Association Between Objectively Measured Physical Activity and Cognitive Function in Older Adults-The Reasons for Geographic and Racial Differences in Stroke Study

Objectively measured levels of moderate to vigorous intensity physical activity are associated with cognitive impairment in diabetic hemodialysis patients: a cross-sectional study

Objective

The purpose of this study was to observe the relationship between objectively measured levels of physical activity and cognitive impairment (CI) in the presence or absence of diabetes in middle-aged and elderly hemodialysis patients.

Methods

In this multicenter cross-sectional study, 339 clinically stable hemodialysis patients (210 males; mean age: 67.38 ± 8.07 years) aged ≥55 years were included from 7 dialysis units in Shanghai, China. The Chinese version of the Modified Mini-Mental State Examination (MMSE) was used to assess the CI. The duration of physical activity at different intensities, including moderate to vigorous physical activity (MVPA) as well as light physical activity (LPA), was measured using a triaxial accelerometer (ActiGraph GT3X+, Pensacola, FL, USA). Logistic regression and multiple linear regression were used for analyses.

Results

The prevalence of CI was higher in hemodialysis patients with comorbid diabetes (24.3%). In diabetic patients, MVPA (increase per 10 min/day) was negatively associated with CI after adjusting for covariates [(OR = 0.89, 95%CI = 0.79-0.99), p = 0.042]. However, no significant association between physical activity and CI was found in non-diabetic hemodialysis patients. Further analyses revealed that MVPA was positively associated with temporal orientation, attention and calculation and recall in diabetic hemodialysis patients.

Conclusion

Physical activity was associated with CI in diabetic hemodialysis patients rather than the non-diabetes group. This study is important for early differential diagnosis of CI and improvement of cognitive status in hemodialysis patients.

The Association Between Physical Activity and Cognition in a Racially/Ethnically Diverse Cohort of Older Adults: Results From the Kaiser Healthy Aging and Diverse Life Experiences Study

OBJECTIVE

Most prior research on physical activity (PA) and cognition is based on predominantly white cohorts and focused on associations of PA with mean (average) cognition versus the distribution of cognition. Quantile regression offers a novel way to quantify how PA affects cognition across the entire distribution.

METHODS

The Kaiser Healthy Aging and Diverse Life Experiences study includes 30% white, 19% black, 25% Asian, and 26% Latinx adults age 65+ living in Northern California (n = 1600). The frequency of light or heavy PA was summarized as 2 continuous variables. Outcomes were z-scored executive function, semantic memory, and verbal episodic memory. We tested associations of PA with mean cognition using linear regression and used quantile regression to estimate the association of PA with the 10th-90th percentiles of cognitive scores.

RESULTS

Higher levels of PA were associated with higher mean semantic memory (b = 0.10; 95% CI: 0.06, 0.14) and executive function (b = 0.05; 95% CI: 0.01, 0.09). Associations of PA across all 3 cognitive domains were stronger at low quantiles of cognition.

CONCLUSION

PA is associated with cognition in this racially/ethnically diverse sample and may have larger benefits for individuals with low cognitive scores, who are most vulnerable to dementia.

Circuit Training Improves the Levels of β-Amyloid and Brain-Derived Neurotrophic Factor Related to Cognitive Impairment Risk Factors in Obese Elderly Korean Women

Background: The purpose of this study was to investigate the effect of circuit training on β-amyloid, BDNF, and cognitive function in untrained obese elderly Korean women. Methods: The subjects for the study were aged 65-70 years and were each assigned to a circuit training group (EG, n = 12) or a control group (CG, n = 11). The 60 min combined exercise was performed 3 times per week for 16 weeks. The exercise intensity was progressively increased from a 40% heart rate reserve to a 70% heart rate reserve. The test data were analyzed using a paired t-test, an independent t-test, and a two-way repeated measures ANOVA, and an alpha level of 0.05 was set for all tests of significance. Results: Group-by-time interaction effects were observed for β-amyloid (p < 0.05), brain-derived neurotrophic factor (p < 0.01), and cognitive function (p < 0.05). Within the exercise group, significant differences were found in β-amyloid (p < 0.05), brain-derived neurotrophic factor (p < 0.001), and cognitive function (p < 0.05) when comparing across different time points. Additionally, there were statistically significant differences between groups in post-exercise β-amyloid (p < 0.05), change in β-amyloid (p < 0.05), brain-derived neurotrophic factor (p < 0.01), and cognitive function (p < 0.05). Conclusions: Therefore, it is suggested that the circuit training used in this study could be an effective exercise method for improving the risk factors of cognitive impairment in obese elderly Korean women.

Association between physical activity measured by accelerometry and cognitive function in older adults: a systematic review

OBJECTIVE

To analyze studies that investigated the association between physical activity assessed by accelerometry and cognitive function in older people.

METHODS

A systematic review was carried out in four electronic databases (PubMed, Web of Science, Scopus, and SportsDiscus).

RESULTS

In total, 195 records were identified. Fifty-two studies were selected for a full evaluation; 23 were selected according to the inclusion criteria adopted and divided into four chapters (characteristics of the studies, the association between physical activity level and cognitive function decline, effects of physical activity in reducing the chances of cognitive function decline and effects of physical activity on brain plasticity. The cross-sectional studies had an average score of 7 points, and the cohort studies obtained 10 points, indicating the high quality of the selected studies. Seven studies indicated an association between Moderate to vigorous physical activities (MVPA) and cognitive function, two specifically indicated a reduction in the chances of cognitive function decline according to the interquartile of MVPA, and three studies indicated improvements in MVPA in brain plasticity.

CONCLUSION

Measured by accelerometry, seems to be favorably associated with important outcomes in cognitive function assessed through questionnaires, imaging analyses, and biochemical markers with older adults.

Ambient temperatures associated with reduced cognitive function in older adults in China

The cognitive function status of older adults determines the social function and living quality of older adults, which is related to the healthy development and stability of the society. However, the impact of high or low ambient temperature on cognitive function in older adults remains unclear. Based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we comprehensively assessed the impact of ambient temperature on the cognitive function of older adults in this study. The findings exhibited that for each 1 °C ascent in monthly temperature of high temperature, the examination score of global cognitive function of older adults decreased by 0.48 (95% CI 0.21-0.74), which was greater than that of 0.14 (95% CI 0.06-0.25) for each 1 °C reduction in low temperature. Overall, the detrimental effect of high temperature on cognitive function in older adults was more significant than that of low temperature, including on the five sub-cognitive functions involved. Our research provides vital technical guidance and reference for the health protection and prevention of cognitive function of older adults in specific external environmental conditions under the current climatic variation and temperature rise.

Move Your Body, Boost Your Brain: The Positive Impact of Physical Activity on Cognition across All Age Groups

While the physical improvements from exercise have been well documented over the years, the impact of physical activity on mental health has recently become an object of interest. Physical exercise improves cognition, particularly attention, memory, and executive functions. However, the mechanisms underlying these effects have yet to be fully understood. Consequently, we conducted a narrative literature review concerning the association between acute and chronic physical activity and cognition to provide an overview of exercise-induced benefits during the lifetime of a person. Most previous papers mainly reported exercise-related greater expression of neurotransmitter and neurotrophic factors. Recently, structural and functional magnetic resonance imaging techniques allowed for the detection of increased grey matter volumes for specific brain regions and substantial modifications in the default mode, frontoparietal, and dorsal attention networks following exercise. Here, we highlighted that physical activity induced significant changes in functional brain activation and cognitive performance in every age group and could counteract psychological disorders and neural decline. No particular age group gained better benefits from exercise, and a specific exercise type could generate better cognitive improvements for a selected target subject. Further research should develop appropriate intervention programs concerning age and comorbidity to achieve the most significant cognitive outcomes.

A non-pharmacological multidomain intervention of dual-task exercise and social activity affects the cognitive function in community-dwelling older adults with mild to moderate cognitive decline: A randomized controlled trial

The present study aimed to determine the impact of a 10-month multidomain program using dual-task exercise and social activity conducted at a community-based facility on improved cognitive function in older adults with mild to moderate cognitive decline. The participants included 280 community-dwelling older adults (age 71–91 years) with mild to moderate cognitive decline. The intervention group exercised for 90 min/day, once a week. Their routine included aerobic exercise and dual-task training which cognitive tasks were performed in combination with exercise. The control group attended health education classes thrice. Before and after the intervention, we measured their cognitive function, physical function, daily conversation, and physical activity. The mean adherence rate of the intervention class was 83.0%. According to a repeated-measures multivariate analysis of covariance in an intent-to-treat analysis, logical memory and 6-min walking distance demonstrated a significant time and group interaction effect. Regarding daily physical activities, we observed significant differences in the daily step count and moderate-to-vigorous physical activity in the intervention group. Our non-pharmacological multidomain intervention resulted in a modest improvement in the cognitive or physical function and building health behavior. It may be a helpful program with a potential role in preventing dementia.

Clinical Trial Registration: http://clinicaltrials.gov Identifier ID: UMIN000013097.

The Associations of Loneliness and Social Support with Cognitive Impairment among Middle-Aged and Older Individuals with Diabetes

Diabetes mellitus is a chronic disease with significant morbidity and mortality and it is associated with poor cognitive performance in later life. This study seeks to determine the relationship between social support and cognitive function among participants with type 2 diabetes mellitus (T2DM). We used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, including participants with T2DM aged 45 and older (n = 4821). We examined different aspects of perceived social support, measured as structural social support (e.g., marital status), functional social support (having a caregiver in case of sickness or disability), and loneliness. We examined cognitive functioning using a six-item screener. Our results indicate that adults who felt lonely for 5-7 days per week had almost double the odds of cognitive impairment compared to those who didn't feel lonely. These results suggest that among middle-aged and older individuals with T2DM, interventions targeting lonely adults and which aim to reduce loneliness may combat some of the risks of cognitive decline.

Accelerometer-Assessed Physical Activity and Cognitive Performance among European Adults Aged 50+: The Mediating Effects of Social Contacts and Depressive Symptoms

BACKGROUND

Cognitive decline is a major public health concern worldwide and it is vital to identify and better understand effective population-based means to improve cognitive performance in old age. The current study set out to examine the links between accelerometer-based physical activity with cognitive performance in later life, as well the indirect pathways through one's social network contacts and depression.

METHOD

We used data from 855 participants aged 50 and above who took part in a cross-sectional accelerometer study as part of the Survey of Ageing, Retirement and Health (SHARE). Cognitive function was measured as an average score of fluency, immediate and delayed recall tests, social contacts were the average contact frequency with members of the social support network, and depression was the Euro-D summary score of depressive symptoms. A multiple mediation analysis was conducted to test the direct and indirect associations between total physical activity (intensity gradient) and cognitive function, as well as the mediation of this association by social contacts and depressive symptoms.

RESULTS

Intensity of physical activity was directly related to better cognitive performance (B = 0.170, p = 0.007). The association was partially mediated by social contacts (B = 0.022, 95% CI 0.005, 0.046) and depressive symptoms (B = 0.009, 95% CI 0.009, 0.025), such that total physical activity was linked to cognitive health via more frequent contacts with network members and low depressive symptoms.

CONCLUSIONS

Practitioners might consider encouraging a physically active lifestyle that involves social interactions to support better cognitive aging and mental health.

Total Sedentary Time and Cognitive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-analysis

Background

An estimated 47 million people have dementia globally, and around 10 million new cases are diagnosed each year. Many lifestyle factors have been linked to cognitive impairment; one emerging modifiable lifestyle factor is sedentary time.

Objective

To conduct a systematic review and meta-analysis of peer-reviewed literature examining the association between total sedentary time with cognitive function in middle-aged and older adults under the moderating conditions of (a) type of sedentary time measurement; (b) the cognitive domain being assessed; (c) looking at sedentary time using categorical variables (i.e., high versus low sedentary time); and (d) the pattern of sedentary time accumulation (e.g., longer versus shorter bouts). We also aimed to examine the prevalence of sedentary time in healthy versus cognitively impaired populations and to explore how experimental studies reducing or breaking up sedentary time affect cognitive function. Lastly, we aimed to conduct a quantitative pooled analysis of all individual studies through meta-analysis procedures to derive conclusions about these relationships.

Methods

Eight electronic databases (EMBASE; Web of Science; PsycINFO; CINAHL; SciELO; SPORTDiscus; PubMed; and Scopus) were searched from inception to February 2021. Our search included terms related to the exposure (i.e., sedentary time), the population (i.e., middle-aged and older adults), and the outcome of interest (i.e., cognitive function). PICOS framework used middle-aged and older adults where there was an intervention or exposure of any sedentary time compared to any or no comparison, where cognitive function and/or cognitive impairment was measured, and all types of quantitative, empirical, observational data published in any year were included that were published in English. Risk of bias was assessed using QualSyst.

Results

Fifty-three studies including 83,137 participants met the inclusion criteria of which 23 studies had appropriate data for inclusion in the main meta-analysis. The overall meta-analysis suggested that total sedentary time has no association with cognitive function (r = −0.012 [95% CI − 0.035, 0.011], p = 0.296) with marked heterogeneity (I² = 89%). Subgroup analyses demonstrated a significant negative association for studies using a device to capture sedentary time r = −0.035 [95% CI − 0.063, − 0.008], p = 0.012). Specifically, the domains of global cognitive function (r = −0.061 [95% CI − 0.100, − 0.022], p = 0.002) and processing speed (r = −0.067, [95% CI − 0.103, − 0.030], p < 0.001). A significant positive association was found for studies using self-report (r = 0.037 [95% CI − 0.019, 0.054], p < 0.001). Specifically, the domain of processing speed showed a significant positive association (r = 0.057 [95% CI 0.045, 0.069], p < 0.001). For prevalence, populations diagnosed with cognitive impairment spent significantly more time sedentary compared to populations with no known cognitive impairments (standard difference in mean = −0.219 [95% CI − 0.310, − 0.128], p < 0.001).

Conclusions

The association of total sedentary time with cognitive function is weak and varies based on measurement of sedentary time and domain being assessed. Future research is needed to better categorize domains of sedentary behaviour with both a validated self-report and device-based measure in order to improve the strength of this relationship. PROSPERO registration number: CRD42018082384.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-022-00507-x.

Processing speed mediates the association between physical activity and executive functioning in elderly adults

Advanced aging is associated with cognitive decline. To decrease the healthcare system and socio-economic burdens as well as to promote better quality of life, is important to uncover the factors that may be related to the delay of cognitive impairments in older adults. This study investigated the relationship between physical activity levels, sedentary behavior and cardiorespiratory fitness with cognitive functioning in healthy older adults. Furthermore, it examined the mediating role of processing speed on the association between physical activity and executive functions and long-term memory. Thirty-two individuals aged between 63 and 77 years (M = 68.16, SD = 3.73) underwent measurements of maximal oxygen uptake (VO₂peak), 1-week of PA accelerometer measurement and a comprehensive cognitive assessment. Significant associations were observed between MVPA and cognitive processing speed. Equally, a significant positive indirect effect of MVPA on executive functioning and long-term memory was mediated by processing speed. Also, MVPA levels differentiated cognitive functioning in older adults – the physical active group outperformed the physical inactive group in processing speed, executive functions, and language abilities. Our results contribute to the literature on the MVPA levels as an important tool to promote healthier cognitive aging.

Status of Sedentary Time and Physical Activity of Rural Residents: A Cross-Sectional Population-Based Study in Eastern China

Background

The urbanization process may affect the lifestyle of rural residents in China. Limited information exists on the extent of sedentarism and physical activity (PA) level of rural residents in middle-income countries. This is the first survey on sedentary time (ST) and PA among rural residents in eastern China.

Methods

This cross-sectional observational study randomly samples rural adults from Zhejiang Province in eastern China (n = 1,320). Participants' ST and PA levels were determined from the International Physical Activity Questionnaire Short Form through face-to-face interviews, and the influencing factors of PA levels were assessed through multi-class logistic regression analysis.

Results

The findings showed that the daily ST of the participants ranged from 30 to 660 min, with a median of 240 min (P25, P75:120, 240 min), and 54.6% of participants were sedentary for 240 min or above. The daily ST in men, people aged 18 to 44 years, people with bachelors' degree and above, people working for government agencies or institutions, people with unmarried status, and people with an average income of &lt; 2,000 Yuan was longer than that of other respective groups (p &lt; 0.01). In contrast, the daily ST of people with hypertension or with patients with osteoporosis or osteopenia was less than that of normal people (p &lt; 0.01). Additionally, 69.4% of participants generally had a low level of PA (LPA). Compared with those living in northern Zhejiang, people living in southern Zhejiang who were aged 18–44 years, had bachelor's degree or above, were farmers, and had household incomes below 10,000 Yuan per month were more likely to engage in LPA compared to people &gt; 60 years, with high school or technical education levels or with junior college degrees, working in government agencies and institutions, and with household income above 10,000 Yuan per month (p &lt; 0.05). Furthermore, there was no correlation between ST and PA levels.

Conclusion

Most rural residents in the Zhejiang Province of eastern China had longer daily ST and a LPA. This was predominant in men, young people, highly educated people, unmarried people, and middle to high-income people. Health education programs should be targeted toward specific population groups to decrease the ST and increase PA.

How are combinations of physical activity, sedentary behaviour and sleep related to cognitive function in older adults? A systematic review

The relationships between cognitive function and each of physical activity, sleep and sedentary behaviour in older adults are well documented. However, these three "time use" behaviours are co-dependent parts of the 24-hour day (spending time in one leaves less time for the others), and their best balance for cognitive function in older adults is still largely unknown. This systematic review summarises the existing evidence on the associations between combinations of two or more time-use behaviours and cognitive function in older adults. Embase, Pubmed, PsycInfo, Medline and Emcare databases were searched in March 2020 and updated in May 2021, returning a total of 25,289 papers for screening. A total of 23 studies were included in the synthesis, spanning >23,000 participants (mean age 71 years). Findings support previous evidence that spending more time in physical activity and limiting sedentary behaviour is broadly associated with better cognitive outcomes in older adults. Higher proportions of moderate-vigorous physical activity in the day were most frequently associated with better cognitive function. Some evidence suggests that certain types of sedentary behaviour may be positively associated with cognitive function, such as reading or computer use. Sleep duration appears to share an inverted U-shaped relationship with cognition, as too much or too little sleep is negatively associated with cognitive function. This review highlights considerable heterogeneity in methodological and statistical approaches, and encourages a more standardised, transparent approach to capturing important daily behaviours in older adults. Investigating all three time-use behaviours together against cognitive function using suitable statistical methodology is strongly recommended to further our understanding of optimal 24-hour time-use for brain function in aging.

Deducing the Impact of Physical Activity, Sedentary Behavior, and Physical Performance on Cognitive Function in Healthy Older Adults

Objectives: Participating in physical activity and maintaining physical performance as well as reducing sedentary behavior are discussed to be beneficially associated with cognitive function in older adults. The purpose of this cross-sectional analysis was to differentiate the relevance of objectively measured physical activity, physical performance, and sedentary behavior on cognitive function in healthy older adults (n = 56, age = 76 ± 7 yrs, gender = 30 female). Methods: Accelerometer based physical activity and sedentary behavior were analyzed as minutes per week spent sedentary and physically active with light or moderate to vigorous intensity. Participants' physical performance was assessed via cardiopulmonary exercise testing and analyzed as maximal workload and heart rate, heart rate reserve and peak oxygen uptake. The assessment of cognitive function included working memory, attention, executive function, and verbal memory. Data was analyzed with Spearman and partial correlations. Trial registration: NCT02343029. Results: Light physical activity was moderately associated with executive function (r = -0.339, p = 0.015). Attention was significantly associated with maximal workload (r = -0.286, p = 0.042) and peak oxygen uptake (r = -0.337, p = 0.015). Working memory was associated with maximal workload (r = 0.329, p = 0.017). Conclusion: Whereas a broad range of cognitive function were beneficially linked to physical performance, light intensity activities in particular showed an impact on executive function. Our research underlines the need to separate the impact of physical performance and physical activity on cognitive function and highlights the relevance of light physical activity.

Physical activity moderates the association between executive function and functional connectivity in older adults

Recent evidence suggests that physical activity may influence the functional connectivity of the aging brain. The purpose of this study was to examine the influence of physical activity on the association between executive function and functional connectivity of key brain networks and graph theory metrics in community-dwelling older adults. Participants were 47 older adults (M = 73 years; SD = 5.92) who participated in neuropsychological testing, physical activity measurements, and magnetic resonance imaging (MRI). Seed-to-voxel moderation analyses and graph theory analyses were conducted. Physical activity was significantly positively associated with default mode network functional connectivity (DMN FC; Posterior Cingulate Gyrus, p-FDR = 0.005; Frontal Pole (L), p-FDR = 0.005; Posterior Cingulate Gyrus, p-FDR = 0.006; Superior Frontal Gyrus (L), p-FDR = 0.016) and dorsal attention network functional connectivity (DAN FC; Inferior Frontal Gyrus Pars Opercularis (R), p-FDR = 0.044). The interaction between physical activity and executive function on the DMN FC and DAN FC was analyzed. The interaction between executive function and physical activity was significantly associated with DMN FC. When this significant interaction was probed, the association between physical activity and DMN FC differed between levels of high and low executive function such that the association was only significant at levels of high executive function. These results suggest that greater physical activity in later life is associated with greater DMN and DAN FC and provides evidence for the importance of physical activity in cognitively healthy older adults.

Promoting brain health through physical activity among adults exposed to early life adversity: Potential mechanisms and theoretical framework

Adverse childhood experiences such as abuse, neglect, and poverty, profoundly alter neurobehavioral development in a manner that negatively impacts health across the lifespan. Adults who have been exposed to such adversities exhibit premature and more severe age-related declines in brain health. Unfortunately, it remains unclear whether the negative effects of early life adversity (ELA) on brain health can be remediated through intervention in adulthood. Physical activity may represent a low-cost behavioral approach to address the long-term consequences of ELA on brain health. However, there has been limited research examining the impact of physical activity on brain health among adults with a history of ELA. Accordingly, the purpose of this review is to (1) review the influence of ELA on brain health in adulthood and (2) highlight evidence for the role of neurotrophic factors, hypothalamic-adrenal-pituitary axis regulation, inflammatory processes, and epigenetic modifications in mediating the effects of both ELA and physical activity on brain health outcomes in adulthood. We then propose a theoretical framework to guide future research in this area.

Cognitive Function is a Predictor of the Daily Step Count in Patients With Subacute Stroke With Independent Walking Ability: A Prospective Cohort Study

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Cognition at admission may predict daily step count.

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Cognitive impairment may increase risk of poor ambulation after subacute stroke.

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Ambulation poststroke is influenced by both physical and cognitive factors.

Objectives

To investigate the physical, cognitive, and psychological factors related to daily step count in patients with subacute stroke.

Design

Prospective cohort study.

Setting

A subacute rehabilitation ward with 160 beds.

Participants

Patients with subacute stroke who could walk independently (N=101). Among the 101 participants enrolled in this study (mean age, 64.5±13.5y), 64.4% (n=65) were men and 69.3% (n=70) were patients with cerebral infarction.

Interventions

We assessed ambulatory activity using a pedometer placed in the pants pocket on the nonparalyzed side continuously for 7 consecutive days. We also obtained demographic and clinical information and recorded the following measurement scores: Stroke Impairment Assessment Set, FIM, Mini-Mental State Examination (MMSE), Self-Rating Depression Scale, and Apathy Scale. All measurements were collected at admission and discharge.

Main Outcome Measures

The outcomes assessed were ambulatory activity, motor and sensory functions, functional disability, cognitive function, depressive symptoms, and motivation.

Results

The median daily steps ambulated at admission and discharge were 5584 steps (interquartile range, 3763-7096 steps) and 5991 steps (interquartile range, 4329-8204 steps), respectively. In the univariate regression analysis, age, sex, serum albumin level, affected side of the brain, and MMSE score at admission were significantly associated with the daily step count at discharge. Multiple regression analysis using these 5 items as independent variables revealed that the MMSE score at admission (reference, 28-30 points; B, −2.07; 95% confidence interval, −3.89 to −0.35; β, −0.22; P=.027) was significantly associated with the daily step count at discharge.

Conclusions

Cognitive function at admission had a significant association with the daily step count at discharge in patients with subacute stroke who could walk independently.

Effects of Aerobic, Resistance, or Combined Exercise Training Among Older Adults with Subjective Memory Complaints: A Randomized Controlled Trial

BACKGROUND

Physical exercise is suggested to be effective for preventing cognitive decline in older adults, but the relative efficacy of different types of exercise have yet to be clarified.

OBJECTIVE

This single-blinded randomized controlled trial was designed to investigate the differential effects of aerobic exercise training (AT), resistance exercise training (RT), and combined exercise training (CT) on cognition in older adults with subjective memory complaints (SMC).

METHODS

Community-dwelling older adults with SMC (n = 415; mean age = 72.3 years old) were randomly assigned to one of the four groups: AT, RT, CT, or control group. The study consisted of two phases: a 26-week intervention and a 26-week follow-up. The participants were evaluated at baseline, 26 weeks (postintervention), and 52 weeks (follow-up). The primary outcome of this study was memory function, which was assessed using the Logical Memory II subtest of the Wechsler Memory Scale-Revised (WMS-R) score. The secondary outcomes included global cognitive function, verbal fluency, working memory, processing speed, and executive functions.

RESULTS

Intention-to-treat analysis by a mixed-effect model repeated measure showed that the AT group had significantly improved performance on the WMS-R Logical Memory II test (2.74 [1.82-3.66] points) than the control group (1.36 [0.44-2.28] points) at the postintervention assessment (p = 0.037). The effect was more pronounced in those without amnesia than those with amnesia. No significant improvement was observed in the RT and CT groups.

CONCLUSION

This study suggests that AT intervention can improve delayed memory in community-dwelling older adults, particularly in individuals without objective memory decline.

Racial segregation and cognitive function among older adults in the United States: Findings from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study

OBJECTIVES

Residential segregation is one of the fundamental features of health disparities in the United States. Yet little research has examined how living in segregated metropolitan areas is related to cognitive function and cognitive decline with age. We examined the association between segregation at the Metropolitan Statistical Area (MSA) level and trajectories of age-related cognitive function.

METHOD

Using data from Black and White older adults in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study (n=18,913), we employed linear growth curve models to examine how living in racially segregated MSAs at baseline, measured by the degree of Non-Hispanic Black [NHB] isolation and NHB dissimilarity, was associated with trajectories of age-related cognitive function and how the associations varied by race and education.

RESULTS

Living in MSAs with greater levels of isolation was associated with lower cognitive function (b=-0.093, p<0.05) but was not associated with rates of change in cognitive decline with age. No effects of living in isolated MSAs were found for those with at least a high school education, but older adults with less than a high school education had lower cognitive function in MSAs with greater isolation (b=-0.274, p<0.05). The degree of dissimilarity was not associated with cognitive function. The association between segregation and cognitive function did not vary by race.

DISCUSSION

Metropolitan segregation was associated with lower cognitive function among older adults, especially for those with lower education living in racially isolated MSAs. This suggests complex associations between individual socioeconomic status, place, and cognitive health.

The Association Between Light Physical Activity and Cognition Among Adults: A Scoping Review

BACKGROUND

The physical and cognitive benefits of moderate-vigorous intensity physical activity (MVPA) for adults have been well documented. Recently, there has been increasing interest in the independent health benefits of light-intensity physical activity (LPA). This research has primarily focused on the relationship between LPA and morbidity and mortality risk, with few studies investigating cognitive associations. The purpose of this scoping review was to catalog existing evidence on the association between device-based or technologically measured LPA and cognition among adults, identify trends in the literature, and recommend future areas for research.

METHODS

Six electronic databases were searched between January and June 2020. Forty published studies met the inclusion criteria, which included both healthy and clinical young and older adult populations. Among the 40 articles were 14 acute exercise studies, 4 randomized control trials (RCTs), 18 cross-sectional studies, and 4 longitudinal studies.

RESULTS

7/14 (50%) acute, 3/4 (75%) RCT, 10/18 (56%) cross-sectional, and 2/4 (50%) longitudinal studies reported a significant, positive relationship between LPA and one or more cognitive outcomes. These heterogeneous findings can largely be attributed to the diverse study designs and populations, as well as the numerous assessments used to test the cognitive domains.

CONCLUSION

These collective findings suggest LPA may be a potential lifestyle intervention to improve cognition across adulthood. However, the inconsistent approaches used among these studies suggest a more concerted, unified scientific approach is needed to further understand the LPA-cognition relationship.

Physical Activity and Trajectory of Cognitive Change in Older Persons: Mayo Clinic Study of Aging

BACKGROUND

Little is known about the association between physical activity (PA) and cognitive trajectories in older adults.

OBJECTIVE

To examine the association between PA and change in memory, language, attention, visuospatial skills, and global cognition, and a potential impact of sex or Apolipoprotein E (APOE) ɛ4 status.

METHODS

Longitudinal study derived from the population-based Mayo Clinic Study of Aging, including 2,060 cognitively unimpaired males and females aged ≥70 years. Engagement in midlife (ages 50-65) and late-life (last year) PA was assessed using a questionnaire. Neuropsychological testing was done every 15 months (mean follow-up 5.8 years). We ran linear mixed-effect models to examine whether mid- or late-life PA at three intensities (mild, moderate, vigorous) was associated with cognitive z-scores.

RESULTS

Light intensity midlife PA was associated with less decline in memory function compared to the no-PA reference group (time x light PA; estimate [standard error] 0.047 [0.016], p = 0.004). Vigorous late-life PA was associated with less decline in language (0.033 [0.015], p = 0.030), attention (0.032 [0.017], p = 0.050), and global cognition (0.039 [0.016], p = 0.012). Females who were physically inactive in midlife experienced more pronounced cognitive decline than females physically active in midlife and males regardless of PA (p-values for time interaction terms with midlife PA levels and sex were all p < 0.05 for global cognition). APOE ɛ4 carriership did not moderate the association between PA and cognition.

CONCLUSION

Engaging in PA, particularly of vigorous intensity in late-life, was associated with less pronounced decline in global and domain-specific cognition. This association may differ by sex.

Weather Woes? Exploring Potential Links between Precipitation and Age-Related Cognitive Decline

Rain, snow, or ice may discourage older adults from leaving their homes with potential consequences for social isolation, decreased physical activity, and cognitive decline. This study is the first to examine potential links between annual precipitation exposure and cognitive function in a large population-based cohort of older Americans. We examined the association between precipitation (percent of days with snow or rain in the past year) and cognitive function in 25,320 individuals aged 45+ from the Reasons for Geographic and Racial Differences in Stroke Study. Linear mixed models assessed the relationship between precipitation and cognitive function, as well as rates of change in cognitive function with age. We found a non-linear relationship between precipitation and cognitive function. Compared to those exposed to infrequent precipitation (less than 20% of days with rain/snow in the past year), cognitive function was higher among older adults experiencing moderately frequent precipitation (20–40% of annual days with precipitation). However, beyond more than about 45% of days with precipitation in the past year, there was a negative association between precipitation and cognitive function, with faster rates of cognitive decline with age. These exploratory findings motivate further research to better understand the complex role of precipitation for late-life cognitive function.

Acute exercise, memory, and neural activation in young adults

Acute exercise benefits memory, and the temporal placement of exercise relative to exposure can affect the magnitude of benefits observed. Although the temporal placement appears to be important, there is a limited understanding as to how cognitive benefits in response to acute exercise are achieved. Hence, we conducted a two-part study including a behavioral study and a follow-up functional magnetic resonance imaging (fMRI) study to advance our understanding of the potential role of the effects of exercise on memory and neural activation. For Study One, we assessed the effect of acute exercise on memory in young adults. Participants were randomized to exercise before exposure for 20 min (before only, BO), after exposure for 20 min (After Only, AO), before and after exposure for 10 min at each time (before and after, BA), or to receive no exercise (No-exercise Control, NC). Similar to previous findings, any exercise prior to exposure (BO, BA) benefited some aspects of memory performance. Interestingly, the more consistent and larger benefits were seen with a shorter duration of exercise both before and after exposure (BA). Study Two replicated the methods of Study One comparing the BA condition (which had the most robust benefits) to the NC condition while collecting fMRI data during the memory task. Analyses assessed condition differences of activation during encoding and recall. There were no condition differences during memory encoding, however there was a condition effect on activation in occipito-temporal regions during the memory recall trials. Consistent with previous research, exercise appears to benefit memory with some exercise prior to exposure being important for the benefits achieved. Further, exercise affects neural activation and the results appear complementary to the behavior findings. Future research should use a within-subjects design to control for heterogeneity in behavior and neural activation.

The association between health-related factors, physical and mental diseases, social activities, and cognitive function in elderly Koreans: a population-based cross-sectional study

AIM

The purpose of this study was to verify the association of cognitive function with health-related variables, diseases, and social activities.

METHODS

Data from the 2016 Korean Longitudinal Study of Aging were analyzed. The participants of that study were 5678 adults aged 60 years or older living in 17 major Korean regions nationwide.

RESULTS

Hierarchical multiple regression analyses indicated that gender, age, education, marital status, depressive symptoms, body mass index, regular exercise, activities of daily living, instrumental activities of daily living, hand grip strength, and social activities were all significantly associated with cognitive function in elderly Koreans. However, socioeconomic status, diabetes, smoking, alcohol consumption, attendance at school reunions, volunteer work, and participation in political or civic organizations had no impact on cognitive function. First, the results indicated that men had better cognitive function than women; likewise, married individuals and those with a higher level of education also had better cognitive function. As age increased, cognitive function declined. Second, higher body mass index was related to poorer cognitive function, whereas regular exercise was positively associated with better cognitive function. In addition, higher activities of daily living and instrumental activities of daily living scores were associated with poorer cognitive function. Third, depressive symptoms were negatively associated with cognitive function. Finally, religious activities, social activities, and participation in leisure activities, cultural events, and sports were associated with better cognitive functioning. The possibility of reverse association exists between some of the variables (e.g. religious activity and cognitive function), and it is necessary to verify this possibility through a longitudinal study. The biggest limitation is that this is a cross-sectional study, which made it unfeasible to investigate the causal pathways.

CONCLUSIONS

This study suggests that regularly exercising and attending social activities each help to improve cognitive function in the elderly.

Fast-food for thought: Retail food environments as resources for cognitive health and wellbeing among aging Americans?

In this exploratory sequential mixed-methods study, interviews with 125 adults aged 55-92 (mean age 71) living in the Minneapolis (Minnesota) metropolitan area suggested that eateries, including coffee shops and fast-food restaurants, represent popular neighborhood destinations for older adults and sources of wellbeing. Thematic analysis of how older adults perceived and utilized local eateries included sites of familiarity and comfort; physical and economic accessibility; sociability with friends, family, staff, and customers; and entertainment (e.g., destinations for outings and walks, free newspapers to read). To test the hypothesis that these sites, and the benefits they confer, are associated with cognitive welfare, we analyzed data from urban and suburban community-dwelling participants in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study, a national racially diverse sample of older Americans followed since 2003 (n = 16,404, average age at assessment 72 years). Results from multilevel linear regression models of these data demonstrated a positive association between kernel density of local eateries and cognitive functioning, which corroborated qualitative findings. Taken together, these results complicate our understanding of casual eatery settings as possible sites of wellbeing through social interaction and leisure activities. Results prompt further research investigating whether and how retail food environments can serve as community spaces for older adults that may help buffer against cognitive decline.

Twin studies on the association of physical activity with cognitive and cerebral outcomes

Regular physical activity (PA) offers positive effects on the human body. However, the effects of PA on cognition and in the brain are less clear. In this paper, we narratively review the relationship of PA with cognition and dementia, first from general perspective and then through genetically informed studies on the topic. Then we move on to imaging studies on exercise and brain anatomy first by presenting an overall picture of the topic and then discussing brain imaging studies addressing PA and brain structure in twins in more detailed way. Regarding PA and cognition or dementia, genetically informed studies are uncommon, even though the relationship between PA and cognitive ageing has been extensively studied. It is challenging to find twin pairs discordant for PA and dementia. Concerning brain imaging studies, among PA discordant young adult twin pairs, the more active co-twins showed larger gray matter volumes in striatal, prefrontal, and hippocampal regions and in electrophysiological studies automatic deviance-detection processes differed in brain regions involved with sensorimotor, visual and memory functions.

Relationships of accelerometer-based measured objective physical activity and sedentary behaviour with cognitive function: a comparative cross-sectional study of China's elderly population

Background

This study explored the effects of physical activity and sedentary behaviour on the decline of cognitive ability among the elderly. To compensate for the limitations of self-reported physical activity, objective measures were used.

Methods

A cross-sectional survey of 308 aged people mean 68.66 ± 5.377 years, in Nanjing, China, was conducted. Physical activity was measured using the ActiGraph GT3X+, and cognitive function was measured using the Montreal Cognitive Assessment.

Results

The overall participant model, adjusted for age, BMI, education, and monthly average income, found that light physical activity (β = 0.006, p < 0.01), moderate-vigorous physical activity (β = 0.068, p < 0.001), and total physical activity (β = 0.006, p < 0.01) had a significant linear relationship with cognitive ability, while sedentary time did not (β = − 0.020, p>0.05). Further, light physical activity only affects the cognitive ability of elderly females (β = 0.006, p < 0.05). There was an inverted ‘U’ association between moderate-vigorous physical activity and cognitive ability. The association models found that moderate-vigorous physical activity in the 22.13 min·day^− 1~38.79 min·day^− 1 range affected cognitive ability most beneficially, with the highest beta coefficient among all groups (β = 0.091, p < 0.05).

Conclusions

While physical activity can significantly improve cognitive ability among the elderly, sedentary behaviour is associated with decreased cognitive function across genders.

Long-Term Recreational Football Training and Health in Aging

This narrative review aims to critically analyze the effects of exercise on health in aging. Here we discuss the main clinical and biomolecular modifications induced by long-term recreational football training in older subjects. In particular, the effects induced by long-term recreational football training on cardiovascular, metabolic and musculo-skeletal fitness, together with the modifications in the muscle expression of hallmarks related to oxidative metabolism, DNA repair and senescence suppression pathways and protein quality control mechanisms will be provided. All these topics will be debated also in terms of preventing non-communicable metabolic diseases, in order to achieve successful aging over time.

Predictors of real-life mobility in community-dwelling older adults: an exploration based on a comprehensive framework for analyzing mobility

BACKGROUND

Reduced mobility is associated with a plethora of adverse outcomes. To support older adults in maintaining their independence, it first is important to have deeper knowledge of factors that impact on their mobility. Based on a framework that encompasses demographical, environmental, physical, cognitive, psychological and social domains, this study explores predictors of different aspects of real-life mobility in community-dwelling older adults.

METHODS

Data were obtained in two study waves with a total sample of n = 154. Real-life mobility (physical activity-based mobility and life-space mobility) was assessed over one week using smartphones. Active and gait time and number of steps were calculated from inertial sensor data, and life-space area, total distance, and action range were calculated from GPS data. Demographic measures included age, gender and education. Physical functioning was assessed based on measures of cardiovascular fitness, leg and handgrip strength, balance and gait function; cognitive functioning was assessed based on measures of attention and executive function. Psychological and social assessments included measures of self-efficacy, depression, rigidity, arousal, and loneliness, sociableness, perceived help availability, perceived ageism and social networks. Maximum temperature was used to assess weather conditions on monitoring days.

RESULTS

Multiple regression analyses indicated just physical and psychological measures accounted for significant but rather low proportions of variance (5-30%) in real-life mobility. Strength measures were retained in most of the regression models. Cognitive and social measures did not remain as significant predictors in any of the models.

CONCLUSIONS

In older adults without mobility limitations, real-life mobility was associated primarily with measures of physical functioning. Psychological functioning also seemed to play a role for real-life mobility, though the associations were more pronounced for physical activity-based mobility than life-space mobility. Further factors should be assessed in order to achieve more conclusive results about predictors of real-life mobility in community-dwelling older adults.

Accelerometer-determined physical activity and cognitive function in middle-aged and older adults from two generations of the Framingham Heart Study

INTRODUCTION

Physical activity (PA) may play a role in maintenance of cognitive function in both middle and older ages and prevention of outcomes such as dementia and Alzheimer's disease.

METHODS

Cross-sectional regression analyses were performed in Framingham Heart Study Third Generation (n = 1861) and Offspring (n = 909) cohort participants assessing the association of accelerometry-measured PA with cognitive function, adjusting for age, sex, accelerometer wear time, education, occupational status/PA, and smoking status.

RESULTS

In each cohort, achieving just 10-21.4 min/day moderate-to-vigorous PA related to better executive function (P < .02); and just 10 min/day moderate-to-vigorous PA was associated with better verbal memory in middle-aged adults in the Third Generation cohort (P = .02). In older adults of the Offspring cohort, total PA (measured in steps/day) was associated with better executive function (P < .02).

DISCUSSION

PA at levels lower than the current PA Guidelines (just 10 min/day moderate-to-vigorous PA and total PA including lower intensity PA) were associated with better cognitive function.

Objectively measured physical activity profile and cognition in Finnish elderly twins

Introduction

We studied whether objectively measured physical activity (PA) and sedentary behavior (SB) are associated with cognition in Finnish elderly twins.

Methods

This cross-sectional study comprised twins born in Finland from 1940 to 1944 in the Older Finnish Twin Cohort (mean age, 72.9 years; 726 persons). From 2014 to 2016, cognition was assessed with a validated telephonic interview, whereas PA was measured with a waist-worn accelerometer.

Results

In between-family models, SB and light physical activity had significant linear associations with cognition after adjusting for age, sex, wearing time, education level, body mass index, and living condition (SB: β-estimate, -0.21 [95% confidence intervals, -0.42 to -0.003]; light physical activity: β-estimate, 0.30 [95% confidence intervals, 0.02-0.58]). In within-family models, there were no significant linear associations between objectively measured PA and cognition.

Discussion

Objectively measured light physical activity and SB are associated with cognition in Finnish twins in their seventies, but the associations were attributable to genetic and environmental selection.

General cognitive impairment as a risk factor for motor vehicle collision involvement: a prospective population-based study

This study examined whether cognitive impairment and decline as assessed by a brief mental status screening test is associated with future crash risk in a cohort of older drivers. A three-year prospective study was conducted in a population-based sample of 2000 licensed drivers, aged 70 years and older. At the baseline visit, cognitive impairment was defined as <24 on the Mini Mental State Exam (MMSE). Decline was defined as those with a one-year change in MMSE scores in the lowest quartile (largest decrease). Motor vehicle collision involvement was obtained from the Alabama Department of Public Safety. Poisson regression was used to calculate crude and adjusted rate ratios (RR). There were 278 crashes during the follow-up period. Rates of crash involvement were higher for those with cognitive impairment (crude RR = 2.33) compared to those without impairment at baseline; adjustment for potential confounders namely age and visual processing speed attenuated this relationship (adjusted RR = 1.26, 95% confidence interval (CI) 0.65–2.44). Drivers who experienced a pronounced decline in estimated MMSE scores in one year were 1.64 (95% CI 1.04–2.57) times more likely to have a future at-fault crash, as compared to those whose scores did not decline. Evaluation of MMSE over time may provide important insight in an older driver’s future risk of at-fault crash involvement.

Increased Physical Fitness Is Associated with Higher Executive Functioning in People with Dementia

Physical fitness (PF) has been associated with improved cognition in older age, but less is known about its effects on different cognitive domains in individuals diagnosed with dementia. We explored the associations between PF and cognitive performance in 40 healthy elderly and 30 individuals with dementia. Participants completed a battery of standardized cognitive tests (Mini-Mental State Exam, Verbal Fluency, Prospective and Retrospective Memory Questionnaire, Clock Drawing, and California Verbal Learning Test) and were classified into high versus low levels of PF based on their score on the Physical Fitness Questionnaire. Analyses took into account age, gender, education, occupation, head injury, Internet use, brain training, and past levels of exercise and revealed overall benefits of PF, in particular for the people with dementia. Discriminant analysis showed high accuracy of reclassification, with most errors being due to the misclassification of dementia cases as healthy when they had high PF. The first discriminant function accounted for 83% of the variance. Using individual estimates of this function, which reflected global cognitive performance, confirmed the beneficial role of PF in dementia, even when taking into account age, past level of exercise, and the number of years since the dementia diagnosis. Finally, univariate analyses confirmed the differential sensitivity of the cognitive tests, with MMSE and clock drawing showing reliable interaction effects. This work shows that PF is associated with a reduced level of cognitive deterioration expected with dementia, especially in executive functioning and provides empirical support for the cognitive benefits of interventions promoting PF for individuals with dementia.

Cognitive functioning is more closely related to real-life mobility than to laboratory-based mobility parameters

Increasing evidence indicates that mobility depends on cognitive resources, but the exact relationships between various cognitive functions and different mobility parameters still need to be investigated. This study examines the hypothesis that cognitive functioning is more closely related to real-life mobility performance than to mobility capacity as measured with standardized laboratory tests. The final sample used for analysis consisted of 66 older adults (72.3 ± 5.6 years). Cognition was assessed by measures of planning (HOTAP test), spatial working memory (Grid-Span test) and visuospatial attention (Attention Window test). Mobility capacity was assessed by an instrumented version of the Timed Up-and-Go test (iTUG). Mobility performance was assessed with smartphones which collected accelerometer and GPS data over one week to determine the spatial extent and temporal duration of real-life activities. Data analyses involved an exploratory factor analysis and correlation analyses. Mobility measures were reduced to four orthogonal factors: the factor 'real-life mobility' correlated significantly with most cognitive measures (between r = .229 and r = .396); factors representing 'sit-to-stand transition' and 'turn' correlated with fewer cognitive measures (between r = .271 and r = .315 and between r = .210 and r = .316, respectively), and the factor representing straight gait correlated with only one cognitive measure (r = .237). Among the cognitive functions tested, visuospatial attention was associated with most mobility measures, executive functions with fewer and spatial working memory with only one mobility measure. Capacity and real-life performance represent different aspects of mobility. Real-life mobility is more closely associated with cognition than mobility capacity, and in our data this association is most pronounced for visuospatial attention. The close link between real-life mobility and visuospatial attention should be considered by interventions targeting mobility in old age.

Accelerometer assessed moderate-to-vigorous physical activity and successful ageing: results from the Whitehall II study

Physical activity is key for successful ageing, but questions remain regarding the optimal physical activity pattern. We examined the cross-sectional association between physical activity and successful ageing using data on 3,749 participants (age range = 60-83years) of the Whitehall II study. The participants underwent a clinical assessment, completed a 20-item physical activity questionnaire, and wore a wrist-mounted accelerometer for 9 days. Successful ageing was defined as good cognitive, motor, and respiratory functioning, along with absence of disability, mental health problems, and major chronic diseases. Time spent in moderate-to-vigorous physical activity (MVPA) episodes assessed by accelerometer was classified as "short" (1-9.59 minutes) and "long" (≥10 minutes) bouts. Linear multivariate regression showed that successful agers (N = 789) reported 3.79 (95% confidence interval (CI): 1.39-6.19) minutes more daily MVPA than other participants. Accelerometer data showed this difference to be 3.40 (95% CI:2.44-4.35) minutes for MVPA undertaken in short bouts, 4.16 (95% CI:3.11-5.20) minutes for long bouts, and 7.55 (95% CI:5.86-9.24) minutes for all MVPA bouts lasting 1 minute or more. Multivariate logistic regressions showed that participants undertaking ≥150 minutes of MVPA per week were more likely to be successful agers with both self-reported (Odd Ratio (OR) = 1.29,95% (CI):1.09-1.53) and accelerometer data (length bout ≥1 minute:OR = 1.92, 95%CI:1.60-2.30). Successful agers practice more MVPA, having both more short and long bouts, than non-successful agers.

Objectively Measured Physical Activity and Cognitive Function in Older Adults

PURPOSE

Emerging evidence suggests physical activity (PA) is associated with cognitive function. To overcome limitations of self-report PA measures, this study investigated the association of accelerometer-measured PA with incident cognitive impairment and longitudinal cognition among older adults.

METHODS

Participants were recruited from the cohort study Reasons for Geographic and Racial Differences in Stroke in the United States. Accelerometers provided PA measures, including the percentage of total accelerometer wearing time spent in moderate-to-vigorous-intensity PA (MVPA%), light-intensity PA, and sedentary time for four to seven consecutive days at baseline. Cognitive impairment was defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning, and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.

RESULTS

Participants (N = 6452, 69.7 ± 8.5 yr, 55.3% women, 30.5% Black) with usable accelerometer and cognition measures spent extremely limited time in MVPA (1.5% ± 1.9% of accelerometer wearing time). During an average of 3 yr of follow-up, 346 cases of incident cognitive impairment were observed. After adjustments, participants in higher MVPA% quartiles had a lower risk of cognitive impairment (i.e., quartile 2: odds ratio = 0.64, 95% confidence interval = 0.48-0.84) and better maintenance in executive function (≥0.03 z-score units) and memory (≥0.12 z-score units) compared with quartile 1 (P < 0.05). Stratified analyses showed the same association among White adults, but higher MVPA% was associated with better maintenance of only memory among Black adults. No significance was found for light-intensity PA or sedentary time.

CONCLUSION

There was a dose-response relationship between MVPA% and cognitive function in older adults, with higher levels associated with a 36% or lower risk of cognitive impairment and better maintenance of memory and executive function over time, particularly in White adults.

Physical activity among older Chinese adults living in urban and rural areas: A review

With an increase in rural-to-urban migration, a rapidly aging population, and the rising risk of developing noncommunicable diseases in China, it is important to understand the epidemiology of physical activity (PA) and health in the context of disease prevention and population health. Despite its public health importance, there is a significant lack of knowledge about PA in older Chinese adults that may hamper primary prevention efforts of health promotion in an increasingly aging population. To fill this gap, this article presents a narrative review of PA in the older Chinese adult population with a special focus on residential settings (i.e., urban and rural). Using existing studies, the review examines overall PA patterns and their correlates and discusses public health implications and future research. Although there are some preliminary indications of urban and rural differences in PA in the aging population in China, continued research efforts are needed to facilitate primary prevention efforts aimed at reducing noncommunicable diseases and promoting an active lifestyle among the largest population of older people in the world.