1
|
Kugler BA, Lysaker CR, Franczak E, Hauger BM, Csikos V, Stopperan JA, Allen JA, Stanford JA, Koch LG, Britton SL, Thyfault JP, Wilkins HM. Intrinsic aerobic capacity modulates Alzheimer's disease pathological hallmarks, brain mitochondrial function and proteome during aging. GeroScience 2024; 46:4955-4967. [PMID: 38867031 PMCID: PMC11336007 DOI: 10.1007/s11357-024-01248-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/06/2024] [Indexed: 06/14/2024] Open
Abstract
Low aerobic capacity is strongly associated with all-cause mortality and risk for Alzheimer's disease (AD). Individuals with early dementia and AD have lower aerobic capacity compared to age-matched controls. The mechanism by which aerobic capacity influences AD risk is unknown but is likely mediated by sexual dimorphism and tissue-level differences in mitochondrial energetics. Here, we used rats selectively bred for large differences in intrinsic aerobic exercise capacity. Brain tissue from 18-month and 24-month-old female and male low-capacity runner (LCR) and high-capacity runner (HCR) rats were analyzed for markers of mitochondrial function and AD-associated pathologies. LCR rats, irrespective of sex, exhibited a greater increase in brain amyloid beta (Aβ42) and tau hyperphosphorylation (pTauthr181/total tau) with aging. In female LCR rats, brain mitochondrial respiration at states 3, 4, and FCCP-induced uncoupling, when stimulated with pyruvate/malate, was reduced at 18 and 24 months, leading to lower ATP-linked mitochondrial respiration compared to mitochondria from HCR rats. Male LCR rats also showed reduced complex II-stimulated mitochondrial respiration (succinate + rotenone) at 24 months compared to HCR rats. Differences in mitochondrial respiration were associated with tau hyperphosphorylation and Aβ42 alterations in both HCR and LCR strains. Proteomic analysis unveiled a distinct difference in the mitochondrial proteome, wherein female LCR rats displayed diminished mitochondrial translation and oxidative phosphorylation (OXPHOS) proteins at 18 months compared to female HCR rats. Conversely, male LCR rats exhibited increased OXPHOS protein abundance but reduced tricarboxylic acid (TCA) cycle proteins compared to male HCR rats. These findings underscore a robust association between intrinsic aerobic exercise capacity, brain mitochondrial function, and AD pathologies during aging.
Collapse
Affiliation(s)
- Benjamin A Kugler
- University of Kansas Medical Center Department of Cell Biology and Physiology and Internal Medicine, Kansas City, KS, USA
| | - Colton R Lysaker
- University of Kansas Alzheimer's Disease Center and Department of Neurology, Kansas City, KS, USA
| | - Edziu Franczak
- University of Kansas Medical Center Department of Cell Biology and Physiology and Internal Medicine, Kansas City, KS, USA
| | - Brittany M Hauger
- University of Kansas Alzheimer's Disease Center and Department of Neurology, Kansas City, KS, USA
| | - Vivien Csikos
- University of Kansas Alzheimer's Disease Center and Department of Neurology, Kansas City, KS, USA
| | - Julia A Stopperan
- University of Kansas Alzheimer's Disease Center and Department of Neurology, Kansas City, KS, USA
| | - Julie A Allen
- University of Kansas Medical Center Department of Cell Biology and Physiology and Internal Medicine, Kansas City, KS, USA
| | - John A Stanford
- University of Kansas Medical Center Department of Cell Biology and Physiology and Internal Medicine, Kansas City, KS, USA
| | - Lauren G Koch
- Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Steven L Britton
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - John P Thyfault
- University of Kansas Alzheimer's Disease Center and Department of Neurology, Kansas City, KS, USA
- University of Kansas Medical Center Department of Cell Biology and Physiology and Internal Medicine, Kansas City, KS, USA
- Research Service, Kansas City VA Medical Center Department of Veterans Affairs, University of Kansas Diabetes Center, Kansas City, KS, USA
- University of Kansas Medical Center Department of Molecular Biology and Biochemistry, Kansas City, KS, USA
| | - Heather M Wilkins
- University of Kansas Alzheimer's Disease Center and Department of Neurology, Kansas City, KS, USA.
- University of Kansas Medical Center Department of Molecular Biology and Biochemistry, Kansas City, KS, USA.
- Department of Neurology University of Kansas Medical Center, Kansas City, KS, USA.
| |
Collapse
|
2
|
Fan L, Zhao J, Hu Y, Zhang J, Wang X, Wang F, Wu M, Lin T. Predicting physical functioning status in older adults: insights from wrist accelerometer sensors and derived digital biomarkers of physical activity. J Am Med Inform Assoc 2024:ocae224. [PMID: 39178361 DOI: 10.1093/jamia/ocae224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/23/2024] [Accepted: 08/13/2024] [Indexed: 08/25/2024] Open
Abstract
OBJECTIVE Conventional physical activity (PA) metrics derived from wearable sensors may not capture the cumulative, transitions from sedentary to active, and multidimensional patterns of PA, limiting the ability to predict physical function impairment (PFI) in older adults. This study aims to identify unique temporal patterns and develop novel digital biomarkers from wrist accelerometer data for predicting PFI and its subtypes using explainable artificial intelligence techniques. MATERIALS AND METHODS Wrist accelerometer streaming data from 747 participants in the National Health and Aging Trends Study (NHATS) were used to calculate 231 PA features through time-series analysis techniques-Tsfresh. Predictive models for PFI and its subtypes (walking, balance, and extremity strength) were developed using 6 machine learning (ML) algorithms with hyperparameter optimization. The SHapley Additive exPlanations method was employed to interpret the ML models and rank the importance of input features. RESULTS Temporal analysis revealed peak PA differences between PFI and healthy controls from 9:00 to 11:00 am. The best-performing model (Gradient boosting Tree) achieved an area under the curve score of 85.93%, accuracy of 81.52%, sensitivity of 77.03%, and specificity of 87.50% when combining wrist accelerometer streaming data (WAPAS) features with demographic data. DISCUSSION The novel digital biomarkers, including change quantiles, Fourier transform (FFT) coefficients, and Aggregated (AGG) Linear Trend, outperformed traditional PA metrics in predicting PFI. These findings highlight the importance of capturing the multidimensional nature of PA patterns for PFI. CONCLUSION This study investigates the potential of wrist accelerometer digital biomarkers in predicting PFI and its subtypes in older adults. Integrated PFI monitoring systems with digital biomarkers would improve the current state of remote PFI surveillance.
Collapse
Affiliation(s)
- Lingjie Fan
- College of Computer Science, Sichuan University, Chengdu, Sichuan 610000, China
| | - Junhan Zhao
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02114, United States
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02114, United States
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Yao Hu
- School of Communication and Information Engineering, Chongqing University of Posts and Telecommunications, Chongqing 400000, China
| | - Junjie Zhang
- College of Computer Science, Sichuan University, Chengdu, Sichuan 610000, China
| | - Xiyue Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, United States
| | - Fengyi Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, China
| | - Mengyi Wu
- School of Communication and Information Engineering, Chongqing University of Posts and Telecommunications, Chongqing 400000, China
| | - Tao Lin
- College of Computer Science, Sichuan University, Chengdu, Sichuan 610000, China
| |
Collapse
|
3
|
Plini ERG, Melnychuk MC, Andrews R, Boyle R, Whelan R, Spence JS, Chapman SB, Robertson IH, Dockree PM. Greater physical fitness ( VO 2 max ) in healthy older adults associated with increased integrity of the locus coeruleus-noradrenergic system. Acta Physiol (Oxf) 2024; 240:e14191. [PMID: 38895950 PMCID: PMC11250687 DOI: 10.1111/apha.14191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024]
Abstract
AIM Physical activity (PA) is a key component for brain health and Reserve, and it is among the main dementia protective factors. However, the neurobiological mechanisms underpinning Reserve are not fully understood. In this regard, a noradrenergic (NA) theory of cognitive reserve (Robertson, 2013) has proposed that the upregulation of NA system might be a key factor for building reserve and resilience to neurodegeneration because of the neuroprotective role of NA across the brain. PA elicits an enhanced catecholamine response, in particular for NA. By increasing physical commitment, a greater amount of NA is synthetised in response to higher oxygen demand. More physically trained individuals show greater capabilities to carry oxygen resulting in greaterVo 2 max - a measure of oxygen uptake and physical fitness (PF). METHODS We hypothesized that greaterVo 2 max would be related to greater Locus Coeruleus (LC) MRI signal intensity. In a sample of 41 healthy subjects, we performed Voxel-Based Morphometry analyses, then repeated for the other neuromodulators as a control procedure (Serotonin, Dopamine and Acetylcholine). RESULTS As hypothesized, greaterVo 2 max related to greater LC signal intensity, and weaker associations emerged for the other neuromodulators. CONCLUSION This newly established link betweenVo 2 max and LC-NA system offers further understanding of the neurobiology underpinning Reserve in relationship to PA. While this study supports Robertson's theory proposing the upregulation of the NA system as a possible key factor building Reserve, it also provides ground for increasing LC-NA system resilience to neurodegeneration viaVo 2 max enhancement.
Collapse
Affiliation(s)
- Emanuele R G Plini
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Michael C Melnychuk
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Ralph Andrews
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Robert Whelan
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Jeffrey S Spence
- Center for BrainHealth, The University of Texas at Dallas, Dallas, Texas, USA
| | - Sandra B Chapman
- Center for BrainHealth, The University of Texas at Dallas, Dallas, Texas, USA
| | - Ian H Robertson
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Paul M Dockree
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
4
|
Marino FR, Deal JA, Dougherty RJ, Bilgel M, Tian Q, An Y, Simonsick EM, Resnick SM, Ferrucci L, Spira AP, Wanigatunga AA, Schrack JA. Differences in Daily Physical Activity by Alzheimer's Risk Markers Among Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glae119. [PMID: 38742659 PMCID: PMC11157965 DOI: 10.1093/gerona/glae119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Daily physical activity patterns differ by Alzheimer's disease (AD) status and might signal cognitive risk. It is critical to understand whether patterns are disrupted early in the AD pathological process. Yet, whether established AD risk markers (β-amyloid [Aβ] or apolipoprotein E-ε4 [APOE-ε4]) are associated with differences in objectively measured activity patterns among cognitively unimpaired older adults is unclear. METHODS Wrist accelerometry, brain Aβ (+/-), and APOE-ε4 genotype were collected in 106 (Aβ) and 472 (APOE-ε4) participants (mean age 76 [standard deviation{SD}: 8.5) or 75 [SD: 9.2] years, 60% or 58% women) in the Baltimore Longitudinal Study of Aging. Adjusted linear and function-on-scalar regression models examined whether Aβ or APOE-ε4 status was cross-sectionally associated with activity patterns (amount, variability, or fragmentation) overall and by time of day, respectively. Differences in activity patterns by combinations of Aβ and APOE-ε4 status were descriptively examined (n = 105). RESULTS There were no differences in any activity pattern by Aβ or APOE-ε4 status overall. Aβ+ was associated with lower total amount and lower within-day variability of physical activity overnight and early evening, and APOE-ε4 carriers had higher total amount of activity in the evening and lower within-day variability of activity in the morning. Diurnal curves of activity were blunted among those with Aβ+ regardless of APOE-ε4 status, but only when including older adults with mild cognitive impairment/dementia. CONCLUSIONS Aβ+ in cognitively unimpaired older adults might manifest as lower amount and variability of daily physical activity, particularly during overnight/evening hours. Future research is needed to examine changes in activity patterns in larger samples and by other AD biomarkers.
Collapse
Affiliation(s)
- Francesca R Marino
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ryan J Dougherty
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Murat Bilgel
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Qu Tian
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Yang An
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Susan M Resnick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Adam P Spira
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging & Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
5
|
Marino FR, Wu HT, Etzkorn L, Rooney MR, Soliman EZ, Deal JA, Crainiceanu C, Spira AP, Wanigatunga AA, Schrack JA, Chen LY. Associations of Physical Activity and Heart Rate Variability from a Two-Week ECG Monitor with Cognitive Function and Dementia: The ARIC Neurocognitive Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:4060. [PMID: 39000839 PMCID: PMC11244549 DOI: 10.3390/s24134060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/16/2024]
Abstract
Low physical activity (PA) measured by accelerometers and low heart rate variability (HRV) measured from short-term ECG recordings are associated with worse cognitive function. Wearable long-term ECG monitors are now widely used, and some devices also include an accelerometer. The objective of this study was to evaluate whether PA or HRV measured from long-term ECG monitors was associated with cognitive function among older adults. A total of 1590 ARIC participants had free-living PA and HRV measured over 14 days using the Zio® XT Patch [aged 72-94 years, 58% female, 32% Black]. Cognitive function was measured by cognitive factor scores and adjudicated dementia or mild cognitive impairment (MCI) status. Adjusted linear or multinomial regression models examined whether higher PA or higher HRV was cross-sectionally associated with higher factor scores or lower odds of MCI/dementia. Each 1-unit increase in the total amount of PA was associated with higher global cognition (β = 0.30, 95% CI: 0.16-0.44) and executive function scores (β = 0.38, 95% CI: 0.22-0.53) and lower odds of MCI (OR = 0.38, 95% CI: 0.22-0.67) or dementia (OR = 0.25, 95% CI: 0.08-0.74). HRV (i.e., SDNN and rMSSD) was not associated with cognitive function. More research is needed to define the role of wearable ECG monitors as a tool for digital phenotyping of dementia.
Collapse
Affiliation(s)
- Francesca R. Marino
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Hau-Tieng Wu
- Courant Institute of Mathematical Sciences, New York University, New York, NY 10012, USA
| | - Lacey Etzkorn
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Mary R. Rooney
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Welch Center for Prevention, Epidemiologic, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Elsayed Z. Soliman
- Department of Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC 27109, USA
| | - Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Adam P. Spira
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 20205, USA
| | - Amal A. Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Lin Yee Chen
- Lillehei Heart Institute, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| |
Collapse
|
6
|
Kim HK, Kimura Y, Takahashi M, Nakaoka T, Yamada Y, Ono R, Shibata S. Morning physical activity may be more beneficial for blood lipids than afternoon physical activity in older adults: a cross-sectional study. Eur J Appl Physiol 2024:10.1007/s00421-024-05526-y. [PMID: 38874620 DOI: 10.1007/s00421-024-05526-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/30/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND The effect of differences in daily physical activity patterns on blood lipids has not been determined. This study examines the effects of the differences in free-living daily physical activity patterns (amount and intensity) on blood lipid levels in older adults. METHODS This cross-sectional study included 51 older participants (71.8 ± 0.6 years, men = 8, women = 43). A triaxial accelerometer was used to assess physical activity patterns. The time from awakening to bedtime for each participant was used for group classification based on the amount (number of steps) and intensity (moderate-to-vigorous physical activity, MVPA) of physical activity. The morning step group (M Step) was defined as those who took more steps in the morning, and the afternoon step group (A Step) was defined as those who took more steps in the afternoon. The same method was used for MVPA (morning MVPA: M MVPA; afternoon MVPA: A MVPA). Blood samples were collected at the start of the study to determine blood lipid levels. RESULTS Number of steps taken showed a trend toward lower low-density lipoprotein cholesterol (LDL-C) levels in the M Step group compared with the A Step group. The LDL/high-density lipoprotein (HDL) ratio was significantly lower in the M Step group than the A Step group (p < 0.05). The M MVPA group also had higher HDL-C levels and significantly lower LDL/HDL ratios than the A MVPA group (p < 0.05). CONCLUSIONS These results suggest that compared with afternoon physical activity, daily morning physical activity (amount and intensity) is more effective in improving blood lipid levels.
Collapse
Affiliation(s)
- Hyeon-Ki Kim
- National Institute of Biomedical Innovation, Health and Nutrition, 3-17 Senriokashimmachi, Settsu-shi, Osaka, 566-0002, Japan.
| | - Yuga Kimura
- School of Advance Science and Engineering, Waseda University, Tokyo, Japan
| | - Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
| | - Takashi Nakaoka
- Japan Organization of Occupational Health and Safety, Kanagawa, Japan
| | - Yosuke Yamada
- National Institute of Biomedical Innovation, Health and Nutrition, 3-17 Senriokashimmachi, Settsu-shi, Osaka, 566-0002, Japan
| | - Rei Ono
- National Institute of Biomedical Innovation, Health and Nutrition, 3-17 Senriokashimmachi, Settsu-shi, Osaka, 566-0002, Japan
| | - Shigenobu Shibata
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
7
|
Paillard T, Blain H, Bernard PL. The impact of exercise on Alzheimer's disease progression. Expert Rev Neurother 2024; 24:333-342. [PMID: 38390841 DOI: 10.1080/14737175.2024.2319766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
INTRODUCTION The preventive effects of chronic physical exercise (CPE) on Alzheimer's disease (AD) are now admitted by the scientific community. Curative effects of CPE are more disputed, but they deserve to be investigated, since CPE is a natural non-pharmacological alternative for the treatment of AD. AREAS COVERED In this perspective, the authors discuss the impact of CPE on AD based on an exhaustive literature search using the electronic databases PubMed, ScienceDirect and Google Scholar. EXPERT OPINION Aerobic exercise alone is probably not the unique solution and needs to be complemented by other exercises (physical activities) to optimize the slowing down of AD. Anaerobic, muscle strength and power, balance/coordination and meditative exercises may also help to slow down the AD progression. However, the scientific evidence does not allow a precise description of the best training program for patients with AD. Influential environmental conditions (e.g. social relations, outdoor or indoor exercise) should also be studied to optimize training programs aimed at slowing down the AD progression.
Collapse
Affiliation(s)
- Thierry Paillard
- Movement, Balance, Performance, and Health Laboratory, Université de Pau & Pays de l'Adour, Tarbes, France
| | - Hubert Blain
- Pole de Gérontologie Antonin Balmes, CHU de Montpellier; EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Alès, France
| | - Pierre Louis Bernard
- UFR STAPS, EuroMov Digital Health in Motion, Université de Montpellier, IMT Mines Ales, Alès, France
| |
Collapse
|
8
|
Marino FR, Wu HT, Etzkorn L, Rooney MR, Soliman EZ, Deal JA, Crainiceanu C, Spira AP, Wanigatunga AA, Schrack JA, Chen LY. Associations of Physical Activity and Heart Rate Variability from a Two-Week ECG Monitor with Cognitive Function and Dementia: the ARIC Neurocognitive Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.01.24303633. [PMID: 38496423 PMCID: PMC10942521 DOI: 10.1101/2024.03.01.24303633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND Low physical activity (PA) measured from accelerometers and low heart rate variability (HRV) measured from short-term ECG recordings are associated with worse cognitive function. Wearable long-term ECG monitors are now widely used. These monitors can provide long-term HRV data and, if embedded with an accelerometer, they can also provide PA data. Whether PA or HRV measured from long-term ECG monitors is associated with cognitive function among older adults is unknown. METHODS Free-living PA and HRV were measured simultaneously over 14-days using the Zio ® XT Patch among 1590 participants in the Atherosclerosis Risk in Communities Study [aged 72-94 years, 58% female, 32% Black]. Total amount of PA was estimated by total mean amplitude deviation (TMAD) from the 14-day accelerometry raw data. HRV indices (SDNN and rMSSD) were measured from the 14-day ECG raw data. Cognitive factor scores for global cognition, executive function, language, and memory were derived using latent variable methods. Dementia or mild cognitive impairment (MCI) status was adjudicated. Linear or multinomial regression models examined whether higher PA or higher HRV was cross-sectionally associated with higher factor scores or lower odds of MCI/dementia. Models were adjusted for demographic and medical comorbidities. RESULTS Each 1-unit higher in total amount of PA was significantly associated with 0.30 higher global cognition factor scores (95% CI: 0.16-0.44), 0.38 higher executive function factor scores (95% CI: 0.22-0.53), and 62% lower odds of MCI (OR: 0.38, 95% CI: 0.22-0.67) or 75% lower odds of dementia (OR: 0.25, 95% CI: 0.08-0.74) versus unimpaired cognition. Neither HRV measure was significantly associated with cognitive function or dementia. CONCLUSIONS PA derived from a 2-week ECG monitor with an embedded accelerometer was significantly associated with higher cognitive test performance and lower odds of MCI/dementia among older adults. By contrast, HRV indices measured over 2 weeks were not significantly associated with cognitive outcomes. More research is needed to define the role of wearable ECG monitors as a tool for digital phenotyping of dementia. CLINICAL PERSPECTIVE What Is New?: This cross-sectional study evaluated associations between physical activity (PA) and heart rate variability (HRV) measured over 14 days from a wearable ECG monitor with cognitive function.Higher total amount of PA was associated with higher global cognition and executive function, as well as lower odds of mild cognitive impairment or dementia.HRV indices measured over 2 weeks were not significantly associated with cognitive outcomes.What Are the Clinical Implications?: These findings replicate positive associations between PA and cognitive function using accelerometer data from a wearable ECG monitor with an embedded accelerometer.These findings raise the possibility of using wearable ECG monitors (with embedded accelerometers) as a promising tool for digital phenotyping of dementia.
Collapse
|
9
|
Ilan Y. Variability in exercise is linked to improved age-related dysfunctions: A potential role for the constrained-disorder principle-based second-generation artificial intelligence system. RESEARCH SQUARE 2023:rs.3.rs-3671709. [PMID: 38196652 PMCID: PMC10775380 DOI: 10.21203/rs.3.rs-3671709/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Objective: Regular physical activity (PA) promotes mental and physical health. Nevertheless, inactivity is a worldwide pandemic, and methods to augment exercise benefits are required. The constrained disorder principle (CDP) characterizes biological systems based on their inherent variability. We aimed to investigate the association between intra-individual variability in PA and disability among non-athlete adults. Methods: In this retrospective analysis of the longitudinal SHARE survey, we included non-disabled adults aged >50 with at least six visits over 14 years. Self-reported PA frequency was documented bi- to triennially. Low PA intensity was defined as vigorous PA frequency less than once a week. Stable PA was described as an unchanged PA intensity in all consecutive middle observations. The primary outcome was defined as a physical limitation in everyday activities at the end of the survey. Secondary outcomes were cognitive functions, including short-term memory, long-term memory, and verbal fluency. Results: The study included 2,049 non-disabled adults with a mean age of 53 and 49.1% women. In the initially high PA intensity group, variability in PA was associated with increased physical disability prevalence (23.3% vs. 33.2%, stable vs. unstable PA ; P<0.01; adjusted P<0.01). In the initially low PA intensity group, variability was associated with a reduced physical disability (45.6% vs. 33.3%, stable vs. unstable PA ; P=0.02; adjusted P=0.03). There were no statistically significant differences in cognitive parameters between the groups. Among individuals with the same low PA intensity at the beginning and end of follow-up, variability was associated with reduced physical disability (56.9% vs. 36.5%, stable vs. unstable PA ; P=0.02; adjusted P=0.04) and improved short-term memory (score change: -0.28 vs. +0.29, stable vs. unstable PA ; P=0.05). Conclusion: Incorporating variability into PA regimens of inactive adults may enhance their physical and cognitive benefits.
Collapse
|
10
|
Plini ERG, Melnychuk MC, Andrews R, Boyle R, Whelan R, Spence JS, Chapman SB, Robertson IH, Dockree PM. Greater physical fitness (Vo2Max) in healthy older adults associated with increased integrity of the Locus Coeruleus-Noradrenergic system. RESEARCH SQUARE 2023:rs.3.rs-2556690. [PMID: 36798156 PMCID: PMC9934752 DOI: 10.21203/rs.3.rs-2556690/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Physical activity (PA) is a key component for brain health and Reserve, and it is among the main dementia protective factors. However, the neurobiological mechanisms underpinning Reserve are not fully understood. In this regard, a noradrenergic (NA) theory of cognitive reserve (Robertson, 2013) has proposed that the upregulation of NA system might be a key factor for building reserve and resilience to neurodegeneration because of the neuroprotective role of NA across the brain. PA elicits an enhanced catecholamine response, in particular for NA. By increasing physical commitment, a greater amount of NA is synthetised in response to higher oxygen demand. More physically trained individuals show greater capabilities to carry oxygen resulting in greater Vo2max - a measure of oxygen uptake and physical fitness (PF). In the current study, we hypothesised that greater Vo2 max would be related to greater Locus Coeruleus (LC) MRI signal intensity. As hypothesised, greater Vo2max related to greater LC signal intensity across 41 healthy adults (age range 60-72). As a control procedure, in which these analyses were repeated for the other neuromodulators' seeds (for Serotonin, Dopamine and Acetylcholine), weaker associations emerged. This newly established link between Vo2max and LC-NA system offers further understanding of the neurobiology underpinning Reserve in relationship to PA. While this study supports Robertson's theory proposing the upregulation of the noradrenergic system as a possible key factor building Reserve, it also provide grounds for increasing LC-NA system resilience to neurodegeneration via Vo2max enhancement.
Collapse
Affiliation(s)
- Emanuele RG Plini
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Michael C Melnychuk
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Ralph Andrews
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Building 149, Charlestown MA, USA
| | - Robert Whelan
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Jeffrey S. Spence
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
| | - Sandra B. Chapman
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
| | - Ian H Robertson
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Building 149, Charlestown MA, USA
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
- Department of Psychology, Global Brain Health Institute, Trinity College Dublin, Lloyd Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Paul M Dockree
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| |
Collapse
|
11
|
Plini ERG, Melnychuk MC, Andrews R, Boyle R, Whelan R, Spence JS, Chapman SB, Robertson IH, Dockree PM. Greater physical fitness (Vo2Max) in healthy older adults associated with increased integrity of the Locus Coeruleus-Noradrenergic system. RESEARCH SQUARE 2023:rs.3.rs-2556690. [PMID: 36798156 PMCID: PMC9934752 DOI: 10.21203/rs.3.rs-2556690/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Physical activity (PA) is a key component for brain health and Reserve, and it is among the main dementia protective factors. However, the neurobiological mechanisms underpinning Reserve are not fully understood. In this regard, a noradrenergic (NA) theory of cognitive reserve (Robertson, 2013) has proposed that the upregulation of NA system might be a key factor for building reserve and resilience to neurodegeneration because of the neuroprotective role of NA across the brain. PA elicits an enhanced catecholamine response, in particular for NA. By increasing physical commitment, a greater amount of NA is synthetised in response to higher oxygen demand. More physically trained individuals show greater capabilities to carry oxygen resulting in greater Vo2max - a measure of oxygen uptake and physical fitness (PF). In the current study, we hypothesised that greater Vo2 max would be related to greater Locus Coeruleus (LC) MRI signal intensity. As hypothesised, greater Vo2max related to greater LC signal intensity across 41 healthy adults (age range 60-72). As a control procedure, in which these analyses were repeated for the other neuromodulators' seeds (for Serotonin, Dopamine and Acetylcholine), weaker associations emerged. This newly established link between Vo2max and LC-NA system offers further understanding of the neurobiology underpinning Reserve in relationship to PA. While this study supports Robertson's theory proposing the upregulation of the noradrenergic system as a possible key factor building Reserve, it also provide grounds for increasing LC-NA system resilience to neurodegeneration via Vo2max enhancement.
Collapse
Affiliation(s)
- Emanuele RG Plini
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Michael C Melnychuk
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Ralph Andrews
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Building 149, Charlestown MA, USA
| | - Robert Whelan
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Jeffrey S. Spence
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
| | - Sandra B. Chapman
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
| | - Ian H Robertson
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Building 149, Charlestown MA, USA
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, USA
- Department of Psychology, Global Brain Health Institute, Trinity College Dublin, Lloyd Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| | - Paul M Dockree
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland
| |
Collapse
|
12
|
Ghosal R, Varma VR, Volfson D, Hillel I, Urbanek J, Hausdorff JM, Watts A, Zipunnikov V. Distributional data analysis via quantile functions and its application to modeling digital biomarkers of gait in Alzheimer's Disease. Biostatistics 2023; 24:539-561. [PMID: 36519565 PMCID: PMC10544806 DOI: 10.1093/biostatistics/kxab041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/10/2021] [Accepted: 10/19/2021] [Indexed: 07/20/2023] Open
Abstract
With the advent of continuous health monitoring with wearable devices, users now generate their unique streams of continuous data such as minute-level step counts or heartbeats. Summarizing these streams via scalar summaries often ignores the distributional nature of wearable data and almost unavoidably leads to the loss of critical information. We propose to capture the distributional nature of wearable data via user-specific quantile functions (QF) and use these QFs as predictors in scalar-on-quantile-function-regression (SOQFR). As an alternative approach, we also propose to represent QFs via user-specific L-moments, robust rank-based analogs of traditional moments, and use L-moments as predictors in SOQFR (SOQFR-L). These two approaches provide two mutually consistent interpretations: in terms of quantile levels by SOQFR and in terms of L-moments by SOQFR-L. We also demonstrate how to deal with multi-modal distributional data via Joint and Individual Variation Explained using L-moments. The proposed methods are illustrated in a study of association of digital gait biomarkers with cognitive function in Alzheimers disease. Our analysis shows that the proposed methods demonstrate higher predictive performance and attain much stronger associations with clinical cognitive scales compared to simple distributional summaries.
Collapse
Affiliation(s)
- Rahul Ghosal
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Vijay R Varma
- National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, MD, USA
| | - Dmitri Volfson
- Neuroscience Analytics, Computational Biology, Takeda, Cambridge, MA, USA
| | - Inbar Hillel
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Jacek Urbanek
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel, and Rush Alzheimer’s Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Amber Watts
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
13
|
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: Systematic Review. J Med Internet Res 2023; 25:e44352. [PMID: 37200065 PMCID: PMC10236281 DOI: 10.2196/44352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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 .
Collapse
|
14
|
Seo K, Takayanagi N, Sudo M, Yamashiro Y, Chiba I, Makino K, Lee S, Niki Y, Shimada H. Association between daily gait speed patterns and cognitive impairment in community-dwelling older adults. Sci Rep 2023; 13:2783. [PMID: 36797381 PMCID: PMC9935628 DOI: 10.1038/s41598-023-29805-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
Gait speed over a short distance is associated with cognitive impairment in older adults. Recently, daily gait speed has been assessed using accelerometers. However, because daily gait speed is only weakly correlation with gait speed over a short distance, its association with cognitive impairment needs to be investigated. The present study compared the daily gait speed patterns of normal cognition (NC), mild cognitive impairment (MCI), and general cognitive impairment (GCI) subjects measured every 3 h for two weeks using accelerometers. A total of 1959 participants were classified into the NC (N = 1519), MCI (N = 353), and GCI groups (N = 87). The results showed that the average daily gait speed of the GCI group was significantly lower than that of the NC group (p = 0.03). Furthermore, the average daily gait speeds of the MCI and NC groups were the same. However, the average daily gait speed of the MCI group during a specific time (12-15 o'clock) was significantly lower than that of the NC group (p < 0.01). These results suggest that changes in daily patterns may be detected by measuring daily gait speed, which depends on the degree of cognitive function.
Collapse
Affiliation(s)
- Kanako Seo
- Tokyo Research Laboratories, Kao Corporation, 2-1-3 Bunka, Sumida-Ku, Tokyo, 131-8501, Japan.
| | - Naoto Takayanagi
- grid.419719.30000 0001 0816 944XTokyo Research Laboratories, Kao Corporation, 2-1-3 Bunka, Sumida-Ku, Tokyo, 131-8501 Japan
| | - Motoki Sudo
- grid.419719.30000 0001 0816 944XTokyo Research Laboratories, Kao Corporation, 2-1-3 Bunka, Sumida-Ku, Tokyo, 131-8501 Japan
| | - Yukari Yamashiro
- grid.419719.30000 0001 0816 944XTokyo Research Laboratories, Kao Corporation, 2-1-3 Bunka, Sumida-Ku, Tokyo, 131-8501 Japan
| | - Ippei Chiba
- grid.419257.c0000 0004 1791 9005Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511 Japan ,grid.69566.3a0000 0001 2248 6943Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8573 Japan
| | - Keitaro Makino
- grid.419257.c0000 0004 1791 9005Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511 Japan
| | - Sangyoon Lee
- grid.419257.c0000 0004 1791 9005Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511 Japan
| | - Yoshifumi Niki
- grid.419719.30000 0001 0816 944XTokyo Research Laboratories, Kao Corporation, 2-1-3 Bunka, Sumida-Ku, Tokyo, 131-8501 Japan
| | - Hiroyuki Shimada
- grid.419257.c0000 0004 1791 9005Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511 Japan
| |
Collapse
|
15
|
Fanning J, Miller ME, Chen SH, Davids C, Kershner K, Rejeski WJ. Is Wrist Accelerometry Suitable for Threshold Scoring? A Comparison of Hip-Worn and Wrist-Worn ActiGraph Data in Low-Active Older Adults With Obesity. J Gerontol A Biol Sci Med Sci 2022; 77:2429-2434. [PMID: 34791237 PMCID: PMC9923693 DOI: 10.1093/gerona/glab347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Hip- and wrist-worn ActiGraph accelerometers are widely used in research on physical activity as they offer an objective assessment of movement intensity across the day. Herein we characterize and contrast key structured physical activities and common activities of daily living via accelerometry data collected at the hip and wrist from a sample of community-dwelling older adults. METHODS Low-active, older adults with obesity (age 60+ years) were fit with an ActiGraph GT3X+ accelerometer on their nondominant wrist and hip before completing a series of tasks in a randomized order, including sitting/standing, sweeping, folding laundry, stair climbing, ambulation at different intensities, and cycling at different intensities. Participants returned a week later and completed the tasks once again. Vector magnitude counts/second were time-matched during each task and then summarized into counts/minute (CPM). RESULTS Monitors at both wear locations similarly characterized standing, sitting, and ambulatory tasks. A key finding was that light home chores (sweeping, folding laundry) produced higher and more variable CPM values than fast walking via wrist ActiGraph. Regression analyses revealed wrist CPM values were poor predictors of hip CPM values, with devices aligning best during fast walking (R2 = 0.25) and stair climbing (R2 = 0.35). CONCLUSIONS As older adults spend a considerable portion of their day in nonexercise activities of daily living, researchers should be cautious in the use of simply acceleration thresholds for scoring wrist-worn accelerometer data. Methods for better classifying wrist-worn activity monitor data in older adults are needed.
Collapse
Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Michael E Miller
- Department of Biostatistical and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Shyh-Huei Chen
- Department of Biostatistical and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Carlo Davids
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Kyle Kershner
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| |
Collapse
|
16
|
Dillon K, Morava A, Prapavessis H, Grigsby-Duffy L, Novic A, Gardiner PA. Total Sedentary Time and Cognitive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:127. [PMID: 36224459 PMCID: PMC9556686 DOI: 10.1186/s40798-022-00507-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/14/2022] [Indexed: 11/06/2022]
Abstract
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.
Collapse
Affiliation(s)
- Kirsten Dillon
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Anisa Morava
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Harry Prapavessis
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Lily Grigsby-Duffy
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1021.20000 0001 0526 7079Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220 Australia
| | - Adam Novic
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1022.10000 0004 0437 5432School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Paul A. Gardiner
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1048.d0000 0004 0473 0844Faculty of Health, Engineering and Sciences, The University of Southern Queensland, Brisbane, Australia
| |
Collapse
|
17
|
Lee KH, Lee JY, Kim B. Information and communication technology for physical activity in persons living with dementia: A systematic review with implications for evidence-based practice. Worldviews Evid Based Nurs 2022; 19:275-281. [PMID: 35635249 DOI: 10.1111/wvn.12591] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/30/2022] [Accepted: 04/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Persons living with dementia often encounter many difficulties in their community due to functional limitations. Information and Communication Technology (ICT) could be useful to monitor changes in their physical function. However, there is a lack of systematic reviews about using ICT for physical activity. AIM This review aimed to synthesize the literature regarding the use of ICT to monitor the physical activity of persons living with dementia. METHODS A systematic search was conducted in five electronic databases using search terms derived from the Patient, Intervention, Comparison, Outcome (PICO) framework. We included articles published in English from 2011 to 2021. Quality of the included studies was evaluated by two independent authors using the Mixed Methods Appraisal Tool (MMAT). RESULTS Thirty-three quantitative studies were included for review. Included studies showed fairly good quality in the MMAT evaluation. Wearable devices were mainly employed (88%). The ICTs were used to objectively measure physical activity, activity status, gait, and circadian rhythm. ICTs have been utilized for four purposes: (1) comparing physical activity within the dementia subgroups or with the normal group, (2) exploring the relationship with other variables, 3) examining the experimental study's outcomes, and (4) checking the sensors' feasibility. The results demonstrated that ICT devices were feasible to use in persons living with dementia in the community, helpful for monitoring the physical activity of persons living with dementia, and useful for improving physical activity when properly incorporated in care planning. LINKING EVIDENCE TO ACTION ICTs can help gather objective data regarding the type, intensity, and level of physical activity in persons living with dementia without time constraints. Also, ICTs use in persons living with dementia in the community was acceptable. We suggest future studies to activate and use ICTs in dementia research.
Collapse
Affiliation(s)
- Kyung Hee Lee
- Yonsei University College of Nursing and Mo-Im Kim Nursing Research Institute, Seoul, South Korea
| | - Ji Yeon Lee
- Yonsei University College of Nursing and Mo-Im Kim Nursing Research Institute, Seoul, South Korea
| | - Bora Kim
- Yonsei University College of Nursing and the Brain Korea 21 FOUR Project, Seoul, South Korea
| |
Collapse
|
18
|
Ghosal R, Varma VR, Volfson D, Urbanek J, Hausdorff JM, Watts A, Zipunnikov V. Scalar on time-by-distribution regression and its application for modelling associations between daily-living physical activity and cognitive functions in Alzheimer's Disease. Sci Rep 2022; 12:11558. [PMID: 35798763 PMCID: PMC9263176 DOI: 10.1038/s41598-022-15528-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/24/2022] [Indexed: 11/26/2022] Open
Abstract
Wearable data is a rich source of information that can provide a deeper understanding of links between human behaviors and human health. Existing modelling approaches use wearable data summarized at subject level via scalar summaries in regression, temporal (time-of-day) curves in functional data analysis (FDA), and distributions in distributional data analysis (DDA). We propose to capture temporally local distributional information in wearable data using subject-specific time-by-distribution (TD) data objects. Specifically, we develop scalar on time-by-distribution regression (SOTDR) to model associations between scalar response of interest such as health outcomes or disease status and TD predictors. Additionally, we show that TD data objects can be parsimoniously represented via a collection of time-varying L-moments that capture distributional changes over the time-of-day. The proposed method is applied to the accelerometry study of mild Alzheimer's disease (AD). We found that mild AD is significantly associated with reduced upper quantile levels of physical activity, particularly during morning hours. In-sample cross validation demonstrated that TD predictors attain much stronger associations with clinical cognitive scales of attention, verbal memory, and executive function when compared to predictors summarized via scalar total activity counts, temporal functional curves, and quantile functions. Taken together, the present results suggest that SOTDR analysis provides novel insights into cognitive function and AD.
Collapse
Affiliation(s)
- Rahul Ghosal
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Vijay R Varma
- National Institute on Aging (NIA), National Institutes of Health (NIH), Baltimore, MD, USA
| | - Dmitri Volfson
- Neuroscience Analytics, Computational Biology, Takeda, Cambridge, MA, USA
| | - Jacek Urbanek
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Rush Alzheimer's Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Amber Watts
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
19
|
Janssen I, Campbell JE, Zahran S, Saunders TJ, Tomasone JR, Chaput JP. Timing of physical activity within the 24-hour day and its influence on health: a systematic review. Health Promot Chronic Dis Prev Can 2022; 42:129-138. [PMID: 35481335 PMCID: PMC9116725 DOI: 10.24095/hpcdp.42.4.02] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Recent studies report that the health benefits of physical activity differ depending on whether the activity is performed in the morning, afternoon or evening. The purpose of this systematic review was to examine whether the timing of physical activity within the 24-hour day is associated with health. METHODS Five databases were searched for English or French language peer-reviewed studies that examined whether the timing of physical activity within the day is associated with health. No limits were placed on publication year, study population, study design or health outcomes. Studies that examined acute effects of physical activity or timing of physical activity around food intake were excluded. RESULTS This systematic review examined 35 studies, with 17 259 participants, and the following health outcomes: measures of sleep health, adiposity, fat-free mass and muscle size, cardiometabolic biomarkers, physical function and mobility, mental health, and risk of cardiovascular disease, cancer, and mortality. Heterogeneity across studies precluded meta-analyses, and we present our findings using narrative syntheses. Of the 35 studies, 11 reported that morning physical activity provides greater health benefits than afternoon/ evening physical activity, while 12 found that morning physical activity provides fewer health benefits than afternoon/evening physical. In the remaining 12 studies, there was no clear difference in health benefits based on the timing of physical activity. The quality of evidence for the different health outcomes across study designs was very low. CONCLUSION There is no consistent evidence that physical activity at one time of day provides more favourable health benefits than physical activity at a different time of day. (PROSPERO registration no.: CRD42021231088).
Collapse
Affiliation(s)
- Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Julie E Campbell
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Samah Zahran
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Travis J Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| |
Collapse
|
20
|
Keller JL, Tian F, Fitzgerald KC, Mische L, Ritter J, Costello MG, Mowry EM, Zippunikov V, Zackowski KM. Using real-world accelerometry-derived diurnal patterns of physical activity to evaluate disability in multiple sclerosis. J Rehabil Assist Technol Eng 2022; 9:20556683211067362. [PMID: 35070348 PMCID: PMC8771734 DOI: 10.1177/20556683211067362] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 12/01/2021] [Indexed: 12/30/2022] Open
Affiliation(s)
| | - Fan Tian
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Leah Mische
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jesse Ritter
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Ellen M. Mowry
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Vadim Zippunikov
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathleen M. Zackowski
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
21
|
Wanigatunga AA, Liu F, Wang H, Urbanek JK, An Y, Spira AP, Dougherty RJ, Tian Q, Moghekar A, Ferrucci L, Simonsick EM, Resnick SM, Schrack JA. Daily Physical Activity Patterns as a Window on Cognitive Diagnosis in the Baltimore Longitudinal Study of Aging (BLSA). J Alzheimers Dis 2022; 88:459-469. [PMID: 35599480 DOI: 10.3233/jad-215544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Gradual disengagement from daily physical activity (PA) could signal present or emerging mild cognitive impairment (MCI) or Alzheimer's disease (AD). OBJECTIVE This study examined whether accelerometry-derived patterns of everyday movement differ by cognitive diagnosis in participants of the Baltimore Longitudinal Study of Aging (BLSA). METHODS Activity patterns, overall and by time-of-day, were cross-sectionally compared between participants with adjudicated normal cognition (n = 549) and MCI/AD diagnoses (n = 36; 5 participants [14%] living with AD) using covariate-adjusted regression models. RESULTS Compared to those with normal cognition, those with MCI/AD had 2.1% higher activity fragmentation (SE = 1.0%, p = 0.036) but similar mean total activity counts/day (p = 0.075) and minutes/day spent active (p = 0.174). Time-of-day analyses show MCI/AD participants had lower activity counts and minutes spent active during waking hours (6:00 am-5:59 pm; p < 0.01 for all). Also, they had lower activity fragmentation from 12:00-5:59 am (p < 0.001), but higher fragmentation from 12:00-5:59 pm (p = 0.026). CONCLUSION Differences in the timing and patterns of physical activity throughout the day linked to MCI/AD diagnoses warrant further investigation into potential clinical utility.
Collapse
Affiliation(s)
- Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Fangyu Liu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hang Wang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacek K Urbanek
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
- Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Yang An
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Adam P Spira
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ryan J Dougherty
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Qu Tian
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Abhay Moghekar
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Susan M Resnick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
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: 39] [Impact Index Per Article: 13.0] [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.
Collapse
|
24
|
Cote AC, Phelps RJ, Kabiri NS, Bhangu JS, Thomas KK. Corrigendum: Evaluation of Wearable Technology in Dementia: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:659639. [PMID: 33777985 PMCID: PMC7992363 DOI: 10.3389/fmed.2021.659639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fmed.2020.501104.].
Collapse
Affiliation(s)
- Alanna C Cote
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Riley J Phelps
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States
| | - Nina Shaafi Kabiri
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States
| | - Jaspreet S Bhangu
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States.,Division of Geriatric Medicine, Department of Medicine, Western University, London, ON, Canada
| | - Kevin Kip Thomas
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States
| |
Collapse
|
25
|
Varma VR, Ghosal R, Hillel I, Volfson D, Weiss J, Urbanek J, Hausdorff JM, Zipunnikov V, Watts A. Continuous gait monitoring discriminates community-dwelling mild Alzheimer's disease from cognitively normal controls. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12131. [PMID: 33598530 PMCID: PMC7864220 DOI: 10.1002/trc2.12131] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/25/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Few studies have explored whether gait measured continuously within a community setting can identify individuals with Alzheimer's disease (AD). This study tests the feasibility of this method to identify individuals at the earliest stage of AD. METHODS Mild AD (n = 38) and cognitively normal control (CNC; n = 48) participants from the University of Kansas Alzheimer's Disease Center Registry wore a GT3x+ accelerometer continuously for 7 days to assess gait. Penalized logistic regression with repeated five-fold cross-validation followed by adjusted logistic regression was used to identify gait metrics with the highest predictive performance in discriminating mild AD from CNC. RESULTS Variability in step velocity and cadence had the highest predictive utility in identifying individuals with mild AD. Metrics were also associated with cognitive domains impacted in early AD. DISCUSSION Continuous gait monitoring may be a scalable method to identify individuals at-risk for developing dementia within large, population-based studies.
Collapse
Affiliation(s)
- Vijay R. Varma
- Clinical and Translational Neuroscience SectionLaboratory of Behavioral NeuroscienceNational Institute on Aging (NIA)National Institutes of Health (NIH)BaltimoreMarylandUSA
| | - Rahul Ghosal
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Inbar Hillel
- Center for the Study of Movement, Cognition and MobilityTel Aviv Sourasky Medical Center, Neurological InstituteTel AvivIsrael
| | - Dmitri Volfson
- Neuroscience AnalyticsComputational Biology, TakedaCambridgeMassachusettsUSA
| | - Jordan Weiss
- Department of DemographyUniversity of California, BerkeleyBerkeleyCaliforniaUSA
| | - Jacek Urbanek
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Jeffrey M. Hausdorff
- Center for the Study of Movement, Cognition and MobilityTel Aviv Sourasky Medical Center, Neurological InstituteTel AvivIsrael
- Sagol School of NeuroscienceTel Aviv UniversityTel AvivIsrael
- Rush Alzheimer's Disease Center and Department of Orthopaedic SurgeryRush University Medical CenterChicagoUSA
- Department of Physical Therapy, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Vadim Zipunnikov
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Amber Watts
- Department of PsychologyUniversity of KansasLawrenceKansasUSA
| |
Collapse
|
26
|
Cote AC, Phelps RJ, Kabiri NS, Bhangu JS, Thomas KK. Evaluation of Wearable Technology in Dementia: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 7:501104. [PMID: 33505979 PMCID: PMC7829192 DOI: 10.3389/fmed.2020.501104] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 11/30/2020] [Indexed: 01/22/2023] Open
Abstract
Background: The objective of this analysis was to systematically review studies employing wearable technology in patients with dementia by quantifying differences in digitally captured physiological endpoints. Methods: This systematic review and meta-analysis was based on web searches of Cochrane Database, PsycInfo, Pubmed, Embase, and IEEE between October 25–31st, 2017. Observational studies providing physiological data measured by wearable technology on participants with dementia with a mean age ≥50. Data were extracted according to PRISMA guidelines and methodological quality assessed independently using Downs and Black criteria. Standardized mean differences between cases and controls were estimated using random-effects models. Results: Forty-eight studies from 18,456 screened abstracts (Dementia: n = 2,516, Control: n = 1,224) met inclusion criteria for the systematic review. Nineteen of these studies were included in one or multiple meta-analyses (Dementia: n = 617, Control: n = 406). Participants with dementia demonstrated lower levels of daily activity (standardized mean difference (SMD), −1.60; 95% CI, −2.66 to −0.55), decreased sleep efficiency (SMD, −0.52; 95% CI, −0.89 to −0.16), and greater intradaily circadian variability (SMD, 0.46; 95% CI, 0.27 to 0.65) than controls, among other measures. Statistical between-study heterogeneity was observed, possibly due to variation in testing duration, device type or patient setting. Conclusions and Relevance: Digitally captured data using wearable devices revealed that adults with dementia were less active, demonstrated increased fragmentation of their sleep-wake cycle and a loss of typical diurnal variation in circadian rhythm as compared to controls.
Collapse
Affiliation(s)
- Alanna C Cote
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Riley J Phelps
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States
| | - Nina Shaafi Kabiri
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States
| | - Jaspreet S Bhangu
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States.,Division of Geriatric Medicine, Department of Medicine, Western University, London, ON, Canada
| | - Kevin Kip Thomas
- Department of Anatomy and Neurobiology, Boston University Medical Center, Boston, MA, United States
| |
Collapse
|
27
|
Salisbury DL, Yu F. A Comparison of Cardiopulmonary Exercise Testing and Field Walking Tests in Community-Dwelling Older Adults With Mild-to-Moderate Alzheimer's Dementia. J Aging Phys Act 2020; 28:911-919. [PMID: 32498039 DOI: 10.1123/japa.2019-0387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/13/2020] [Accepted: 03/30/2020] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to investigate the relationships among peak exercise parameters on 6-min walk test, shuttle walk test, and laboratory-based cardiopulmonary exercise testing in persons with Alzheimer's dementia. This study is a cross-sectional analysis of the baseline data of 90 participants (age 77.1 [6.6] years, 43% female) from the FIT-AD trial. Cardiopulmonary exercise testing produced significantly higher peak heart rate (118.6 [17.5] vs. 106 [22.8] vs. 106 [18.8] beats/min), rating of perceived exertion (16 [2.1] vs. 12 [2.3] vs. 11 [2.1]), and systolic blood pressure (182 [23.7] vs. 156 [18.9] vs. 150 [16.9] mmHg) compared with the shuttle walk test and 6-min walk test, respectively. Peak walking distance on shuttle walk test (241.3 [127.3] m) and 6-min walk test (365.0 [107.9] m) significantly correlated with peak oxygen consumption (17.1 [4.3] ml·kg-1·min-1) on cardiopulmonary exercise testing (r = .449, p ≤ .001 and r = .435, p ≤ .001), respectively, which is considerably lower than what is seen in older adults and persons with cardiopulmonary diseases.
Collapse
|
28
|
Ptomey LT, Szabo-Reed AN, Vidoni ED, Washburn RA, Gorczyca AM, Little TD, Lee J, Helsel BC, Williams KN, Donnelly JE. A dyadic approach for a remote physical activity intervention in adults with Alzheimer's disease and their caregivers: Rationale and design for an 18-month randomized trial. Contemp Clin Trials 2020; 98:106158. [PMID: 32979515 PMCID: PMC7686020 DOI: 10.1016/j.cct.2020.106158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022]
Abstract
Adults with Alzheimer's disease and related dementia (ADRD) and their caregivers represent a sizeable and underserved segment of the population with low levels of moderate physical activity (MPA). Options for increasing MPA in community dwelling adults with ADRD and their caregivers are limited. A home-based physical activity intervention delivered remotely via video conferencing to groups of adults with ADRD and their caregivers (RGV), represents a potentially effective approach for increasing MPA in this group. We will conduct an 18-month randomized trial (6 mos. Active intervention, 6 mos. Maintenance, 6 mos. no contact) to compare the effectiveness of the RGV approach with usual care, enhanced with caregiver support (EUC), for increasing MPA in 100 community dwelling adults with ADRD and their caregiver. The primary aim is to compare MPA (min/wk.), assessed by accelerometer, across the 6-mo. active intervention in adults with ADRD randomized to RGV or EUC. Secondarily, we will compare adults with ADRD and their caregivers randomized to RGV or ECU on the following outcomes across 18 mos.: MPA (min/wk.), sedentary time (min/wk.), percentage meeting 150 min/wk. MPA goal, functional fitness, activities of daily living, quality of life, residential transitions, cognitive function, and caregiver burden. Additionally, we will evaluate the influence of age, sex, BMI, attendance (exercise/support sessions), use of recorded sessions, self-monitoring, peer interactions during group sessions, caregiver support, type and quality of dyadic relationship, and number of caregivers on changes in MPA in adults with ADRD and their caregiver across 18 mos.
Collapse
Affiliation(s)
- Lauren T Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Amanda N Szabo-Reed
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Eric D Vidoni
- Department of Neurology, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Richard A Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Anna M Gorczyca
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Todd D Little
- Department of Educational Psychology and Leadership, Texas Tech University, 2500 Broadway, Lubbock, TX 79409, USA.
| | - Jaehoon Lee
- Department of Educational Psychology and Leadership, Texas Tech University, 2500 Broadway, Lubbock, TX 79409, USA.
| | - Brian C Helsel
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Kristine N Williams
- School of Nursing, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Joseph E Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| |
Collapse
|
29
|
Reuter C, Bellettiere J, Liles S, Di C, Sears DD, LaMonte MJ, Stefanick ML, LaCroix AZ, Natarajan L. Diurnal patterns of sedentary behavior and changes in physical function over time among older women: a prospective cohort study. Int J Behav Nutr Phys Act 2020; 17:88. [PMID: 32646435 PMCID: PMC7346671 DOI: 10.1186/s12966-020-00992-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/29/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Sedentary behavior (SB) is linked to negative health outcomes in older adults. Most studies use summary values, e.g., total sedentary minutes/day. Diurnal timing of SB accumulation may further elucidate SB-health associations. METHODS Six thousand two hundred four US women (mean age = 79 ± 7; 50% White, 34% African-American) wore accelerometers for 7-days at baseline, yielding 41,356 person-days with > 600 min/day of data. Annual follow-up assessments of health, including physical functioning, were collected from participants for 6 years. A novel two-phase clustering procedure discriminated participants' diurnal SB patterns: phase I grouped day-level SB trajectories using longitudinal k-means; phase II determined diurnal SB patterns based on proportion of phase I trajectories using hierarchical clustering. Mixed models tested associations between SB patterns and longitudinal physical functioning, adjusted for covariates including total sedentary time. Effect modification by moderate-vigorous-physical activity (MVPA) was tested. RESULTS Four diurnal SB patterns were identified: p1 = high-SB-throughout-the-day; p2 = moderate-SB-with-lower-morning-SB; p3 = moderate-SB-with-higher-morning-SB; p4 = low-SB-throughout-the-day. High MVPA mitigated physical functioning decline and correlated with better baseline and 6-year trajectory of physical functioning across patterns. In low MVPA, p2 had worse 6-year physical functioning decline compared to p1 and p4. In high MVPA, p2 had similar 6-year physical functioning decline compared to p1, p3, and p4. CONCLUSIONS In a large cohort of older women, diurnal SB patterns were associated with rates of physical functioning decline, independent of total sedentary time. In particular, we identified a specific diurnal SB subtype defined by less SB earlier and more SB later in the day, which had the steepest decline in physical functioning among participants with low baseline MVPA. Thus, diurnal timing of SB, complementary to total sedentary time and MVPA, may offer additional insights into associations between SB and physical health, and provide physicians with early warning of patients at high-risk of physical function decline.
Collapse
Affiliation(s)
- Chase Reuter
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California 92093 USA
| | - John Bellettiere
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California 92093 USA
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University, San Diego, CA 92123 USA
| | - Sandy Liles
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California 92093 USA
- Center for Behavioral Epidemiology and Community Health (CBEACH), San Diego State University, San Diego, CA 92123 USA
| | - Chongzhi Di
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109 USA
| | - Dorothy D. Sears
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California 92093 USA
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004 USA
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92037 USA
| | - Michael J. LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo–SUNY, New York, NY 14214 USA
| | - Marcia L. Stefanick
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford University, Stanford, CA 94305 USA
| | - Andrea Z. LaCroix
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California 92093 USA
| | - Loki Natarajan
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California 92093 USA
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Dr, La Jolla, CA 92037 USA
| |
Collapse
|
30
|
Dong Z, Liu Z, Liu Y, Zhang R, Mo H, Gao L, Shi Y. Physical exercise rectifies CUMS-induced aberrant regional homogeneity in mice accompanied by the adjustment of skeletal muscle PGC-1a/IDO1 signals and hippocampal function. Behav Brain Res 2020; 383:112516. [DOI: 10.1016/j.bbr.2020.112516] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/11/2020] [Accepted: 01/27/2020] [Indexed: 12/21/2022]
|
31
|
Salisbury D, Yu F. Establishing Reference Cardiorespiratory Fitness Parameters in Alzheimer's Disease. Sports Med Int Open 2020; 4:E1-E7. [PMID: 32010759 PMCID: PMC6992417 DOI: 10.1055/a-1089-4957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/28/2019] [Indexed: 01/18/2023] Open
Abstract
Evidence is growing for aerobic exercise training as a viable means to attenuate cognitive losses associated with Alzheimer's disease. The mechanism of action for aerobic exercise's cognitive benefits is likely enhanced cardiorespiratory fitness and its response to incremental aerobic exercise have been incompletely evaluated in Alzheimer's disease. The aim of this analysis was to establish cardiorespiratory fitness reference values in older adults with mild to moderate Alzheimer's disease using a cardiopulmonary graded exercise testing. Ninety-seven community-dwelling older adults with mild to moderate Alzheimer's disease underwent a symptom limited cardiopulmonary graded exercise test on a cycle ergometer. Differences between sexes and between Alzheimer's disease participants with and without diagnosis of cardiovascular diseases were assessed by independent T-tests. Peak oxygen consumption was 10-20% lower than those achieved by similar clinical populations on treadmill tests. As expected, males produced significantly higher peak oxygen consumption compared to females (p =0 .02). However, the presence of concurrent cardiovascular disease did not result in statistically significant lower peak oxygen consumption compared to those without cardiovascular disease. These data provide a frame of reference for metabolic, cardiovascular, and ventilatory function during cardiopulmonary graded exercise testing performed on cycle ergometer in older adults with mild to moderate Alzheimer's disease.
Collapse
Affiliation(s)
- Dereck Salisbury
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, United States
| | - Fang Yu
- School of Nursing, University of Minnesota Twin Cities, Minneapolis, United States
| |
Collapse
|
32
|
Bevan A, Vidoni E, Watts A. Rate of Perceived Exertion and Cardiorespiratory Fitness in Older Adults with and without Alzheimer's Disease. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2020; 13:18-35. [PMID: 32148626 PMCID: PMC7039494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Exercise has many benefits for physical and cognitive health in older adults, yet there are many barriers to exercise adherence in this population. Subjective perception of exercise difficulty, or rate of perceived exertion (RPE), may especially be a barrier to exercise in individuals with Alzheimer's disease (AD), due to changes in initiation and motivation that accompany changes in cognition and brain function. RPE is the most commonly used measure of subjective effort in exercise research, yet the relationship between RPE and objective fitness is not fully understood in older adults. A better understanding is needed to support initiation, engagement, and maintenance of exercise and determine the appropriateness for use of RPE as a measure in this population. Our study aimed to 1) evaluate the degree to which objective measures of cardiorespiratory fitness correlates with the most commonly used subjective measure of effort, RPE and 2) examine any difference in the relationship between objective cardiorespiratory fitness and RPE between individuals with and without AD. We explored these relationships during a graded exercise test. Objective fitness and subjective effort were negatively associated. Independent of cardiorespiratory fitness, older age, female gender, cognitive impairment, and use of heart medications predicted greater self-reported effort during exercise. Results are discussed in terms of social psychological phenomena and potential neuropsychological deficits leading to increased subjective feelings of effort. These findings establish that the RPE measure may not be appropriate and may even detract from effort during graded exercise testing among older adults with AD.
Collapse
Affiliation(s)
- Andrea Bevan
- University of Kansas Alzheimer's Disease Center, Fairway, KS, USA
| | - Eric Vidoni
- University of Kansas Alzheimer's Disease Center, Fairway, KS, USA
| | - Amber Watts
- Department of Psychology, University of Kansas, Lawrence, KS, USA
- University of Kansas Alzheimer's Disease Center, Fairway, KS, USA
| |
Collapse
|
33
|
Lu Z, Harris TB, Shiroma EJ, Leung J, Kwok T. Patterns of Physical Activity and Sedentary Behavior for Older Adults with Alzheimer's Disease, Mild Cognitive Impairment, and Cognitively Normal in Hong Kong. J Alzheimers Dis 2019; 66:1453-1462. [PMID: 30412502 DOI: 10.3233/jad-180805] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common form of dementia, and mild cognitive impairment (MCI) is a transitional phase between healthy cognition and dementia. Physical activity (PA) has protective effects on cognitive decline. However, few studies have examined how PA and sedentary behavior is structured throughout the day in older adults across varied cognitive status in Hong Kong. OBJECTIVE This study aimed to compare patterns of PA and sedentary behavior among individuals with AD, MCI, or normal cognition living in Hong Kong. METHODS Participants in the MrOs and MsOs Hong Kong cohort study and the Hong Kong AD biomarker study (n = 810) wore a wrist-worn accelerometer for 7 days in free-living environment. Patterns of PA in wake time and in-bed time, and detailed analysis of sedentary bouts were compared between groups using analysis of covariance adjusting for covariates. RESULTS Participants with MCI and low MoCA only did not differ from their cognitively normal peers in PA and sedentary behavior. Nevertheless, when comparing to the others, participants with AD exhibited significantly lower average daily counts per minute during the day (p < 0.05), and tended to start their activity later in the morning. AD participants spent a larger proportion of time in sedentary behavior (p < 0.05) and had more sedentary bouts≥30 minutes (p < 0.05). CONCLUSIONS The pattern of PA and sedentary behavior was different between individuals with AD and the others. Cognitive status may alter the purpose and type of PA intervention for AD individuals.
Collapse
Affiliation(s)
- Zhihui Lu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Tamara B Harris
- Lab of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Eric J Shiroma
- Lab of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy Kwok
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
34
|
Association between adiposity levels and cognitive impairment in the Chilean older adult population. J Nutr Sci 2019; 8:e33. [PMID: 31656624 PMCID: PMC6794473 DOI: 10.1017/jns.2019.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 01/30/2023] Open
Abstract
Although both obesity and ageing are risk factors for cognitive impairment, there is no evidence in Chile on how obesity levels are associated with cognitive function. Therefore, the aim of the present study was to investigate the association between adiposity levels and cognitive impairment in older Chilean adults. This cross-sectional study includes 1384 participants, over 60 years of age, from the Chilean National Health Survey 2009-2010. Cognitive impairment was evaluated using the Mini-Mental State Examination. BMI and waist circumference (WC) were used as measures of adiposity. Compared with people with a normal BMI, the odds of cognitive impairment were higher in participants who were underweight (OR 4·44; 95 % CI 2·43, 6·45; P < 0·0001), overweight (OR 1·86; 95 % CI 1·06, 2·66; P = 0·031) and obese (OR 2·26; 95 % CI 1·31, 3·21; P = 0·003). The associations were robust after adjustment for confounding variables. Similar results were observed for WC. Low and high levels of adiposity are associated with an increased likelihood of cognitive impairment in older adults in Chile.
Collapse
|
35
|
A Method to Detect Type 1 Diabetes Based on Physical Activity Measurements Using a Mobile Device. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9122555] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Type 1 diabetes is a chronic disease marked by high blood glucose levels, called hyperglycemia. Diagnosis of diabetes typically requires one or more blood tests. The aim of this paper is to discuss a non-invasive method of type 1 diabetes detection, based on physical activity measurement. We solved a binary classification problem using a variety of computational intelligence methods, including non-linear classification algorithms, which were applied and comparatively assessed. Prediction of disease presence among children and adolescents was evaluated using performance measures, such as accuracy, sensitivity, specificity, precision, the goodness index, and AUC. The most satisfying results were obtained when using the random forest method. The primary parameters in disease detection were weekly step count and the weekly number of vigorous activity minutes. The dependance between the weekly number of steps and the type 1 diabetes presence was established after an insightful analysis of data using classification and clustering algorithms. The findings have shown promising results that type 1 diabetes can be diagnosed using physical activity measurement. This is essential regarding the non-invasiveness and flexibility of the detection method, which can be tested at any time anywhere. The proposed technique can be implemented on a mobile device.
Collapse
|
36
|
Use of Physical Activity Questionnaires in People With Dementia: A Scoping Review. J Aging Phys Act 2019; 27:413-421. [DOI: 10.1123/japa.2018-0031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
37
|
Watts AS, Mortby ME, Burns JM. Depressive symptoms as a barrier to engagement in physical activity in older adults with and without Alzheimer's disease. PLoS One 2018; 13:e0208581. [PMID: 30532212 PMCID: PMC6286143 DOI: 10.1371/journal.pone.0208581] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/20/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Physical activity shows promise for reduced risk of Alzheimer's disease (AD) and protection against cognitive decline among individuals with and without AD. Older adults face many barriers to adoption of physically active lifestyles and people with AD face even further challenges. Physical activity is a promising non-pharmacological approach to improve depressive symptoms, but little is known about the impact of depressive symptoms as a potential barrier to engagement in physical activity. The present study aimed to investigate depressive symptoms as a potential barrier for participation in physical activity across a range of dementia severity. METHOD We used longitudinal structural equation modelling to investigate the bi-directional relationship between depressive symptoms and physical activity in 594 older adults with and without AD over a 2 year longitudinal follow up. Participants ranged from no cognitive impairment to moderately severe AD. RESULTS We found that depressive symptoms predicted reduced engagement in subsequent physical activity, but physical activity did not predict subsequent reductions in depressive symptoms. CONCLUSION We conclude that depressive symptoms may be an important barrier to engagement in physical activity that may be addressed in clinical practice and intervention research.
Collapse
Affiliation(s)
- Amber S. Watts
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, United States of America
| | - Moyra E. Mortby
- School of Psychology, University of New South Wales and Neuroscience Research Australia (NeuRA), Randwick, Sydney, NSW, Australia
| | - Jeffrey M. Burns
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, United States of America
| |
Collapse
|