Cognitive function in midlife and beyond: physical and cognitive activity related to episodic memory and executive functions

Impact of Optimism on Cognitive Performance of People Living in Rural Area: Findings From a 20-Year Study in US Adults

Objectives: Mid- or early-late-life cognitive function is an indicator for developing late-life dementia. However, it is still unclear whether rural/urban living contexts provide cognitive benefits across adulthood. Further, higher optimism serves as a general protective factor for many health outcomes. The present study examines associations between rurality/urbanicity, optimism, and change in mid/late-life cognitive functions over time. Methods: Data were from waves 1 to 3 (1995-2015) of the Midlife in the United States (MIDUS) study (N = 2,507). Structural equation models examine whether long-term rural living across both waves (1-2) or intermittent rural living at one wave is associated with better cognitive function over 20 years, compared to no rural living, while controlling for prior cognitive function and covariates (baseline socio-demographics, health, and functional status). Additionally, we assessed if optimism mediates the above associations. Results: After controlling for covariates, long-term rural living (waves 1-2) was indirectly (through less optimism) associated with significantly lower levels of cognitive executive function and episodic memory in wave 3. Conclusions: While long-term rural living and cognitive outcomes have no direct association for MIDUS middle-aged and older adults, mediating roles of optimism in these associations were evident. Future investigations could examine mechanisms that underlie these risk/protective factors on late-life cognition.

Fifty years of executive control research in attention-deficit/hyperactivity disorder:What we have learned and still need to know

For 50 years, attention-deficit/hyperactivity disorder (ADHD) has been considered a disorder of executive control (EC), the higher-order, cognitive skills that support self-regulation, goal attainment and what we generally call "attention." This review surveys our current understanding of the nature of EC as it pertains to ADHD and considers the evidence in support of eight hypotheses that can be derived from the EC theory of ADHD. This paper provides a resource for practitioners to aid in clinical decision-making. To support theory building, I draw a parallel between the EC theory of ADHD and the common gene-common variant model of complex traits such as ADHD. The conclusion offers strategies for advancing collaborative research.

Intervention for a Digital, Cognitive, Multi-Domain Alzheimer Risk Velocity Study: Protocol for a Randomized Controlled Trial

Background

In the United States, more than 6 million adults live with Alzheimer disease (AD) that affects 1 out of every 3 older adults. Although there is no cure for AD currently, lifestyle-based interventions aimed at slowing the rate of cognitive decline or delaying the onset of AD have shown promising results. However, most studies primarily focus on older adults (>55 years) and use in-person interventions.

Objective

The aim of this study is to determine the effects of a 2-year digital lifestyle intervention on AD risk among at-risk middle-aged and older adults (45-75 years) compared with a health education control.

Methods

The lifestyle intervention consists of a digitally delivered, personalized health coaching program that directly targets the modifiable risk factors for AD. The primary outcome measure is AD risk as determined by the Australian National University-Alzheimer Disease Risk Index; secondary outcome measures are functional fitness, blood biomarkers (inflammation, glucose, cholesterol, and triglycerides), and cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status and Neurotrack Cognitive Battery). Screening commenced in January 2021 and was completed in June 2021.

Results

Baseline characteristics indicate no difference between the intervention and control groups for AD risk (mean −1.68, SD 7.31; P=.90).

Conclusions

The intervention in the Digital, Cognitive, Multi-domain Alzheimer Risk Velocity is uniquely designed to reduce the risk of AD through a web-based health coaching experience that addresses the modifiable lifestyle-based risk factors.

Trial Registration

ClinicalTrials.gov NCT04559789; https://clinicaltrials.gov/show/NCT04559789

International Registered Report Identifier (IRRID)

DERR1-10.2196/31841

Assessing Motor and Cognitive Areas in Older People: Confirmatory Factor Analysis of Portuguese Version of Éxamen Géronto-Psychomoteur

Aging involves changes in psychomotor performance. Few studies are focused on psychomotor skills among older people due, in part, to the inexistence of valid instruments in the field. The purpose of this article is to analyze the factor structure model of the Portuguese version of Exámen Géronto-Psychomoteur. The confirmatory factor analysis was completed in a sample of 497 older persons, aged between 60 and 99 years, with and without dementia (74.4% female; M = 78.0; standard deviation = 8.6). A baseline one-factor model was compared against 2 three-factor models (first and second order) that were developed based on the previous exploratory factor analysis. Fit indices for the one-factor model were slightly higher when compared with other models; however, the second-order model seems to be more representative of human behavior. The results of this study provide evidence to support a three-factor model: cognition, motor function, and physical aspects.

Interactive Effects of Physical Activity and Cognitive Activity on Cognition in Older Adults Without Mild Cognitive Impairment or Dementia

Objective: The purpose of this secondary analysis was to test effects of interactions between accelerometer-measured physical activity and self-reported cognitive activity on cognition in older adults without cognitive impairment. Method: Participants were 742 older adults from the Rush Memory and Aging Project who completed annual clinical evaluations. A series of parallel growth models tested effects of interactions between physical activity and cognitive activity on cognition (global index, five domains) at Year 5, controlling for demographics, health factors, and corresponding cognition measures at Year 1. Results: Results were mixed, with significant physical and cognitive activity interactive effects for working and semantic memory. In models without interactions, higher physical and cognitive activities at Year 1 and less decline in cognitive activity over time were independently associated with better cognition at Year 5. Discussion: These findings may inform interventions that enhance physical and cognitive activities to prevent cognitive impairment in older adults.

Prevalence and Preferences of Self-Reported Physical Activity and Nonsedentary Behaviors in Portuguese Adults

BACKGROUND

This study describes levels of self-reported physical activity, frequency of selected opportunistic nonsedentary behaviors, and preferences of leisure-time activities in a representative sample of Portuguese adults, using data from a national survey on diet and activity behaviors (National Food, Nutrition and Physical Activity Survey, IAN-AF, 2015-2016).

METHODS

Participants were 3873 Portuguese adults (1827 men). They were interviewed face to face, and the short version of the International Physical Activity Questionnaire was used. Regular leisure-time programmed activities, and 6 additional items, forming the activity choice index questionnaire, were used to assess 6 discrete nonsedentary behaviors.

RESULTS

Using the International Physical Activity Questionnaire categories, 42.3% of the sample were classified as low active, 30.6% as moderately active, and 27.1% as highly active. Walking, health/fitness activities, running, group gymnastics classes, swimming/pool activities, football/futsal, and cycling were the most popular leisure-time activities. Between 15% (parking further away from destinations) and 48% (using the stairs instead of elevators) of participants reported that they frequently adopted commonly recommended nonsedentary activities.

CONCLUSIONS

This study updates self-reported physical activity prevalence for Portugal adults, including older adults. In addition, it uniquely describes leisure-time activity preferences in the population and also the relative frequency of several nonsedentary activities of daily living.

Measurement matters: higher waist-to-hip ratio but not body mass index is associated with deficits in executive functions and episodic memory

Background

The current study aimed to reconcile the inconsistent findings between obesity, executive functions, and episodic memory by addressing major limitations of previous studies, including overreliance on body mass index (BMI), small sample sizes, and failure to control for confounds.

Methods

Participants consisted of 3,712 midlife adults from the Cognitive Project of the National Survey of Midlife Development. Executive functions and episodic memory were measured by a battery of cognitive function tests.

Results

We found that higher waist-to-hip ratio was associated with deficits in both executive functions and episodic memory, above and beyond the influence of demographics, comorbid health issues, health behaviors, personality traits, and self-perceived obesity. However, higher BMI was not associated with deficits in executive functions and episodic memory. More importantly, these differential associations were robust and stable across adulthood.

Discussion

Our findings confirm the association between obesity and episodic memory while highlighting the need for better measures of obesity when examining its associations with individual differences in cognitive functions.

Executive function impairments in fibromyalgia syndrome: Relevance of clinical variables and body mass index

Background

Several investigations suggest the presence of deterioration of executive function in fibromyalgia syndrome (FMS). The study quantified executive functions in patients with FMS. A wide array of functions was assessed, including updating, shifting and inhibition, as well as decision making and mental planning. Moreover, clinical variables were investigated as possible mediators of executive dysfunction, including pain severity, psychiatric comorbidity, medication and body mass index (BMI).

Methods

Fifty-two FMS patients and 32 healthy controls completed a battery of 14 neuropsychological tests. Clinical interviews were conducted and the McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, Fatigue Severity Scale and Oviedo Quality of Sleep Questionnaire were presented.

Results

Patients performed poorer than controls on the Letter Number Sequencing, Arithmetic and Similarities subtests of the Wechsler Adult Intelligence Scale, the Spatial Span subtest of the Wechsler Memory Scale, an N-back task, a verbal fluency task, the Ruff Figural Fluency Test, the Inhibition score of the Stroop Test, the Inhibition and Shifting scores of the Five Digits Test, the Key Search Test and the Zoo Map Task. Moreover, patients exhibited less steep learning curves on the Iowa Gambling Task. Among clinical variables, BMI and pain severity explained the largest proportion of performance variance.

Conclusions

This study demonstrated impairments in executive functions of updating, shifting inhibition, decision making and planning in FMS. While the mediating role of pain in cognitive impairments in FMS had been previously established, the influence of BMI is a novel finding. Overweight and obesity should be considered by FMS researchers, and in the treatment of the condition.

Leisure-Time Physical Activity, Subjective Age, and Self-Rated Memory in Middle-Aged and Older Adults

Memory concerns are common in middle-aged and older adults. This study investigated the relation of leisure-time physical activity to self-rated memory and the possible mediating role of subjective age in this relationship in middle-aged and older adults. Cross-sectional analyses were conducted with a sample of 1,608 middle-aged and older adults from the second wave of the National Survey of Midlife Development in the United States (MIDUS2). In a path analysis conducted with Mplus, a higher level of leisure-time physical activity was associated with a more positive appraisal of memory compared to others of one's age; younger subjective age partially mediated this relationship. Neither gender nor age-group moderated the association. Age, race, education, marital status, health status, and negative affect were controlled for in the analyses. These findings suggest a possible role of physical activity in countering the effects of age stereotypes on perceived memory.

The association between social participation and cognitive function in community-dwelling older populations: Japan Gerontological Evaluation Study at Taisetsu community Hokkaido

OBJECTIVE

To study the association between the number of area-level and individual-level social participation items and cognitive function in the community-dwelling older populations of three towns in Hokkaido, Japan.

METHODS

A survey on the frequency of social participation was mailed to those in the Japan Gerontological Evaluation Study 2013 who were aged ≥65 years, were not certified as needing long-term care, and lived in Higashikawa, Higashikagura, or Biei. A subset of participants aged 70-74 years completed the Japanese version of the Montreal Cognitive Assessment in a home visit survey. Both the area-level and individual-level social participation and demographic information were obtained on the self-administered questionnaire. A multilevel analysis using a generalized linear mixed-effects model was used to examine the association between variables in the area-level and individual-level social participation items and cognitive function.

RESULTS

Out of 4042 respondents, data from 2576 were used in the area-level analysis. Of those, 180 were aged 70-74 years and completed the home visit survey for the individual-level analysis. A greater number of higher social participation items at the individual level was associated with higher cognitive function scores after adjusting for area-level social participation variables and confounders (regression coefficient: 0.19; 95% confidence interval: 0.03, 0.35). There were no significant associations between area-level social participation item averages and individual-level cognitive function scores.

CONCLUSIONS

Older populations participating in many kinds of social activities exhibited preserved cognitive function even after adjusting for area-level social participation variables. Copyright © 2016 John Wiley & Sons, Ltd.

[The association between paid or voluntary employment and neuropsychological test performance at an older age]

Studies have convincingly shown that both physical and mental activity are positively associated with cognitive task performance in aging. Little is known, however, about whether still being employed or doing volunteer work, which obviously engages physical and/or mental activity, is similarly associated with cognitive ability at an older age. The current study explored this relationship in 28 volunteers aged sixty years and older. Participants completed a neuropsychological test battery, and data regarding the number of working hours (paid and voluntary) per week were collected. A total of 28 participants were included, 13 of whom worked three or more hours per week. As a group, these active participants achieved better episodic memory, sustained attention and psychomotor speed results. This study shows that older people who are still working demonstrate better neuropsychological task performance. An important question for future research concerns the causality of this relationship.

The Effects of Cognitive Training on Cognitive Abilities and Everyday Function: A 10-Week Randomized Controlled Trial

With a random groups design, the current study examined whether a 10-week cognitive training could improve healthy older adult's cognitive functions and everyday problem-solving and whether high ecological validity trainings would have greater positive impact upon everyday problem-solving than low ecological validity trainings. Eighty-six healthy Chinese older adult participants were assigned randomly to five groups, including one control group receiving no training and four groups receiving low ecological memory training, high ecological memory training, low ecological reasoning training, and high ecological reasoning training, respectively. Participants were measured pre- and posttraining on spatial working memory, numerical working memory, reasoning, and everyday problem-solving. Results of this study showed that cognitive training significantly improved targeted cognitive functions and everyday problem-solving performance in all the intervention groups. However, high ecological cognitive trainings failed to show superior impact upon everyday problem-solving compared with low ecological cognitive trainings.

Prevalence of physical activity in European adults - Compliance with the World Health Organization's physical activity guidelines

BACKGROUND

Adults are recommended to engage in at least 150 min/week of moderate-to-vigorous physical activity (PA).

PURPOSE

This study aimed to examine the level of compliance with PA recommendations among European adults.

METHODS

Using data from European Social Survey round 6, PA self-report data was collected from 52,936 European adults from 29 countries in 2012. Meeting PA guidelines was assessed using World Health Organization criteria.

RESULTS

61.47% (60.77% male, 62.05% female) of European adults reported to be engaged in moderate to vigorous PA at least 30 min on 5 or more days per week. The likelihood of achieving the PA recommended levels was higher among respondents older than 18-24. For those aged 45-64 years the likelihood increased 65% (OR=1.65, 95% CI: 1.51-1.82, p<0.001) and 112% (OR=2.12, 95% CI: 1.94-2.32, p<0.001) for males and females, respectively. Those who were high school graduates were more likely to report achieving the recommended PA levels than those with less than high school education (males: OR=1.19, 95% CI: 1.12-1.27, p<0.001; females: OR=1.13, 95% CI: 1.06-1.20, p<0.001).

CONCLUSION

Although about 60% of European adults reported achieving the recommended levels of PA, there is much room for improvement among European adults, particularly among relatively inactive subgroups.

Impact of Short- and Long-term Tai Chi Mind-Body Exercise Training on Cognitive Function in Healthy Adults: Results From a Hybrid Observational Study and Randomized Trial

BACKGROUND

Cognitive decline amongst older adults is a significant public health concern. There is growing interest in behavioral interventions, including exercise, for improving cognition. Studies to date suggest tai chi (TC) may be a safe and potentially effective exercise for preserving cognitive function with aging; however, its short-term and potential long-term impact on physically active, healthy adults is unclear.

OBJECTIVE

To compare differences in cognitive function among long-term TC expert practitioners and age-matched and gender-matched TC-naïve adults and to determine the effects of short-term TC training on measures of cognitive function in healthy, nonsedentary adults.

DESIGN

A hybrid design including an observational comparison and a 2-arm randomized clinical trial (RCT).

PARTICIPANTS

Healthy, nonsedentary, TC-naive adults (50 y-79 y) and age-matched and gender-matched long-term TC experts.

METHODS

A cross-sectional comparison of cognitive function in healthy TC-naïve (n=60) and TC expert (24.5 y ÷ 12 y experience; n=27) adults: TC-naïve adults then completed a 6-month, 2-arm, wait-list randomized clinical trial of TC training. Six measures of cognitive function were assessed for both cross-sectional and longitudinal comparisons.

RESULTS

TC experts exhibited trends towards better scores on all cognitive measures, significantly so for category fluency (P=.01), as well as a composite z score summarizing all 6 cognitive assessments (P=.03). In contrast, random assignment to 6 months of TC training in TC-naïve adults did not significantly improve any measures of cognitive function.

CONCLUSIONS

In healthy nonsedentary adults, long-term TC training may help preserve cognitive function; however, the effect of short-term TC training in healthy adults remains unclear.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01340365.