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Bode M, Kalbe E, Liepelt-Scarfone I. Cognition and Activity of Daily Living Function in people with Parkinson's disease. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02796-w. [PMID: 38976044 DOI: 10.1007/s00702-024-02796-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/08/2024] [Indexed: 07/09/2024]
Abstract
The ability to perform activities of daily living (ADL) function is a multifaceted construct that reflects functionality in different daily life situations. The loss of ADL function due to cognitive impairment is the core feature for the diagnosis of Parkinson's disease dementia (PDD). In contrast to Alzheimer's disease, ADL impairment in PD can be compromised by various factors, including motor and non-motor aspects. This narrative review summarizes the current state of knowledge on the association of cognition and ADL function in people with PD and introduces the concept of "cognitive ADL" impairment for those problems in everyday life that are associated with cognitive deterioration as their primary cause. Assessment of cognitive ADL impairment is challenging because self-ratings, informant-ratings, and performance-based assessments seldomly differentiate between "cognitive" and "motor" aspects of ADL. ADL function in PD is related to multiple cognitive domains, with attention, executive function, and memory being particularly relevant. Cognitive ADL impairment is characterized by behavioral anomalies such as trial-and-error behavior or task step omissions, and is associated with lower engagement in everyday behaviors, as suggested by physical activity levels and prolonged sedentary behavior. First evidence shows that physical and multi-domain interventions may improve ADL function, in general, but the evidence is confounded by motor aspects. Large multicenter randomized controlled trials with cognitive ADL function as primary outcome are needed to investigate which pharmacological and non-pharmacological interventions can effectively prevent or delay deterioration of cognitive ADL function, and ultimately the progression and conversion to PDD.
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Affiliation(s)
- Merle Bode
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Eberhard Karls University Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany
- Medical Faculty, University of Cologne, Cologne, Germany
| | - Inga Liepelt-Scarfone
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, Eberhard Karls University Tübingen, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.
- IB-Hochschule, Stuttgart, Germany.
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Moreau C, Rouaud T, Grabli D, Benatru I, Remy P, Marques AR, Drapier S, Mariani LL, Roze E, Devos D, Dupont G, Bereau M, Fabbri M. Overview on wearable sensors for the management of Parkinson's disease. NPJ Parkinsons Dis 2023; 9:153. [PMID: 37919332 PMCID: PMC10622581 DOI: 10.1038/s41531-023-00585-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
Parkinson's disease (PD) is affecting about 1.2 million patients in Europe with a prevalence that is expected to have an exponential increment, in the next decades. This epidemiological evolution will be challenged by the low number of neurologists able to deliver expert care for PD. As PD is better recognized, there is an increasing demand from patients for rigorous control of their symptoms and for therapeutic education. In addition, the highly variable nature of symtoms between patients and the fluctuations within the same patient requires innovative tools to help doctors and patients monitor the disease in their usual living environment and adapt treatment in a more relevant way. Nowadays, there are various body-worn sensors (BWS) proposed to monitor parkinsonian clinical features, such as motor fluctuations, dyskinesia, tremor, bradykinesia, freezing of gait (FoG) or gait disturbances. BWS have been used as add-on tool for patients' management or research purpose. Here, we propose a practical anthology, summarizing the characteristics of the most used BWS for PD patients in Europe, focusing on their role as tools to improve treatment management. Consideration regarding the use of technology to monitor non-motor features is also included. BWS obviously offer new opportunities for improving management strategy in PD but their precise scope of use in daily routine care should be clarified.
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Affiliation(s)
- Caroline Moreau
- Department of Neurology, Parkinson's disease expert Center, Lille University, INSERM UMRS_1172, University Hospital Center, Lille, France
- The French Ns-Park Network, Paris, France
| | - Tiphaine Rouaud
- The French Ns-Park Network, Paris, France
- CHU Nantes, Centre Expert Parkinson, Department of Neurology, Nantes, F-44093, France
| | - David Grabli
- The French Ns-Park Network, Paris, France
- Assistance Publique Hôpitaux de Paris, Department of Neurology, CIC Neurosciences, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Sorbonne University, Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | - Isabelle Benatru
- The French Ns-Park Network, Paris, France
- Department of Neurology, University Hospital of Poitiers, Poitiers, France
- INSERM, CHU de Poitiers, University of Poitiers, Centre d'Investigation Clinique CIC1402, Poitiers, France
| | - Philippe Remy
- The French Ns-Park Network, Paris, France
- Centre Expert Parkinson, NS-Park/FCRIN Network, CHU Henri Mondor, AP-HP, Equipe NPI, IMRB, INSERM et Faculté de Santé UPE-C, Créteil, FranceService de neurologie, hôpital Henri-Mondor, AP-HP, Créteil, France
| | - Ana-Raquel Marques
- The French Ns-Park Network, Paris, France
- Université Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand University Hospital, Neurology department, Clermont-Ferrand, France
| | - Sophie Drapier
- The French Ns-Park Network, Paris, France
- Pontchaillou University Hospital, Department of Neurology, CIC INSERM 1414, Rennes, France
| | - Louise-Laure Mariani
- The French Ns-Park Network, Paris, France
- Assistance Publique Hôpitaux de Paris, Department of Neurology, CIC Neurosciences, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Sorbonne University, Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | - Emmanuel Roze
- The French Ns-Park Network, Paris, France
- Assistance Publique Hôpitaux de Paris, Department of Neurology, CIC Neurosciences, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Sorbonne University, Paris Brain Institute - ICM, Inserm, CNRS, Paris, France
| | - David Devos
- The French Ns-Park Network, Paris, France
- Parkinson's Disease Centre of Excellence, Department of Medical Pharmacology, Univ. Lille, INSERM; CHU Lille, U1172 - Degenerative & Vascular Cognitive Disorders, LICEND, NS-Park Network, F-59000, Lille, France
| | - Gwendoline Dupont
- The French Ns-Park Network, Paris, France
- Centre hospitalier universitaire François Mitterrand, Département de Neurologie, Université de Bourgogne, Dijon, France
| | - Matthieu Bereau
- The French Ns-Park Network, Paris, France
- Service de neurologie, université de Franche-Comté, CHRU de Besançon, 25030, Besançon, France
| | - Margherita Fabbri
- The French Ns-Park Network, Paris, France.
- Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Centre, NS-Park/FCRIN Network and NeuroToul COEN Center, Toulouse University Hospital, INSERM, University of Toulouse 3, Toulouse, France.
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Bode M, Sulzer P, Schulte C, Becker S, Brockmann K, Elben S, Folkerts AK, Ophey A, Schlenstedt C, Witt K, Wojtecki L, Evers J, Maetzler W, Kalbe E, Liepelt-Scarfone I. Multidomain cognitive training increases physical activity in people with Parkinson's disease with mild cognitive impairment. Parkinsonism Relat Disord 2023:105330. [PMID: 36842867 DOI: 10.1016/j.parkreldis.2023.105330] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/02/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023]
Abstract
INTRODUCTION Cognitive impairment in Parkinson's disease (PD), especially in patients with mild cognitive impairment (PD-MCI), coincides with less physical activity. Cognitive trainings (CT) have been found to promote laboratory environment-based movement. Knowledge about their effect in natural home-based environment, reflecting everyday function, is sparse. This explorative study investigated short-term effects of CT on physical activity assessed by home-based accelerometry, and its relation to change of cognitive function over time and non-cognitive outcomes in patients with PD-MCI. Cognitive and non-cognitive correlates of movement parameters at pretest were evaluated as well. METHODS Eighteen patients with PD-MCI of the TrainParC study were analyzed. Those patients received either a 6-week multidomain group CT or physical training (PT). Physical activity and sedentary behavior were assessed with wearable accelerometers worn up to seven days pre- and post-training. RESULTS Patients in the CT group displayed significantly greater increases in active periods after training than patients assigned to PT. In the CT group, increases in executive functioning were associated with increases in active periods and decreases in active mean bout length after training. At pretest, reduced working memory correlated with longer sedentary mean bout length, and impairment in activities of daily living (ADL) correlated with a higher number of sedentary periods. CONCLUSION Study data revealed that CT can increase physical activity in patients with PD-MCI, possibly due to effects on executive functions, which needs further investigation in larger sample sizes. Lower working memory performance and ADL impairment might be associated with a more inactive lifestyle in patients with PD-MCI.
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Affiliation(s)
- Merle Bode
- German Center of Neurodegenerative Diseases (DZNE), Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Patricia Sulzer
- German Center of Neurodegenerative Diseases (DZNE), Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Claudia Schulte
- German Center of Neurodegenerative Diseases (DZNE), Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Sara Becker
- German Center of Neurodegenerative Diseases (DZNE), Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, 2N 1N4, Canada
| | - Kathrin Brockmann
- German Center of Neurodegenerative Diseases (DZNE), Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Saskia Elben
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Ann-Kristin Folkerts
- Department of Medical Psychology, Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Anja Ophey
- Department of Medical Psychology, Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Christian Schlenstedt
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller-Str. 3, 24105, Kiel, Germany; Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Karsten Witt
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller-Str. 3, 24105, Kiel, Germany; Department of Neurology and Research Center Neurosensory Sciences, Carl von Ossietzky University Oldenburg, Heiligengeisthöfe 4, 26121, Oldenburg, Germany
| | - Lars Wojtecki
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany; Department of Neurology, Hospital Zum Heiligen Geist, Broichhausen-Allee 1, 47906, Kempen, Germany
| | - Jordi Evers
- McRoberts B.V., Raamweg 43, 2596, Den Haag, Netherlands
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Elke Kalbe
- Department of Medical Psychology, Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Inga Liepelt-Scarfone
- German Center of Neurodegenerative Diseases (DZNE), Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; IB-Hochschule, Paulinenstr. 45, 70178, Stuttgart, Germany.
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Mc Ardle R, Jabbar KA, Del Din S, Thomas AJ, Robinson L, Kerse N, Rochester L, Callisaya M. Using digital technology to quantify habitual physical activity in community-dwellers with cognitive impairment: A systematic review (Preprint). J Med Internet Res 2022; 25:e44352. [PMID: 37200065 DOI: 10.2196/44352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Participating in habitual physical activity (HPA) can support people with dementia and mild cognitive impairment (MCI) to maintain functional independence. Digital technology can continuously measure HPA objectively, capturing nuanced measures relating to its volume, intensity, pattern, and variability. OBJECTIVE To understand HPA participation in people with cognitive impairment, this systematic review aims to (1) identify digital methods and protocols; (2) identify metrics used to assess HPA; (3) describe differences in HPA between people with dementia, MCI, and controls; and (4) make recommendations for measuring and reporting HPA in people with cognitive impairment. METHODS Key search terms were input into 6 databases: Scopus, Web of Science, Psych Articles, PsychInfo, MEDLINE, and Embase. Articles were included if they included community dwellers with dementia or MCI, reported HPA metrics derived from digital technology, were published in English, and were peer reviewed. Articles were excluded if they considered populations without dementia or MCI diagnoses, were based in aged care settings, did not concern digitally derived HPA metrics, or were only concerned with physical activity interventions. Key outcomes extracted included the methods and metrics used to assess HPA and differences in HPA outcomes across the cognitive spectrum. Data were synthesized narratively. An adapted version of the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess the quality of articles. Due to significant heterogeneity, a meta-analysis was not feasible. RESULTS A total of 3394 titles were identified, with 33 articles included following the systematic review. The quality assessment suggested that studies were moderate-to-good quality. Accelerometers worn on the wrist or lower back were the most prevalent methods, while metrics relating to volume (eg, daily steps) were most common for measuring HPA. People with dementia had lower volumes, intensities, and variability with different daytime patterns of HPA than controls. Findings in people with MCI varied, but they demonstrated different patterns of HPA compared to controls. CONCLUSIONS This review highlights limitations in the current literature, including lack of standardization in methods, protocols, and metrics; limited information on validity and acceptability of methods; lack of longitudinal research; and limited associations between HPA metrics and clinically meaningful outcomes. Limitations of this review include the exclusion of functional physical activity metrics (eg, sitting/standing) and non-English articles. Recommendations from this review include suggestions for measuring and reporting HPA in people with cognitive impairment and for future research including validation of methods, development of a core set of clinically meaningful HPA outcomes, and further investigation of socioecological factors that may influence HPA participation. TRIAL REGISTRATION PROSPERO CRD42020216744; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216744 .
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Breasail MÓ, Biswas B, Smith MD, Mazhar MKA, Tenison E, Cullen A, Lithander FE, Roudaut A, Henderson EJ. Wearable GPS and Accelerometer Technologies for Monitoring Mobility and Physical Activity in Neurodegenerative Disorders: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:8261. [PMID: 34960353 PMCID: PMC8705556 DOI: 10.3390/s21248261] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/26/2021] [Accepted: 12/02/2021] [Indexed: 12/21/2022]
Abstract
Neurodegenerative disorders (NDDs) constitute an increasing global burden and can significantly impair an individual's mobility, physical activity (PA), and independence. Remote monitoring has been difficult without relying on diaries/questionnaires which are more challenging for people with dementia to complete. Wearable global positioning system (GPS) sensors and accelerometers present a cost-effective and noninvasive way to passively monitor mobility and PA. In addition, changes in sensor-derived outcomes (such as walking behaviour, sedentary, and active activity) may serve as potential biomarkers of disease onset, progression, and response to treatment. We performed a systematic search across four databases to identify papers published within the past 5 years, in which wearable GPS or accelerometers were used to monitor mobility or PA in patients with common NDDs (Parkinson's disease, Alzheimer's disease, motor neuron diseases/amyotrophic lateral sclerosis, vascular parkinsonism, and vascular dementia). Disease and technology-specific vocabulary were searched singly, and then in combination, identifying 4985 papers. Following deduplication, we screened 3115 papers and retained 28 studies following a full text review. One study used wearable GPS and accelerometers, while 27 studies used solely accelerometers in NDDs. GPS-derived measures had been validated against current gold standard measures in one Parkinson's cohort, suggesting that the technology may be applicable to other NDDs. In contrast, accelerometers are widely utilised in NDDs and have been operationalised in well-designed clinical trials.
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Affiliation(s)
- Mícheál Ó. Breasail
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU, UK; (M.Ó.B.); (M.D.S.); (M.K.A.M.); (E.T.); (A.C.); (F.E.L.); (E.J.H.)
| | - Bijetri Biswas
- Department of Electronic and Electrical Engineering, Computer Science and Mathematics, University of Bristol, Bristol BS8 1TH, UK
| | - Matthew D. Smith
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU, UK; (M.Ó.B.); (M.D.S.); (M.K.A.M.); (E.T.); (A.C.); (F.E.L.); (E.J.H.)
- Older Peoples Unit, Royal United Hospital NHS Foundation Trust, Bath BN1 3NG, UK
| | - Md Khadimul A. Mazhar
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU, UK; (M.Ó.B.); (M.D.S.); (M.K.A.M.); (E.T.); (A.C.); (F.E.L.); (E.J.H.)
| | - Emma Tenison
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU, UK; (M.Ó.B.); (M.D.S.); (M.K.A.M.); (E.T.); (A.C.); (F.E.L.); (E.J.H.)
| | - Anisha Cullen
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU, UK; (M.Ó.B.); (M.D.S.); (M.K.A.M.); (E.T.); (A.C.); (F.E.L.); (E.J.H.)
| | - Fiona E. Lithander
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU, UK; (M.Ó.B.); (M.D.S.); (M.K.A.M.); (E.T.); (A.C.); (F.E.L.); (E.J.H.)
| | - Anne Roudaut
- Department of Computer Science, University of Bristol, Bristol BS8 1TH, UK;
| | - Emily J. Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU, UK; (M.Ó.B.); (M.D.S.); (M.K.A.M.); (E.T.); (A.C.); (F.E.L.); (E.J.H.)
- Older Peoples Unit, Royal United Hospital NHS Foundation Trust, Bath BN1 3NG, UK
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Objectively assessed physical activity and sedentary behavior and global cognitive function in older adults: a systematic review. Mech Ageing Dev 2021; 198:111524. [PMID: 34181963 DOI: 10.1016/j.mad.2021.111524] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Both physical activity (PA) and sedentary behavior (SB) are important factors for healthy ageing. This systematic review aimed to determine the association of objectively assessed (instrumented) PA and SB with global cognitive function in older adults. METHODS PubMed, Embase, the Cochrane Library (via Wiley), CINAHL, PsychINFO, and SPORTDiscus (via EBSCO) were searched from inception to June 21, 2020 for articles that described associations of objectively assessed PA/SB with global cognitive function in older adults aged 60 years and older. Results were synthesized using an effect direction heat map and albatross plots portrayed estimated effect sizes (standardized regression coefficients (βs)), which were summarized in boxplots. RESULTS In total, 45 articles were included representing a total of 15,817 older adults (mean/median age ranged from 65 to 88 years; 49.5% female). Longitudinal studies (n = 7) showed that higher moderate-to-vigorous and light PA (MVPA and LPA, respectively) and lower SB were associated with better global cognitive function. Standardized βs of cross-sectional studies (n = 38) showed that lower SB (median [IQR], β = 0.078 [0.004-0.184] and higher LPA (β = 0.096 [0.046-0.188]), activity counts (β = 0.131 [0.049-0.224]), number of steps (β = 0.155 [0.096-0.246]), MVPA (β = 0.163 [0.069-0.285]) and total PA (TPA) (β = 0.174 [0.147-0.255]) were associated with better global cognitive function. CONCLUSIONS Higher PA and lower SB are associated with better global cognitive function in older adults. The greatest estimated effect sizes were found for moderate-to-vigorous and TPA, suggesting that greater duration of any PA, and high intensity PA could be most beneficial for global cognitive function.
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Sulzer P, Gräber S, Schaeffer E, van Lummel R, Berg D, Maetzler W, Liepelt-Scarfone I. Cognitive impairment and sedentary behavior predict health-related attrition in a prospective longitudinal Parkinson's disease study. Parkinsonism Relat Disord 2020; 82:37-43. [PMID: 33242663 DOI: 10.1016/j.parkreldis.2020.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 11/06/2020] [Accepted: 11/15/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION In Parkinson's disease (PD), the high burden of motor and non-motor symptoms, such as cognitive impairment or falls, is associated with rapid disease progression and mortality. This is often reflected by an increased drop-out rate of PD patients in longitudinal studies. Active physical behavior can impact the disease course beneficially and has an overall positive effect on health. Contrarily, sedentary behavior is associated with cognitive impairment in PD. The aim of this study was to investigate whether sedentary physical behavior assessed in the home environment and cognitive impairment can predict health-related study attrition due to sickness and death in PD. METHODS Data of 45 PD patients, longitudinally assessed, were analyzed. Of those, 20 patients completed six yearly visits, 16 dropped out due to sickness or death, and nine for other reasons. All patients wore a mobile device to assess physical behavior and completed cognitive testing. RESULTS Logistic regression revealed global cognition was the primary predictor for health-related drop-out in varying models (p ≤ .04). In the survival analysis, cognitive impairment (p = .005) and longer sedentary mean bout length (p = .02) were associated with drop-out due to sickness and death. The occurrence of health-related study drop-out or death was highest in patients with both impaired cognition and longer sedentary bouts. CONCLUSIONS Cognition was the primary predictor for study drop-out due to sickness and death. However, it seems that sedentary behavior might have a potential negative influence on PD patients' health, especially those with cognitive impairment.
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Affiliation(s)
- Patricia Sulzer
- German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Str. 23, 72076, Tübingen, Germany; Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Susanne Gräber
- Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Eva Schaeffer
- Department of Neurology, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | | | - Daniela Berg
- Department of Neurology, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Inga Liepelt-Scarfone
- German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Str. 23, 72076, Tübingen, Germany; Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany; Studienzentrum Stuttgart, IB Hochschule, 70178, Stuttgart, Germany.
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The association between objectively measured physical activity, depression, cognition, and health-related quality of life in Parkinson's disease. Parkinsonism Relat Disord 2018; 48:74-81. [DOI: 10.1016/j.parkreldis.2017.12.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/13/2017] [Accepted: 12/19/2017] [Indexed: 11/21/2022]
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