Bidirectional within- and between-person relations between physical activity and cognitive function

Enhancing Brain Health and Well-Being in Older Adults: Innovations in Lifestyle Interventions

PURPOSE OF REVIEW

This article will provide clinicians with guidance on helping older adult patients make lifestyle changes to enhance brain health and well-being.

RECENT FINDINGS

Evidence suggests that physical activity might be helpful in improving cognitive functioning. The data on the benefits of cognitive activity is inconsistent and not as robust. The MediDiet, DASH, and MIND diets have been associated with better cognitive health. Sleep hygiene and cognitive behavioral therapies are considered first line evidence-based treatments for insomnia and the maintenance of healthy sleep patterns. Mindfulness based interventions have been shown to reduce anxiety, depression, and stress, and can help some older adults manage pain more constructively. Evidence-based information regarding the four topics of exercise, nutrition, sleep, and mindfulness is reviewed, so that clinicians may be better able to optimize care for their older adult patients.

Historic Cognitive Function Trajectories as Predictors of Sedentary Behavior and Physical Activity in Older Adults

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.

Chronic exercise and neuropsychological function in healthy young adults: a randomised controlled trial investigating a running intervention

Despite the well-known physical and mental health benefits of regular exercise, many of the world's population, including healthy young adults, grossly undershoot recommended physical activity levels. Chronic exercise has potential to improve cognitive performance and affect in most age groups. However, there is currently a poverty of relevant research in young adults, especially randomised controlled trials. To address this, the current research investigated the effects of a running intervention on neuropsychological function (cognition and affect) in young adults. We predicted that following a running intervention, neuropsychological performance would improve alongside increases in aerobic fitness. Thirty-two healthy young adult university students were randomised (using a 3:1 ratio) into an intervention or control group, with the intervention group (n = 24) asked to run for 30 min three times a week over a 6-week period and the control group (n = 8) asked to maintain their current level of exercise over a 6-week period. We assessed fitness, cognitive performance, affect and running enjoyment at baseline and follow-up, and runners recorded the environmental conditions of their runs. Repeated measures ANCOVAs failed to find any significant effects of the running intervention on fitness or the neuropsychological measures. Anecdotal evidence supported running environment and enjoyment as potentially relevant factors. The failure to find any fitness improvements, which likely underpins the lack of neuropsychological improvements, highlights the importance of monitoring exercise sessions. Coupled with other insights gained from this trial, this article may prove useful towards future endeavours to develop exercise interventions beneficial to young adults.TRN: ACTRN12621000242820, Date of registration: 08/03/2021.

Physical Activity and Cognitive Decline Among Older Adults: A Systematic Review and Meta-Analysis

Importance

Physical activity is associated with the risk for cognitive decline, but much of the evidence in this domain comes from studies with short follow-ups, which is prone to reverse causation bias.

Objective

To examine how length of follow-up, baseline age, physical activity amount, and study quality modify the longitudinal associations of physical activity with cognition.

Data Sources

Observational studies of adults with a prospective follow-up of at least 1 year, a valid baseline cognitive measure or midlife cohort, and an estimate of the association of baseline physical activity and follow-up cognition were sought from PsycInfo, Scopus, CINAHL, Web of Science, SPORTDiscus, and PubMed, with the final search conducted on November 2, 2022.

Study Selection

Two independent researchers screened titles with abstracts and full-text reports.

Data Extraction and Synthesis

Two reviewers independently assessed study quality and extracted data. Pooled estimates of association were calculated with random-effects meta-analyses. An extensive set of moderators, funnel plots, and scatter plots of physical activity amount were examined. This study is reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.

Main Outcomes and Measures

Pooled estimates of the associations between physical activity and global cognition, as well as specific cognitive domains, were examined.

Results

A total of 104 studies with 341 471 participants were assessed. Analysis of binary outcomes included 45 studies with 102 452 individuals, analysis of follow-up global cognition included 14 studies with 41 045 individuals, and analysis of change in global cognition included 25 studies with 67 463 individuals. Physical activity was associated with a decreased incidence of cognitive impairment or decline after correction for funnel plot asymmetry (pooled risk ratio, 0.97; 95% CI, 0.97-0.99), but there was no significant association in follow-ups longer than 10 years. Physical activity was associated with follow-up global cognition (standardized regression coefficient, 0.03; 95% CI, 0.02-0.03) and change in global cognition (standardized regression coefficient, 0.01; 95% CI, 0.01 to 0.02) from trim-and-fill analyses, with no clear dose-response or moderation by follow-up length, baseline age, study quality or adjustment for baseline cognition. The specific cognitive domains associated with physical activity were episodic memory (standardized regression coefficient, 0.03; 95% CI, 0.02-0.04) and verbal fluency (standardized regression coefficient, 0.05; 95% CI, 0.03-0.08).

Conclusions and Relevance

In this meta-analysis of the association of physical activity with cognitive decline, physical activity was associated with better late-life cognition, but the association was weak. However, even a weak association is important from a population health perspective.

Purpose in life and accelerometer-measured physical activity among older adults

OBJECTIVE

Purpose in life is associated with engagement in physical activity and better cognitive health. This study examines the association between purpose in life and patterns of physical activity measured with an accelerometer and whether these patterns mediate the association between purpose and episodic memory among older adults.

METHODS AND MEASURES

This research is a secondary analysis of data from the accelerometry sub-study of the National Health and Aging Trends Study. Participants (N = 747; mean age = 79.20) reported on their purpose, wore an accelerometer for eight days, and completed an episodic memory task.

RESULTS

Purpose in life was associated with healthier patterns of physical activity, including higher total activity counts (β = .10, p = .002), more active bouts per day (β = .11, p = .003), less activity fragmentation (β = -.17, p < .001) and more sedentary fragmentation (β = .11, p = .002). These associations were generally similar across age, sex, race and education. Higher total activity counts and less activity fragmentation were associated with better episodic memory and accounted for part of the association between purpose and episodic memory.

CONCLUSION

Purpose in life is associated with healthier patterns of physical activity measured through accelerometry among older adults and such patterns may be one factor in the pathway from purpose to healthier episodic memory.

Physical activity levels in adults with chronic low back pain: A national survey in the general Spanish population

OBJECTIVE

To identify and compare physical activity levels in the Spanish population with chronic low back pain and their associated factors.

DESIGN

Cross-sectional national study.

SUBJECTS

A total of 3,220 adults with chronic low back pain from the 2017 Spanish National Health Survey.

METHODS

Three groups were defined according to physical activity level (low, moderate, and high) assessed with the International Physical Activity Questionnaire. Descriptive analysis and an ordinal regression model were performed.

RESULTS

Thirty percent of the subjects were classed as doing a low level of physical activity, 53% moderate, and 17% high. Females predominated in the low and moderate groups, and the subjects in the high group were younger. Subjects in the low group reported more use of pain-relief, more severe-extreme pain, more functional limitations, and worse quality of life and mental health. Factors more likely to be associated with higher levels of physical activity were: being male, normal body mass index or overweight, better health status, less pain, less physical and cognitive limitations, and more social support.

CONCLUSION

Different aspects of the biopsychosocial framework were associated with the different levels of physical activity in subjects with chronic low back pain. These findings should be taken into consideration in order to establish suitable public health strategies.