successful recruitment of EF when necessary over the long term, increasing the sustainability of health behaviour change. A conceptual overview of the literature supporting the utility of this integrative model, future directions, and anticipated challenges are presented.

The Association Between Weight Status, Weight History, Physical Activity, and Cognitive Task Performance

PURPOSE

Physical activity has been shown to attenuate the association between overweight/obesity and deleterious cardiovascular health-related outcomes, with emerging work also taking the duration of overweight/obesity into consideration. No previous work, however, has explored the interrelationships between physical activity, obesity, and obesity duration in the context of cognitive task performance, which was the purpose of this study.

METHOD

Data from the 1999-2002 National Health and Nutrition Examination Survey were used (N = 2322 adults 60-85 yrs). Physical activity was assessed via self-report, with body mass index (BMI) directly measured. Participants were classified into one of eight mutually exclusive groups: (0) normal weight now and 10 years ago and active now (n = 195), (1) normal weight and 10 years ago and inactive now (n = 265), (2) normal weight now but not 10 years ago and active now (n = 46), (3) normal weight now but not 10 years ago and inactive now (n = 123), (4) overweight/obese now but not 10 years ago and active now (n = 117), (5) overweight/obese now but not 10 years ago and inactive now (n = 168), (6) overweight/obese now and 10 years ago and active now (n = 435), and (7) overweight/obese now and 10 years ago and inactive now (n = 973). The digit symbol substitution test (DSST) was employed to assess cognitive task performance.

RESULTS

After adjustments, only individuals who were inactive (groups 1, 3, 5, and 7) had significantly lower cognitive task performance.

CONCLUSION

Being inactive, regardless of weight classification and duration of overweight/obesity, was inversely associated with cognitive task performance in this national sample of older adults.

Longitudinal Effects of Personality on Physical Activity Among College Students: Examining Executive Function as a Potential Moderator

Objective The purpose of this study was to examine the relationship between personality and physical activity, with a specific focus on whether executive function moderates this relationship. Methods One hundred twenty-six young adults provided complete data at baseline and the five-month follow-up assessment. Executive function was assessed via the parametric Go/No-Go computer task; outcome measures of parametric Go/No-Go were mean reaction time and percent of correct target detection across executive function tasks (simple rule and repeating rule). Personality and moderate-to-vigorous physical activity were assessed via validated questionnaires; one-week test-retest was established on a random sample of the participants, with pedometry employed in the subsample. Results Individuals with a higher baseline conscientiousness personality type had greater five-month follow-up moderate-to-vigorous physical activity (β = 18.5; 95% confidence interval: 5.3, 31.7; p = .006). There was no evidence of an interaction effect for personality trait and executive function on five-month follow-up moderate-to-vigorous physical activity. Conclusion The personality trait conscientiousness was associated with greater moderate-to-vigorous physical activity. However, there was no evidence to suggest that executive function moderates the role between personality and moderate-to-vigorous physical activity. Thus, if confirmed by future work, personality may exert its effects on moderate-to-vigorous physical activity independent of executive function level.

Exercise Facilitates Smoking Cessation Indirectly via Intention to Quit Smoking: Prospective Cohort Study Among a National Sample of Young Smokers

INTRODUCTION

We evaluated the specific association between exercise and smoking cessation via smoking-mediated intentions to quit smoking among a national sample of young daily smokers in the United States.

DESIGN

Prospective cohort study over a 2-year period, with daily smokers assessed across all 50 states in the United States.

SETTING

Data from the 2003 to 2005 National Youth Smoking Cessation Survey were used.

PARTICIPANTS

A total of 1175 young adult smokers aged between 18 and 24 years.

MEASURES

Baseline exercise and intent to quit smoking were assessed via validated survey measures. Smoking status at the 2-year follow-up period was assessed via survey assessment.

RESULTS

After adjustments, meeting exercise guidelines at baseline was associated with an increased baseline intent to quit smoking among this national sample of daily smokers (OR = 1.49; 95% confidence interval [CI]: 1.07-2.07; P = .01). After adjustments, those with a baseline intent to quit smoking had a 71% increased odds ratio (OR) of being a nonsmoker at the 2-year follow-up (OR = 1.71; 95% CI: 1.20-2.44; P = .003). Baseline exercise was not associated with 2-year follow-up smoking status (OR = 0.87; 95% CI: 0.60-1.28; P = .50).

CONCLUSION

In this nationally representative sample of young daily smokers, there was a positive association between exercise participation and intention to quit smoking. Baseline intent to quit smoking was independently associated with nonsmoking status at a 2-year follow-up. Thus, this indirect link between exercise and smoking status may be partially explained by the influence of exercise engagement on smoking-specific intentions.

A Conceptual Neurocognitive Affect-Related Model for the Promotion of Exercise Among Obese Adults

PURPOSE OF REVIEW

Obesity remains a prominent societal threat and burden despite well-promoted prevention and treatment strategies, such as regular engagement in physical activity. Obese individuals, in particular, may be prone to inactivity as a result of a variety of displeasure-related parameters resulting from exercise, such as dyspnea, for instance.

RECENT FINDINGS

This brief conceptual review discusses the integral roles of exercise-induced affective responses within a novel conceptual-based neurocognitive affect-related model. Specifically, this model includes three pathways: (1) pathway A proposes that neurocognition, and especially, executive function-based cognition, may play an influential role in fostering exercise-induced affective responses, (2) pathway B connects an individual's affective response from exercise to their future exercise behavior, and (3) pathway C suggests a cyclical, bi-directional relationship with executive function indirectly influencing future exercise behavior via affective responses to exercise, and exercise itself playing an important role in executive functioning. Future studies should empirically test this model, which may have utility for promoting exercise among the obese population.

Physical activity and cognitive function among older adults with hypertension

OBJECTIVE

We evaluated the specific association between physical activity and cognitive function among a national sample of the broader US adult population with evidence of systemic hypertension.

METHODS

Data from the 1999-2002 National Health and Nutrition Examination Survey were used to identify 1554 older adults, aged 60-85 years, with evidence of hypertension. The Digit Symbol Substitution Test (DSST) was used to assess cognitive function tasks of pairing and free recall among participants. Participants were asked open-ended questions about participation in leisure-time physical activity over the past 30 days. For each of the activities, metabolic equivalent of task-min-month were calculated. Those at or above 2000 metabolic equivalent of task-min-month (equivalent to 150 min/week) were defined as physically active.

RESULTS

In an unadjusted weighted multivariable linear regression model, those meeting moderate-to-vigorous physical activity guidelines (vs. not) had a DSST score 8.3 units higher (β = 8.3; 95% confidence interval: 5.9-10.7; P < 0.001). After adjusting for age, sex, race-ethnicity, smoking status, energy intake, weight status, HDL cholesterol, total cholesterol, cholesterol medication status, glycated hemoglobin, diabetes medication status, and blood pressure medication status, those meeting moderate-to-vigorous physical activity guidelines (vs. not) had a DSST score 6.23 units higher (β = 6.23; 95% confidence interval: 4.6-7.9; P < 0.001).

CONCLUSION

In this national sample of hypertensive older adults, meeting physical activity guidelines was associated with higher cognitive function.

Effects of a Sedentary Intervention on Cognitive Function

PURPOSE

To examine the effects of a free-living, sedentary-inducing intervention on cognitive function.

DESIGN

Randomized controlled, parallel group intervention.

SETTING

University campus.

PARTICIPANTS

Thirty-three young adults (n = 23 intervention; n = 10 control).

MEASURES

The intervention group was asked to eliminate all exercise and minimize steps to ≤5000 steps/day for 1 week, whereas the control group was asked to continue normal physical activity (PA) levels for 1 week. Both groups completed a series of 8 cognitive function assessments (assessing multiple parameters of cognition) preintervention and immediately postintervention. The intervention group was asked to resume normal PA levels for 1 week postintervention and completed the cognitive assessments for a third time at 2 weeks postintervention.

ANALYSIS

Split-plot repeated-measures analysis of variance.

RESULTS

The results of our statistical analyses showed that the group × time interaction effect was not significant ( P > .05) for any of the evaluated cognitive parameters.

CONCLUSION

These findings demonstrate the need for future experimental investigations of sedentary behavior to better understand its effects on cognitive function. However, although previous work has demonstrated favorable effects of acute and chronic PA on cognitive function, our findings suggest that a 1-week period of reduced PA does not detrimentally affect cognitive function, which may have encouraging implications for individuals going through a temporary relapse in PA.

Executive function in weight loss and weight loss maintenance: a conceptual review and novel neuropsychological model of weight control

Weight loss maintenance is a complex, multifaceted process that presents a significant challenge for most individuals who lose weight. A growing body of literature indicates a strong relationship between cognitive dysfunction and excessive body weight, and suggests that a subset of high-order cognitive processes known as executive functions (EF) likely play an important role in weight management. Recent reviews cover neuropsychological correlates of weight status yet fail to address the role of executive function in the central dilemma of successful weight loss maintenance. In this paper, we provide an overview of the existing literature examining executive functions as they relate to weight status and initial weight loss. Further, we propose a novel conceptual model of the relationships between EF, initial weight loss, and weight loss maintenance, mapping specific executive functions onto strategies known to be associated with both phases of the weight control process. Implications for the development of more efficacious weight loss maintenance interventions are discussed.

Dose-Response Association Between Physical Activity and Cognitive Function in a National Sample of Older Adults

PURPOSE

Previous research demonstrates a favorable effect of physical activity on cognitive function among older adults. The potential dose-response relationship between physical activity and cognitive function in this population is less understood, which was the purpose of this study.

SETTING

Data from the 1999 to 2002 National Health and Nutrition Examination Survey were employed.

PARTICIPANTS

A total of 2157 older adults aged 60 to 85 years.

MEASURES

Cognitive function was assessed from the Digit Symbol Substitution Test. Moderate-to-vigorous physical activity (MVPA), expressed as metabolic equivalent of task (MET)-min-month (MET-min-month = days × duration × MET level), was assessed via self-report, with 5 MVPA categories evaluated: (1) <2000 MVPA MET-min-month, (2) 2000 to 3999 MVPA MET-min-month, (3) 4000 to 5999 MVPA MET-min-month, (4) 6000 to 7999 MVPA MET-min-month, and (5) 8000+ MVPA MET-min-month.

ANALYSIS

Weighted multivariable linear regression.

RESULTS

An inverted U-shaped relationship was observed. Consistent across several adjusted models, those who engaged in 6000 to 7999 MVPA MET-min-month had the highest cognitive function score.

CONCLUSION

The results suggest an optimal amount of physical activity to prevent the cognitive decline associated with aging.

Executive function influences sedentary behavior: A longitudinal study

Background: No study has evaluated the effects of executive function on follow-up sedentary behavior, which was this study’s purpose.

Methods: A longitudinal design was employed among 18 young adult college students (M_age = 23.7 years; 88.9% female). Accelerometer-determined sedentary behavior and physical activity, along with executive function, were assessed at baseline. Approximately 8 weeks later, re-assessment of accelerometer-determined sedentary behavior and physical activity occurred. Executive function was assessed using the Parametric Go/No-Go (PGNG) computer task. From this, 2 primary executive function outcome parameters were evaluated, including the Simple Rule and Repeating Rule.

Results: After adjusting for baseline sedentary behavior, age, gender, body mass index and baseline moderate-to-vigorous physical activity (MVPA), for every 25% increase in the number of correctly identified targets for the Repeating rule at the baseline assessment, participants engaged in 91.8 fewer minutes of sedentary behavior at the follow-up assessment (β = -91.8; 95% CI: -173.5, -10.0; P = 0.03). Results were unchanged when also adjusting for total baseline or follow-up physical activity.

Conclusion: Greater executive function is associated with less follow-up sedentary behavior.

A Bidirectional Relationship between Executive Function and Health Behavior: Evidence, Implications, and Future Directions

Physically active lifestyles and other health-enhancing behaviors play an important role in preserving executive function into old age. Conversely, emerging research suggests that executive functions facilitate participation in a broad range of healthy behaviors including physical activity and reduced fatty food, tobacco, and alcohol consumption. They do this by supporting the volition, planning, performance monitoring, and inhibition necessary to enact intentions and override urges to engage in health damaging behavior. Here, we focus firstly on evidence suggesting that health-enhancing behaviors can induce improvements in executive function. We then switch our focus to findings linking executive function to the consistent performance of health-promoting behaviors and the avoidance of health risk behaviors. We suggest that executive function, health behavior, and disease processes are interdependent. In particular, we argue that a positive feedback loop may exist whereby health behavior-induced changes in executive function foster subsequent health-enhancing behaviors, which in turn help sustain efficient executive functions and good health. We conclude by outlining the implications of this reciprocal relationship for intervention strategies, the design of research studies, and the study of healthy aging.

Epidemiological investigation of muscle-strengthening activities and cognitive function among older adults

Limited research has examined the association of muscle-strengthening activities and executive cognitive function among older adults, which was this study's purpose. Data from the 1999-2002 NHANES were employed (N = 2157; 60-85 years). Muscle-strengthening activities were assessed via self-report, with cognitive function assessed using the digit symbol substitution test. After adjusting for age, age-squared, gender, race-ethnicity, poverty level, body mass index, C-reactive protein, smoking, comorbid illness and physical activity, muscle-strengthening activities were significantly associated with cognitive function (βadjusted = 3.4; 95% CI: 1.7-5.1; P < 0.001). Compared to those not engaging in aerobic exercise and not meeting muscle-strengthening activity guidelines, those doing 1 (βadjusted = 3.7; 95% CI: 1.9-5.4; P < 0.001) and both (βadjusted = 6.6; 95% CI: 4.8-8.3; P < 0.001) of these behaviors had a significantly higher executive cognitive function score. In conclusion, muscle-strengthening activities are associated with executive cognitive function among older U.S. adults, underscoring the importance of promoting both aerobic exercise and muscle-strengthening activities to older adults.

Multimorbidity, cognitive function, and physical activity

Previous research demonstrates that both physical activity and multimorbidity are associated with cognitive function. However, the extent to which physical activity may moderate the relationship between multimorbidity and cognitive function has not been thoroughly evaluated. Data from the 1999-2002 NHANES were used (60+ years; N = 2157). A multimorbidity index variable was created based on physician diagnosis of a multitude of chronic diseases. Physical activity was self-reported and cognitive function was evaluated from the digit symbol substitution test. Multimorbidity was inversely associated with cognitive function for the unadjusted and adjusted models. However, generally, multimorbidity was no longer associated with cognitive function for the majority of older adults who achieved the minimum recommended physical activity level (≥2000 MET-min-month), as issued by the United States Department of Health and Human Services. In this national sample of older adults, there was some evidence to suggest that physical activity moderates the relationship between multimorbidity and cognitive function.

The association between habitual physical activity and cigarette cravings, and influence of smokers' characteristics in disadvantaged smokers not ready to quit

RATIONALE

Habitual physical activity (PA) may have an important role in suppressing cigarette cravings. Systematic reviews show a strong acute effect of bouts of PA on reducing cigarette cravings, and it may be that these effects accumulate.

OBJECTIVES

The aim was to investigate the relationship between habitual levels of PA and cigarette cravings in disadvantaged smokers not ready to quit by examining baseline cross-sectional data from the Exercise Assisted Reduction then Stop smoking study (EARS).

METHODS

A series of linear regression models were applied to investigate the relationship between habitual PA and cigarette cravings and to identify additional predictors of cigarette cravings. The analyses were extended by including interaction terms with PA to identify potential moderators of the relationship between PA and cravings.

RESULTS

A higher level of moderate intensity PA was associated with lower cravings (p = 0.033). Additional predictors were the mood and physical symptoms scale (p = 0.007; higher scores were associated with higher cravings) and alcohol consumption (p = 0.002; higher consumption was associated with lower cravings). In addition, a moderation effect of alcohol consumption was found; at higher levels of alcohol consumption, higher PA was significantly associated with higher cravings (p = 0.023).

CONCLUSIONS

Overall, participation in regular PA is associated with reduced cigarette cravings; among those with heavy alcohol consumption, this participation is associated with higher cravings. These exploratory analyses suggest that further research into the relationship between PA, alcohol consumption and cigarette cravings is needed.