Physical activity-related individual differences in functional human connectome are linked to fluid intelligence in older adults

The study examined resting state functional connectivity (rs-FC) associated with moderate-to-vigorous physical activity (MV-PA), sedentary time (ST), TV viewing, computer use, and their relationship to cognitive performance in older adults. We used pre-intervention data from 119 participants from the Fit & Active Seniors trial. Multivariate pattern analysis revealed two seeds associated with MV-PA: right superior frontal gyrus (SFG; spanning frontoparietal [FPN] and ventral attention networks [VAN]) and right precentral (PrG) and postcentral gyri (PoG) of the somatosensory network (SN). A positive correlation between the right SFG seed and a cluster spanning default mode (DMN), dorsal attention (DAN), FPN, and visual networks (VIS) was linked to higher fluid intelligence, as was FC between the right PrG/PoG seed and a cluster in VIS. No significant rs-FC patterns associated with ST, TV viewing, or computer use were found. Our findings suggest that greater functional integration within networks implementing top-down control and within those supporting visuospatial abilities, paired with segregation between networks critical and those not critical to top-down control, may help promote cognitive reserve in more physically active seniors.

Data-driven MRI analysis reveals fitness-related functional change in default mode network and cognition following an exercise intervention

Previous research has indicated that cardiorespiratory fitness (CRF) is structurally and functionally neuroprotective in older adults. However, questions remain regarding the mechanistic role of CRF on cognitive and brain health. The purposes of this study were to investigate if higher pre-intervention CRF was associated with greater change in functional brain connectivity during an exercise intervention and to determine if the magnitude of change in connectivity was related to better post-intervention cognitive performance. The sample included low-active older adults (n = 139) who completed a 6-month exercise intervention and underwent neuropsychological testing, functional neuroimaging, and CRF testing before and after the intervention. A data-driven multi-voxel pattern analysis was performed on resting-state MRI scans to determine changes in whole-brain patterns of connectivity from pre- to post-intervention as a function of pre-intervention CRF. Results revealed a positive correlation between pre-intervention CRF and changes in functional connectivity in the precentral gyrus. Using the precentral gyrus as a seed, analyses indicated that CRF-related connectivity changes within the precentral gyrus were derived from increased correlation strength within clusters located in the Dorsal Attention Network (DAN) and increased anti-correlation strength within clusters located in the Default Mode Network (DMN). Exploratory analysis demonstrated that connectivity change between the precentral gyrus seed and DMN clusters were associated with improved post-intervention performance on perceptual speed tasks. These findings suggest that in a sample of low-active and mostly lower-fit older adults, even subtle individual differences in CRF may influence the relationship between functional connectivity and aspects of cognition following a 6-month exercise intervention.

Physical activity intervention benefits persist months post-intervention: randomized trial in breast cancer survivors

PURPOSE

Determine durable effects of the 3-month Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) physical activity (PA) behavior change intervention 12 months post-baseline (i.e., 9 months after intervention completion).

METHODS

This 2-arm multicenter trial randomized 222 post-primary treatment breast cancer survivors to BEAT Cancer (individualized exercise and group education) vs. usual care (written materials). Assessments occurred at baseline, 3, 6, and 12 months, with the 12 months assessment reported here. Measures included PA (accelerometer, self-report), cardiorespiratory fitness, muscle strength, body mass index, Functional Assessment of Cancer Therapy (FACT), SF-36, fatigue, depression, anxiety, satisfaction with life, Pittsburgh Sleep Quality Index (PSQI), lower extremity joint dysfunction, and perceived memory.

RESULTS

Adjusted linear mixed-model analyses demonstrated statistically significant month 12 between-group differences favoring BEAT Cancer for weekly minutes of moderate-to-vigorous self-report PA (mean between-group difference (M) = 44; 95% confidence interval (CI) = 12 to 76; p = .001), fitness (M = 1.5 ml/kg/min; CI = 0.4 to 2.6; p = .01), FACT-General (M = 3.5; CI = 0.7 to 6.3; p = .014), FACT-Breast (M = 3.6; CI = 0.1 to 7.1; p = .044), social well-being (M = 1.3; CI = 0.1 to 2.5; p = .037), functional well-being (M = 1.2; CI = 0.2 to 2.3; p = .023), SF-36 vitality (M = 6.1; CI = 1.4 to 10.8; p = .011), fatigue (M =  - 0.7; CI =  - 1.1 to - 0.2; p = .004), satisfaction with life (M = 1.9; CI = 0.3 to 3.5; p = .019), sleep duration (M =  - 0.2; CI =  - 0.4 to - 0.03, p = .028), and memory (M = 1.1; CI = 0.2 to 2.1; p = .024).

CONCLUSIONS

A 3-month PA intervention resulted in statistically significant and clinically important benefits compared to usual care at 12 months.

IMPLICATIONS FOR CANCER SURVIVORS

Three months of individualized and group PA counseling causes benefits detectable 9 months later.

TRIAL REGISTRATION

ClinicalTrials.gov NCT00929617 ( https://clinicaltrials.gov/ct2/show/NCT00929617 ; registered June 29, 2009).

Associations between Symptoms and Exercise Barriers in Breast Cancer Survivors

Despite exercise benefits for cancer survivor health, most breast cancer survivors do not meet exercise recommendations. Few studies have examined associations between psychosocial symptoms and exercise barriers in this population. To improve physician exercise counseling by identifying survivors with high barriers in a clinical setting, associations between breast cancer symptoms (fatigue, mood, sleep quality) and exercise barriers were investigated. Physically inactive survivors (N = 320; average age 55 ± 8 years, 81% White, 77% cancer stage I or II) completed a baseline survey for a randomized physical activity trial and secondary analyses were performed. Potential covariates, exercise barriers interference score, Fatigue Symptom Inventory, Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index were assessed. Based on multiple linear regression analyses, only HADS Global (B = 0.463, p < 0.001) and number of comorbidities (B = 0.992, p = 0.01) were independently associated with total exercise barriers interference score, explaining 8.8% of the variance (R2 = 0.088, F(2,317) = 15.286, p < 0.001). The most frequent barriers to exercise for survivors above the HADS clinically important cut point included procrastination, routine, and self-discipline. These results indicate greater anxiety levels, depression levels, and comorbidities may be independently associated with specific exercise barriers. Health professionals should consider mood and comorbidities when evaluating survivors for exercise barriers, and tailoring exercise counseling.

Yoga, aerobic and stretching exercise effects on neurocognition: Randomized controlled trial protocol

As the global population ages, the prevalence of cognitive decline and dementia is expected to rise, creating a significant health and economic burden. The purpose of this trial is to rigorously test, for the first time, the efficacy of yoga training as a physical activity intervention to mitigate age-related cognitive decline and impairment. We are conducting a 6-month randomized controlled trial (RCT) of exercise among 168 middle aged and older adults to compare the efficacy of yoga vs. aerobic exercise on cognitive function, brain structure and function, cardiorespiratory fitness, and circulating inflammatory and molecular markers. Using a single-blind, three arm RCT, 168 older adults ages 55-79 will be assigned to either: a Hatha yoga group, an aerobic exercise group or a stretching-toning active control group. Participants will engage in hour long group exercise 3x/week for 6-months. A comprehensive neurocognitive test battery, brain imaging, cardiovascular fitness test, and a blood draw will take place at baseline; end of the 6-month intervention, and at 12-month follow-up. Our primary outcomes of interest are brain regions, such as hippocampal volume and prefrontal cortex, and cognitive functions, such as episodic memory, working memory and executive functions, that are typically affected by aging and Alzheimer's disease. Not only will this RCT test whether yoga is a means to mitigate age-related cognitive decline, but it may also offer an alternative to aerobic exercise, which could be particularly appealing to older adults with compromised physical functioning. ClinicalTrials.gov Identifier: NCT04323163.

Dynamic interactions between memory and viewing behaviors: Insights from dyadic modeling of eye movements

Humans use eye movements to build visual memories. We investigated how the contributions of specific viewing behaviors to memory formation evolve over individual study epochs. We used dyadic modeling to explain performance on a spatial reconstruction task based on interactions among two gaze measures: (a) the entropy of the scanpath and (b) the frequency of item-to-item gaze transitions. To measure these interactions, our hypothesized model included causal pathways by which early-trial viewing behaviors impacted subsequent memory via downstream effects on later viewing. We found that lower scanpath entropy throughout the trial predicted better memory performance. By contrast, the effect of item-to-item transition frequency changed from negative to positive as the trial progressed. The model also revealed multiple pathways by which early-trial viewing dynamically altered late-trial viewing, thereby impacting memory indirectly. Finally, individual differences in scores on an independent measure of memory ability were found to predict viewing effectiveness, and viewing behaviors partially mediated the relation between memory ability and reconstruction accuracy. In a second experiment, the model showed a good fit for an independent dataset. These results highlight the dynamic nature of memory formation and suggest that the order in which eye movements occur can critically determine their effectiveness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Breast cancer survivors' exercise preferences change during an exercise intervention are associated with post-intervention physical activity

PURPOSE

Exercise program preferences are important for designing physical activity (PA) interventions; yet may change following an intervention. Further, the relationship between preferences and PA behavior change is unclear. This study evaluated exercise program preferences among breast cancer survivors (BCS) before and after a behavioral intervention and associations between program preferences and PA change.

METHODS

BCS were randomized to the BEAT Cancer intervention (n = 110) or written materials (n = 112). Questionnaires assessed exercise program preferences. Minutes per week of moderate-to-vigorous PA (MVPA) were accelerometer-measured and self-reported at baseline (M0), post-intervention (M3), and 3-month follow-up (M6).

RESULTS

At M0, the majority of intervention group participants preferred exercising with others (62%) yet shifted to preferring exercising alone (59%) at M3 (p < 0.001). Furthermore, preferring exercising with others at M0 was associated with greater increases in self-reported MVPA between M0 and M6 (124.2 ± 152 vs. 53.1 ± 113.8, p = 0.014). BCS preferring facility-based exercise decreased after the BEAT Cancer intervention (14% vs. 7%, p = 0.039) and preferring exercising at home/had no preference at M0 had greater improvements in accelerometer-measured MVPA from M0 to M3 (74.3 ± 118.8 vs. -2.3 ± 78.4, p = 0.033) and M0 to M6 (44.9 ± 112.8 vs. 9.3 ± 30.4, p = 0.021). Exercise program preferences regarding mode of counseling, training supervision, and type of exercise changed from M0 to M3 but were not associated with changes in MVPA.

CONCLUSION

Findings suggest BCS exercise program preferences may change after an intervention and be associated with changes in MVPA. Understanding the role of PA preferences will better inform the design and success of PA behavior change interventions. ClinicTrials.gov, ClinicalTrials.gov number: NCT00929617.

Designing home-based physical activity programs for rural cancer survivors: A survey of technology access and preferences

Background

While technology advances have increased the popularity of remote interventions in underserved and rural cancer communities, less is understood about technology access and preferences for home-based physical activity programs in this cancer survivor population.

Purpose

To determine access, preferences, and needs, for a home-based physical activity program in rural cancer survivors.

Methods

A Qualtrics Research Panel was recruited to survey adults with cancer across the United States. Participants self-reported demographics, cancer characteristics, technology access and usage, and preferences for a home-based physical activity program. The Godin Leisure Time Exercise Questionnaire (GLTEQ) assessed current levels of physical activity. Descriptive statistics included means and standard deviations for continuous variables, and frequencies for categorical variables. Independent samples t-tests explored differences between rural and non-rural participants.

Results

Participants (N=298; mean age=55.2 ± 16.5) had a history of cancer (mean age at diagnosis=46.5), with the most commonly reported cancer type being breast (25.5%), followed by prostate (16.1%). 74.2% resided in rural hometowns. 95% of participants reported accessing the internet daily. On a scale of 0-100, computer/laptop (M=63.4) and mobile phone (M=54.6) were the most preferred delivery modes for a home-based physical activity intervention, and most participants preferred balance/flexibility (72.2%) and aerobic (53.9%) exercises. Desired intervention elements included a frequency of 2-3 times a week (53.5%) for at least 20 minutes (75.7%). While there were notable rural disparities present (e.g., older age at diagnosis, lower levels of education; ps<.001), no differences emerged for technology access or environmental barriers (ps>.08). However, bias due to electronic delivery of the survey should not be discounted.

Conclusion

These findings provide insights into the preferred physical activity intervention (e.g., computer delivery, balance/flexibility exercises) in rural cancer survivors, while highlighting the need for personalization. Future efforts should consider these preferences when designing and delivering home-based interventions in this population.

Breast Cancer Survivors' Exercise Preferences Change During an Exercise Intervention and are associated with Post-Intervention Physical Activity

Purpose Exercise program preferences are important for designing physical activity (PA) interventions; yet may change following an intervention. Further, the relationship between preferences and PA behavior change is unclear. This study evaluated exercise program preferences among breast cancer survivors (BCS) before and after a behavioral intervention and associations between program preferences and PA change. Methods BCS were randomized to the BEAT Cancer intervention (n = 110) or written materials (n = 112). Questionnaires assessed exercise program preferences. Minutes per week of moderate-to-vigorous PA (MVPA) were accelerometer-measured and self-reported at baseline (M0), post-intervention (M3), and 3-month follow-up (M6). Results At M0, the majority of intervention group participants preferred exercising with others (62%) yet shifted to preferring exercising alone (59%) at M3 ( p  < 0.001). Furthermore, preferring exercising with others at M0 was associated with greater increases in self-reported MVPA between M0 and M6 (124.2 ± 152 vs. 53.1 ± 113.8, p = 0.014). BCS preferring facility-based exercise decreased after the BEAT Cancer intervention (14% vs. 7%, p  = 0.039) and preferring exercising at home/had no preference at M0 had greater improvements in accelerometer-measured MVPA from M0 to M3 (74.3 ± 118.8 vs. -2.3 ± 78.4, p = 0.033) and M0 to M6 (44.9 ± 112.8 vs. 9.3 ± 30.4, p = 0.021). Exercise program preferences regarding mode of counseling, training supervision, and type of exercise changed from M0 to M3 but were not associated with changes in MVPA. Conclusion Findings suggest BCS exercise program preferences may change after an intervention and be associated with changes in MVPA. Understanding the role of PA preferences will better inform the design and success of PA behavior change interventions. ClinicTrials.gov, ClinicalTrials.gov number: NCT00929617.

Cardiorespiratory fitness levels and body mass index of pre-adolescent children and older adults during the COVID-19 pandemic

Introduction

The social and behavioral effects of the COVID-19 pandemic have impacted the health and physiology of most people, including those never diagnosed with COVID-19. While the impact of the pandemic has been felt across the lifespan, its effects on cardiorespiratory fitness (commonly considered a reflection of total body health) of older adults and children may be particularly profound due to social distancing and stay-at-home advisories, as well as the closure of sport facilities and non-essential businesses. The objective of this investigation was to leverage baseline data from two ongoing clinical trials to determine if cardiorespiratory fitness and body mass index were different during COVID-19 relative to before COVID-19 in older adults and children.

Methods

Healthy older individuals (N = 593; 65-80 years) and 200 typically developing children (8-10 years) completed a graded maximal exercise test and had their height and weight measured.

Results

Results revealed that older adults and children tested during COVID-19 had significantly lower cardiorespiratory fitness levels than those tested before COVID-19 shutdowns (older adults: 30% lower; children: 53% lower; p's ≤ 0.001). In addition, older adults and children tested during COVID-19 had significantly higher BMI (older adults: 31.34 ± 0.57 kg/m2, p = 0.004; children: 19.27 ± 0.44 kg/m2, p = 0.05) than those tested before COVID-19 shutdowns (older adults: 29.51 ± 0.26 kg/m2, children: 18.13 ± 0.35 kg/m2). However, these differences in BMI did not remain significant when controlling for cardiorespiratory fitness.

Discussion

Results from this investigation indicate that the COVID-19 pandemic, and behavior changes taken to reduce potential exposure, may have led to lower cardiorespiratory fitness levels in older adults and children, as well as higher body mass index. These findings provide relevant public health information as lower cardiorespiratory fitness levels and higher body mass indexes recorded during the pandemic could have far-reaching and protracted health consequences. Public health guidance is needed to encourage physical activity to maintain cardiorespiratory fitness and healthy body composition.

Clinical trial registration

Older adults: https://clinicaltrials.gov/ct2/show/NCT02875301, identifier: NCT02875301; Children: https://clinicaltrials.gov/ct2/show/NCT03592238, identifier: NCT03592238.

Physical activity and cognitive function: A comparison of rural and urban breast cancer survivors

PURPOSE

Increasing evidence suggests rural breast cancer survivors (BCS) may experience greater burden in symptoms known to be associated with cancer-associated cognitive decline (CACD). Yet, little is known about CACD in rural BCS. This study (1) examined differences in cognitive function, moderate-to-vigorous physical activity (MVPA), and other CACD correlates and (2) tested the effects of MVPA on cognitive function in rural versus urban BCS.

METHODS

Rural and urban BCS (N = 80), matched on age, education, and time since diagnosis from a larger study, completed cognitive tasks assessing processing speed (Trails-B, Mazes, Task-Switch) and working memory (spatial working memory) and questionnaires assessing subjective memory impairment (SMI), MVPA, and CACD correlates (i.e., sleep quality, fatigue, anxiety/depression). Some participants (n = 62) wore an accelerometer to objectively estimate MVPA. Multiple linear regression and multivariate analysis of covariance were used to test study aims.

RESULTS

Rural BCS (n = 40, M = 61.1±8.4 years-old) performed significantly slower on Trails-B (p<0.01) compared with urban BCS (n = 40, M = 61.0±8.2 years-old) and engaged in less objectively-estimated daily MVPA (mean difference = 13.83±4.73 minutes; p = 0.01). No significant differences in SMI, self-reported MVPA, or CACD correlates were observed (all p>0.28). Regression models did not reveal a significant interaction between MVPA and cognitive performance (all p>0.1); however, estimated marginal means models indicated that the effect of MVPA on processing speed was evident only among rural BCS (Trails-B, p = 0.04; Mazes, p = 0.03).

CONCLUSIONS

Findings suggest rural BCS may suffer greater CACD and engage in less MVPA. Additional research is warranted to further examine CACD and more effectively promote MVPA in rural BCS.

Symmetric data-driven fusion of diffusion tensor MRI: Age differences in white matter

In the past 20 years, white matter (WM) microstructure has been studied predominantly using diffusion tensor imaging (DTI). Decreases in fractional anisotropy (FA) and increases in mean (MD) and radial diffusivity (RD) have been consistently reported in healthy aging and neurodegenerative diseases. To date, DTI parameters have been studied individually (e.g., only FA) and separately (i.e., without using the joint information across them). This approach gives limited insights into WM pathology, increases the number of multiple comparisons, and yields inconsistent correlations with cognition. To take full advantage of the information in a DTI dataset, we present the first application of symmetric fusion to study healthy aging WM. This data-driven approach allows simultaneous examination of age differences in all four DTI parameters. We used multiset canonical correlation analysis with joint independent component analysis (mCCA + jICA) in cognitively healthy adults (age 20-33, n = 51 and age 60-79, n = 170). Four-way mCCA + jICA yielded one high-stability modality-shared component with co-variant patterns of age differences in RD and AD in the corpus callosum, internal capsule, and prefrontal WM. The mixing coefficients (or loading parameters) showed correlations with processing speed and fluid abilities that were not detected by unimodal analyses. In sum, mCCA + jICA allows data-driven identification of cognitively relevant multimodal components within the WM. The presented method should be further extended to clinical samples and other MR techniques (e.g., myelin water imaging) to test the potential of mCCA+jICA to discriminate between different WM disease etiologies and improve the diagnostic classification of WM diseases.

Moderators of physical activity and quality of life response to a physical activity intervention for breast cancer survivors

PURPOSE

Moderate-to-vigorous physical activity (MVPA) can improve the quality of life (QoL) for breast cancer survivors (BCS), yet, most do not achieve 150 + weekly minutes of MVPA. This study investigated moderators of response to a physical activity (PA) behavior change intervention for BCS.

METHODS

BCS (N = 222) were randomized to the 3-month intervention (BEAT Cancer) or usual care. Measurements occurred at baseline, post-intervention, and 3 months post-intervention. Measures included accelerometry, self-reported MVPA, and Functional Assessment of Cancer Therapy (FACT-General, FACT-Breast, physical well-being (PWB), social well-being (SWB), emotional well-being (EWB), functional well-being (FWB), additional concerns (AC), and Trial Outcome Index (TOI)).

RESULTS

Adjusted linear mixed-model analyses indicated individuals ≤ 24 months post-diagnosis and who were single reported smaller increases in weekly self-reported MVPA than those > 24 months (44.07 vs 111.93) and partnered (- 16.24 vs. 49.16 min), all p < 0.05. As for QoL, participants < 12 months post-diagnosis who received chemotherapy experienced smaller improvements than those ≥ 12 months in FACT-General, FACT-Breast, PWB, and SWB scores. Survivors with a history of chemotherapy had smaller improvements in FACT-General, FACT-Breast, PWB, SWB, TOI, and AC scores, all p < 0.05.

CONCLUSION

These findings indicate that being < 2 years post-diagnosis, single, and prior chemotherapy may limit MVPA and QOL responses to a PA intervention. Further studies are needed to determine if and/or what additional PA supports and resources these subgroups of BCS might find beneficial and effective.

TRIAL REGISTRATION

ClinicalTrials.gov number: NCT00929617.

FEASIBILITY AND ACCEPTABILITY OF A HYBRID AEROBIC EXERCISE PROGRAM FOR OLDER ADULTS DURING THE COVID-19 PANDEMIC

The COVID-19 pandemic and ensuing lockdowns, physical distancing and mask mandates exacerbated the challenges older adults (OAs) face towards exercise engagement. We present data on the feasibility, safety, and acceptability of a hybrid (in-person and virtual) aerobic exercise program for OAs. Nf39 (30 females, Mage=64.10) low-active OAs completed an aerobics-based exercise program as part of a larger ongoing RCT. Participants exercised 3x/week by attending one in-person and two Zoom-based exercise classes. Attendance, attrition, format preferences, and adverse events were documented. Participants also completed an anonymous survey to detail their experiences with the hybrid delivery model. Thirty participants completed the program. Total average attendance of 83.64%; 58.93% and 24.71% of the attended sessions were on Zoom and in-person, respectively. On post-program surveys, 36.67% reported preferring Zoom sessions, followed by 33.33% preferring both formats equally. No adverse events were reported. From the anonymous program feedback surveys, common reasons for preferring the Zoom sessions included convenience; not having to wear a mask; not worrying about COVID exposure; and not feeling self-conscious about exercising with others. Commonly reported reasons for preferring the in-person sessions were increased motivation from group energy; social support; more space to move around; and better engagement with instructors. Collectively, these findings show a hybrid aerobic exercise program is feasible and safe for OAs to engage in and is overall well-accepted. Findings are encouraging for the design of future exercise programs for OAs, who continue to remain a vulnerable population during the pandemic but need a structure to remain sufficiently active.

EFFECTS OF A SIX-MONTH EXERCISE PROGRAM ON PHYSICAL ACTIVITY AMONG OLDER ADULTS WITH CHRONIC CONDITIONS

Health benefits of structured physical activity (PA) for older adults have been well documented. Older adults are highly impacted with major chronic conditions, leading to limitations in daily activities. This study examined the effects of an exercise program on moderate-vigorous physical activity (MVPA) and sedentary time after six months of exercise. Participants from a larger-ongoing trial were randomized into either yoga, aerobic or stretch-tone groups. A subsample of 58 participants was classified as chronic individuals (CI) based on presence of at least one chronic condition, and 31 as healthy individuals (HI), who completed accelerometer measures before and after the exercise program. A repeated measures analysis was performed to identify changes in PA over time for HI and CI. At both time-points, MVPA was significantly higher for HI. There was a significant increase in MVPA at month six for all participants, irrespective of health status. Mean MVPA in minutes for baseline HI: 153, CI: 98 and for month 6 HI: 188 CI: 116. There were no significant differences in sedentary time after the six-months of exercise. Although there was an increase in MVPA for HI and CI after structured exercise, no change was noted for sedentary time. Increased sedentary time has been proven to be a risk factor for poor health and although meeting criteria for MVPA is important, it is essential to address sedentary time in CI by implementing educational and interventional components that focus specifically on sedentary time. Funding: This data is from NCT04323163 funded by NIH-NIA – grant-AG066630.

Musical Experience Relates to Insula-Based Functional Connectivity in Older Adults

Engaging in musical activities throughout the lifespan may protect against age-related cognitive decline and modify structural and functional connectivity in the brain. Prior research suggests that musical experience modulates brain regions that integrate different modalities of sensory information, such as the insula. Most of this research has been performed in individuals classified as professional musicians; however, general musical experiences across the lifespan may also confer beneficial effects on brain health in older adults. The current study investigated whether general musical experience, characterized using the Goldsmith Music Sophistication Index (Gold-MSI), was associated with functional connectivity in older adults (age = 65.7 ± 4.4, n = 69). We tested whether Gold-MSI was associated with individual differences in the functional connectivity of three a priori hypothesis-defined seed regions in the insula (i.e., dorsal anterior, ventral anterior, and posterior insula). We found that older adults with more musical experience showed greater functional connectivity between the dorsal anterior insula and the precentral and postcentral gyrus, and between the ventral anterior insula and diverse brain regions, including the insula and prefrontal cortex, and decreased functional connectivity between the ventral anterior insula and thalamus (voxel p < 0.01, cluster FWE p < 0.05). Follow-up correlation analyses showed that the singing ability subscale score was key in driving the association between functional connectivity differences and musical experience. Overall, our findings suggest that musical experience, even among non-professional musicians, is related to functional brain reorganization in older adults.

Brain Structure and Function Predict Adherence to an Exercise Intervention in Older Adults

INTRODUCTION

Individual differences in brain structure and function in older adults are potential proxies of brain reserve or maintenance and may provide mechanistic predictions of adherence to exercise. We hypothesized that multimodal neuroimaging features would predict adherence to a 6-month randomized controlled trial of exercise in 131 older adults (age, 65.79 ± 4.65 yr, 63% female), alone and in combination with psychosocial, cognitive, and health measures.

METHODS

Regularized elastic net regression within a nested cross-validation framework was applied to predict adherence to the intervention in three separate models (brain structure and function only; psychosocial, health, and demographic data only; and a multimodal model).

RESULTS

Higher cortical thickness in somatosensory and inferior frontal regions and less surface area in primary visual and inferior frontal regions predicted adherence. Higher nodal functional connectivity (degree count) in default, frontoparietal, and attentional networks and less nodal strength in primary visual and temporoparietal networks predicted exercise adherence ( r = 0.24, P = 0.004). Survey and clinical measures of gait and walking self-efficacy, biological sex, and perceived stress also predicted adherence ( r = 0.17, P = 0.056); however, this prediction was not significant when tested against a null test statistic. A combined multimodal model achieved the highest predictive strength ( r = 0.28, P = 0.001).

CONCLUSIONS

Our results suggest that there is a substantial utility of using brain-based measures in future research into precision and individualized exercise interventions older adults.

BAILA: A Randomized Controlled Trial of Latin Dancing to Increase Physical Activity in Spanish-Speaking Older Latinos

BACKGROUND

Latinos are the fastest growing minority group of the older adult population. Although physical activity (PA) has documented health benefits, older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance, popular among Latinos, holds promise as a culturally relevant form of PA.

PURPOSE

To describe self-reported and device-assessed changes in PA as a result of a randomized controlled trial of BAILAMOS, a 4-month Latin dance program with a 4-month maintenance program, versus a health education control group.

METHODS

Adults, aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels at baseline, and risk for disability were randomized to the dance program (n = 167) or health education condition (n = 166). Data were analyzed using multilevel modeling with full information maximum likelihood.

RESULTS

A series of multilevel models revealed significant time × group interaction effects for moderate-to-vigorous physical activity (MVPA), dance PA, leisure PA, and total PA. Exploring the interaction revealed the dance group to significantly increase their MVPA, dance PA, leisure PA, and total PA at months 4 and 8. Household PA and activity counts from accelerometry data did not demonstrate significant interaction effects.

CONCLUSIONS

The study supports organized Latin dance programs to be efficacious in promoting self-reported PA among older Latinos. Efforts are needed to make dancing programs available and accessible, and to find ways for older Latinos to add more PA to their daily lives.

CLINICAL TRIAL INFORMATION

NCT01988233.

Latin Dance and Working Memory: The Mediating Effects of Physical Activity Among Middle-Aged and Older Latinos

Background

Physical activity (PA) is a promising method to improve cognition among middle-aged and older adults. Latinos are at high risk for cognitive decline and engaging in low levels of PA. Culturally relevant PA interventions for middle-aged and older Latinos are critically needed to reduce risk of cognitive decline. We examined changes in cognitive performance among middle-aged and older Latinos participating in the BAILAMOS™ dance program or a health education group and compared the mediating effects of PA between group assignment and change in cognitive domains.

Methods

Our 8-month randomized controlled trial tested BAILAMOS™, a 4-month Latin dance program followed by a 4-month maintenance phase. A total of 333 older Latinos aged 55+ were randomized to either BAILAMOS™, or to a health education control group. Neuropsychological tests were administered, scores were converted to z-scores, and specific domains (i.e., executive function, episodic memory, and working memory) were derived. Self-reported PA was assessed, and we reported categories of total PA, total leisure PA, and moderate-to-vigorous PA as minutes/week. A series of ANCOVAs tested changes in cognitive domains at 4 and 8 months. A mediation analysis tested the mediating effects of each PA category between group assignment and a significant change in cognition score.

Results

The ANCOVAs found significant improvement in working memory scores among participants in the dance group at month 8 [F(1,328) = 5.79, p = 0.017, d = 0.20], but not in executive functioning [F(2,328) = 0.229, p = 0.80, Cohen’s d = 0.07] or episodic memory [F(2,328) = 0.241, p = 0.78, Cohen’s d = 0.05]. Follow-up mediation models found that total PA mediated the relationship between group assignment and working memory, in favor of the dance group (β = 0.027, 95% CI [0.0000, 0.0705]). Similarly, total leisure PA was found to mediate this relationship [β = 0.035, 95% CI (0.0041, 0.0807)].

Conclusion

A 4-month Latin dance program followed by a 4-month maintenance phase improved working memory among middle-aged and older Latinos. Improvements in working memory were mediated by participation in leisure PA. Our results support the current literature that leisure time PA influences cognition and highlight the importance of culturally relevant PA modalities for Latinos.

Clinical Trial Registration

[www.ClinicalTrials.gov], identifier [NCT01988233].

Relationships between enriching early life experiences and cognitive function later in life are mediated by educational attainment

The study of how engagement in enriching cognitive, physical and social activities in childhood impacts cognitive function decades later will advance our understanding of how modifiable lifestyle activities promote cognition across the lifespan. 88 healthy older adults (aged 60-80 years) returned a retrospective questionnaire regarding their participation in seven lifestyle activities (musical instrument playing, language learning, sport participation, art/dance lessons, scouting, volunteering, family vacations) before age 13 years. After controlling for current age, educational attainment, socioeconomic status of the mother and current engagement in lifestyle activities, a greater number of activities were significantly associated with better vocabulary abilities, episodic memory and fluid intelligence. The relationships with vocabulary and fluid intelligence were mediated by educational attainment. We postulate that engagement in a higher number of enriching early life activities is a reflection of both one's sociocontextual environment and engagement with that environment. This engagement leads to attributes relevant for educational aspirations/attainment, ultimately contributing to factors that have a lifespan impact on cognitive function.

Investigating impact of cardiorespiratory fitness in reducing brain tissue loss caused by ageing

Mitigating the loss of brain tissue due to age is a major problem for an ageing population. Improving cardiorespiratory fitness has been suggested as a possible strategy, but the influenceon brain morphology has not been fully characterized. To investigate the dependent shifts in brain tissue distribution as a function of cardiorespiratory fitness, we used a 3D transport-based morphometry approach. In this study of 172 inactive older adults aged 58–81 (66.5 ± 5.7) years, cardiorespiratory fitness was determined by VO2 peak (ml/kg/min) during graded exercise and brain morphology was assessed through structural magnetic resonance imaging. After correcting for covariates including age (in the fitness model), gender and level of education, we compared dependent tissue shifts with age to those due to VO2 peak. We found a significant association between cardiorespiratory fitness and brain tissue distribution (white matter, r = 0.30, P = 0.003; grey matter, r = 0.40, P < 0.001) facilitated by direct visualization of the brain tissue shifts due to cardiorespiratory fitness through inverse transformation—a key capability of 3D transport-based morphometry. A strong statistical correlation was found between brain tissue changes related to ageing and those associated with lower cardiorespiratory fitness (white matter, r = 0.62, P < 0.001; grey matter, r = 0.74, P < 0.001). In both cases, frontotemporal regions shifted the most while basal ganglia shifted the least. Our results highlight the importance of cardiorespiratory fitness in maintaining brain health later in life. Furthermore, this work demonstrates 3D transport-based morphometry as a novel neuroinformatic technology that may aid assessment of therapeutic approaches for brain ageing and neurodegenerative diseases.

Musical experience relates to functional connectivity in older adults

Previous studies have shown that engaging in musical activities throughout the lifespan may buffer age-related decline in auditory and motor function, as well as in general cognitive function. MRI studies have demonstrated that individuals with musical training and experience exhibited greater grey matter volume and functional connectivity in extensive brain regions, especially in auditory and motor systems, compared to matched controls with no particular musical training or experience. Therefore, musical activity is a potential protective factor for brain health across lifespan. However, how lifespan musical experience shapes functional connectivity in older adults is still unknown. The current analysis investigated whether general musical experience (Goldsmith Music Sophistication Index) is associated with functional connectivity in older adults (age=65.7±4.4, n=69), focusing on seed regions in primary motor areas (bilateral precentral gyrus) and primary auditory regions (bilateral anterior/posterior superior temporal gyrus) and their functional connectivity towards other areas throughout the whole brain. We found that older adults with more musical experience showed greater functional connectivity between anterior superior temporal gyrus and insula (R2=0.10, p=0.01), and between posterior superior temporal gyrus and cerebellum (R2=0.08, p=0.02). However, musical experience and music-related functional connectivity was not significantly correlated with general cognitive functions in our sample. Overall, our findings suggest that older adults with more musical experience might be more efficient in some aspects of auditory processing and auditory-motor skills, but this may not transfer towards domain-general cognitive tests. Our results support the notion that even non-professional engagement in musical experiences may afford benefits to the aging brain.

Working to Increase Stability through Exercise (WISE): screening, recruitment, and baseline characteristics

Background

The aim of this paper is to describe the utility of various recruitment modalities utilized in the Working to Increase Stability through Exercise (WISE) study. WISE is a pragmatic randomized trial that is testing the impact of a 3-year, multicomponent (strength, balance, aerobic) physical activity program led by trained volunteers or delivered via DVD on the rate of serious fall-related injuries among adults 65 and older with a past history of fragility fractures (e.g., vertebral, fall-related). The modified goal was to recruit 1130 participants over 2 years in three regions of Pennsylvania.

Methods

The at-risk population was identified primarily using letters mailed to patients of three health systems and those over 65 in each region, as well as using provider alerts in the health record, proactive recruitment phone calls, radio advertisements, and presentations at community meetings.

Results

Over 24 months of recruitment, 209,301 recruitment letters were mailed, resulting in 6818 telephone interviews. The two most productive recruitment methods were letters (72% of randomized participants) and the research registries at the University of Pittsburgh (11%). An average of 211 letters were required to be mailed for each participant enrolled. Of those interviewed, 2854 were ineligible, 2,825 declined to enroll and 1139 were enrolled and randomized. Most participants were female (84.4%), under age 75 (64.2%), and 50% took an osteoporosis medication. Not having a prior fragility fracture was the most common reason for not being eligible (87.5%). The most common reason provided for declining enrollment was not feeling healthy enough to participate (12.6%).

Conclusions

The WISE study achieved its overall recruitment goal. Bulk mailing was the most productive method for recruiting community-dwelling older adults at risk of serious fall-related injury into this long-term physical activity intervention trial, and electronic registries are important sources and should be considered.

Effects of a DVD-delivered randomized controlled physical activity intervention on functional health in cancer survivors

Background

Supervised physical activity interventions improve functional health during cancer survivorship, but remain costly and inaccessible for many. We previously reported on the benefits of a DVD-delivered physical activity program (FlexToBa™) in older adults. This is a secondary analysis of the intervention effects among cancer survivors in the original sample.

Methods

Low active, older adults who self-reported a history of cancer (N = 46; M time since diagnosis = 10.7 ± 9.4 years) participated in a 6-month, home-based physical activity intervention. Participants were randomized to either the DVD-delivered physical activity program focused on flexibility, toning, and balance (FlexToBa™; n = 22) or an attentional control condition (n = 24). Physical function was assessed by the Short Physical Performance Battery (SPPB) at baseline, end of intervention, and at 12 and 24 months after baseline.

Results

Repeated measures linear mixed models indicated a significant group*time interaction for the SPPB total score (β = − 1.14, p = 0.048), driven by improved function from baseline to six months in the FlexToBa™ group. The intervention group also had improved balance (β = − 0.56, p = 0.041) compared with controls. Similar trends emerged for the SPPB total score during follow-up; the group*time interaction from 0 to 12 months approached significance (β = − 0.97, p = 0.089) and was significant from 0 to 24 months (β = − 1.84, p = 0.012). No significant interactions emerged for other outcomes (ps > 0.11).

Conclusions

A DVD-delivered physical activity intervention designed for cancer-free older adults was capable of eliciting and maintaining clinically meaningful functional improvements in a subgroup of cancer survivors, with similar effects to the original full sample. These findings inform the dissemination of evidence-based physical activity programs during survivorship.

Trial registration

ClinicalTrials.govNCT01030419. Registered 11 December 2009

Supplementary Information

The online version contains supplementary material available at 10.1186/s12885-021-08608-8.

White matter plasticity in healthy older adults: The effects of aerobic exercise

White matter deterioration is associated with cognitive impairment in healthy aging and Alzheimer's disease. It is critical to identify interventions that can slow down white matter deterioration. So far, clinical trials have failed to demonstrate the benefits of aerobic exercise on the adult white matter using diffusion Magnetic Resonance Imaging. Here, we report the effects of a 6-month aerobic walking and dance interventions (clinical trial NCT01472744) on white matter integrity in healthy older adults (n = 180, 60-79 years) measured by changes in the ratio of calibrated T1- to T2-weighted images (T1w/T2w). Specifically, the aerobic walking and social dance interventions resulted in positive changes in the T1w/T2w signal in late-myelinating regions, as compared to widespread decreases in the T1w/T2w signal in the active control. Notably, in the aerobic walking group, positive change in the T1w/T2w signal correlated with improved episodic memory performance. Lastly, intervention-induced increases in cardiorespiratory fitness did not correlate with change in the T1w/T2w signal. Together, our findings suggest that white matter regions that are vulnerable to aging retain some degree of plasticity that can be induced by aerobic exercise training. In addition, we provided evidence that the T1w/T2w signal may be a useful and broadly accessible measure for studying short-term within-person plasticity and deterioration in the adult human white matter.

The Daily Activity Study of Health (DASH): A pilot randomized controlled trial to enhance physical activity in sedentary older adults

Sedentary behavior increases the risk for multiple chronic diseases, early mortality, and accelerated cognitive decline in older adults. Interventions to reduce sedentary behavior among older adults are needed to improve health outcomes and reduce the burden on healthcare systems. We designed a randomized controlled trial that uses a self-affirmation manipulation and gain-framed health messaging to effectively reduce sedentary behavior in older adults. This message-based intervention lasts 6 weeks, recruiting 80 healthy but sedentary older adults from the community, between the ages of 60 and 95 years. Participants are randomly assigned to one of two groups: 1) an intervention group, which receives self-affirmation followed by gain-framed health messages daily or 2) a control group, which receives daily loss-framed health messages only. Objective physical activity engagement is measured by accelerometers. Accelerometers are deployed a week before, during, and the last week of intervention to examine potential changes in sedentary time and physical activity engagement. Participants undertake structural and functional (resting and task-based) MRI scans, neuropsychological tests, computerized behavioral measures, and neurobehavioral inventories at baseline and after the intervention. A 3-month follow-up assesses the long-term maintenance of any engendered behaviors from the intervention period. This study will assess the effectiveness of a novel behavioral intervention at reducing sedentarism in older adults and examine the neurobehavioral mechanisms underlying any such changes.

Enriching activities during childhood are associated with variations in functional connectivity patterns later in life

Enriching early life experiences (e.g., sport, art, music, volunteering, language learning) during a critical period of brain development may promote structural and functional brain changes that are still present decades later (>60 years). We assessed whether a greater variety of enriching early life activities (EELA) before age 13 years were associated with individual differences in cortical and subcortical (hippocampus and amygdala) structure and function later in life (older adults aged 60-80 years). Results indicated no association between EELA and amygdala and hippocampus volumes, but higher functional connectivity between the amygdala and the insula was associated with more variety of EELA. EELA was not associated with cortical thickness controlling for sex, but sex-specific associations with the right pars opercularis were found. EELA was further associated with variations in functional connectivity patterns of the orbitofrontal cortex, driven by connecitivty to regions within the visual, somatosensory and limbic networks. Early life enriching activities appear to contribute to potential mechanisms of cognitive reserve (functional processes) more so than brain reserve (structure) later in life.

Estimating the financial costs associated with a phase III, multi-site exercise intervention trial: Investigating Gains in Neurocognition in an Intervention Trial of Exercise (IGNITE)

INTRODUCTION

Supervised exercise interventions are expensive and time intensive. However, there are financial costs to consider in addition to the intervention itself, namely: advertising and recruitment, outcome assessments, and other trial-related costs.

OBJECTIVES

In this analysis, we examine the financial costs associated with the administration of Investigating Gains in Neurocognition in an Intervention Trial of Exercise (IGNITE) to quantify the costs associated with large exercise intervention trials and to provide future investigators with financial estimates if they wish to pursue studies of a similar design.

METHODS

Cost per randomized participant were calculated in four areas: (1) advertising and recruitment, (2) outcome assessments, (3) delivery of the intervention, and (4) other trial-related expenses. Overall trial costs associated with data analysis, faculty salaries, and indirect costs were estimated as well.

RESULTS

The total cost per randomized participant was estimated to be $16,494. Outcome assessments accounted for the highest proportion of per-participant (75%) and total trial (38%) costs. Neuroimaging assessments (MRI & PET) cost $8247 per randomized participant, accounting for two-thirds (67%) of outcome assessment costs and half (50%) of per-participant costs.

CONCLUSION

Large clinical trials of exercise are expensive (~$21 million), particularly when administering several visits to assess study aims. Outcome assessments, specifically those involving neuroimaging, accounted for a significant proportion of total costs in this analysis. Future investigators must budget accordingly if they wish to conduct a comprehensive, multi-site exercise intervention trial that examines numerous physiological and psychological outcomes.

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

Background

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

Methods

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

Results

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

Conclusion

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

Can Light Physical Activity Improve Cognition Among Older Adults? A Scoping Review

Although the physical and cognitive benefits of moderate-vigorous intensity physical activity (MVPA) for older adults is well documented, this population often faces age-related functional and physical limitations impeding recommended MVPA participation. Recently, there has been a surge of interest in the independent health benefits of light-intensity physical activity (LPA) and its association with morbidity and mortality risk. LPA is the most common form of activity among older adults and its potential to combat cognitive aging needs to be investigated. The purpose of this scoping review was to catalog existing evidence on the association between device-based or technologically measured LPA and cognition among healthy older adults, identify trends in the literature, and pinpoint future areas of research. Six electronic databases were searched between January and August 2020. Eighteen published studies met the inclusion criteria: one acute exercise study, two randomized control trials (RCTs), twelve cross-sectional studies, and three longitudinal studies. Overall, n=9 studies (n=1 RCT, n=7 cross-sectional, and n=1 longitudinal) reported a significant, positive relationship between LPA and one or more cognitive outcomes including memory, attention, executive function and global cognition (MMSE/MOCA). These heterogeneous findings can largely be attributed to the diverse study designs, inconsistent definitions of LPA and numerous assessments used to test the cognitive domains. Collectively, these findings suggest LPA may be a potential lifestyle intervention to improve cognition among healthy older adults. However, the inconsistent approaches used among these studies suggests a more concerted, unified scientific approach and rigorous methodology are needed to further understand the LPA-cognition relationship.

The IGNITE trial: Participant recruitment lessons prior to SARS-CoV-2

Full and diverse participant enrollment is critical to the success and generalizability of all large-scale Phase III trials. Recruitment of sufficient participants is among the most significant challenges for many studies. The novel SARS-CoV-2 coronavirus pandemic has further changed and challenged the landscape for clinical trial execution, including screening and randomization. The Investigating Gains in Neurocognition in an Intervention Trial of Exercise (IGNITE) study has been designed as the most comprehensive test of aerobic exercise effects on cognition and brain health. Here we assess recruitment into IGNITE prior to the increased infection rates in the United States, and examine new challenges and opportunities for recruitment with a goal of informing the remaining required recruitment as infection containment procedures are lifted. The results may assist the design and implementation of recruitment for future exercise studies, and outline opportunities for study design that are flexible in the face of emerging threats.

A comparison of total and domain-specific sedentary time in breast cancer survivors and age-matched healthy controls

Breast cancer survivors (BCS) engage in more sedentary behavior (SED) than those without cancer. However, the context in which SED is accrued is unknown. The purpose of this study is to examine differences in total and domain-specific SED of BCS and healthy controls. 20 BCS and 20 age-matched, healthy controls wore ActiGraph GT3X + accelerometers to measure SED and activity. Participants self-reported SED for transportation, occupational, screen time and leisure purposes. Multiple linear regressions were used to estimate differences in SED between BCS and controls. BCS spent significantly more time watching TV (152.4 vs. 60.3; p < 0.01) and less time in total SED (490.8 vs. 587.4; p = 0.046) and other leisure activities (57.6 vs. 106.9; p < 0.01) than healthy controls. BCS engage in more TV watching and less time in other leisure activities than controls, thus interventions should focus on reducing TV time. Understanding facilitators of TV viewing is needed to determine specific intervention targets.

Sensor-measured sedentariness and physical activity are differentially related to fluid and crystallized abilities in aging

Aerobic exercise and physical activity (PA) are known to benefit cognition in adulthood. However, a typical older adult spends most of the day sedentary or in light PA, behaviors that are typically poorly captured by questionnaires. To better understand the associations between time spent in different intensities of lifestyle PA and cognition, we measured average time spent daily in sedentariness, light, and moderate to vigorous PA using hip-worn sensors (ActiGraph accelerometers). We studied baseline data from 228 cognitively normal adults (Age 60-80) who took part in a clinical trial (clinical study identifier: NCT01472744). Fluid (processing speed, memory, and reasoning) and crystallized abilities (vocabulary knowledge) were assessed with the Virginia Cognitive Aging Battery. Adjusting for age, sex, and several modifiable socioeconomic, physical and functional health factors, time spent daily in moderate to vigorous PA was positively related with fluid abilities (perceptual speed and reasoning). Furthermore, we found that those spending more time sedentary performed better on vocabulary knowledge and reasoning tasks. In contrast, time spent in light PA was not related to either fluid or crystallized abilities. Our results add to the previous literature by providing the first sensor-based evidence that crystallized and fluid abilities in older age may be associated with engagement in different intensities of daily activity. Moreover, our findings suggest that the behavior of moderate to vigorous PA is at least as important in relation to cognition as the desirable long-term physiological effects of higher intensity PA and exercise. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Occupational Physical Stress Is Negatively Associated With Hippocampal Volume and Memory in Older Adults

Our jobs can provide intellectually and socially enriched environments but also be the source of major psychological and physical stressors. As the average full-time worker spends >8 h at work per weekday and remains in the workforce for about 40 years, occupational experiences must be important factors in cognitive and brain aging. Therefore, we studied whether occupational complexity and stress are associated with hippocampal volume and cognitive ability in 99 cognitively normal older adults. We estimated occupational complexity, physical stress, and psychological stress using the Work Design Questionnaire (Morgeson and Humphrey, 2006), Quantitative Workload Inventory and Interpersonal Conflict at Work Scale (Spector and Jex, 1998). We found that physical stress, comprising physical demands and work conditions, was associated with smaller hippocampal volume and poorer memory performance. These associations were independent of age, gender, brain size, socioeconomic factors (education, income, and job title), duration of the job, employment status, leisure physical activity and general stress. This suggests that physical demands at work and leisure physical activity may have largely independent and opposite effects on brain and cognitive health. Our findings highlight the importance of considering midlife occupational experiences, such as work physical stress, in understanding individual trajectories of cognitive and brain aging.

Dose-Response Effects of Acute Aerobic Exercise Duration on Cognitive Function in Patients With Breast Cancer: A Randomized Crossover Trial

OBJECTIVE

To examine the differential effects of acute exercise duration on domains of executive function and processing speed in patients with breast cancer.

METHODS

Participants (N = 48, M age = 56.02 ± 10.99) completed two sessions in counterbalanced order: moderate-intensity treadmill walking and sitting. Participants were also randomized to one of three duration conditions: 10 (n = 15), 20 (n = 16), or 30 (n = 17) min, reflecting the length of time spent walking and sitting. Immediately before and after each session, women completed a battery of cognitive tasks (e.g., inhibition, cognitive flexibility, spatial working memory, and processing speed).

RESULTS

Within- and between-subjects repeated-measures analyses of variance revealed time by condition interactions on both processing speed (p = 0.02) and spatial working memory (ps < 0.07), such that women demonstrated improved cognitive functioning regardless of the time spent walking. There were also several moderately sized three-way (e.g., time by condition by duration) interactions driven by declines in cognitive functioning after sitting on cognitive flexibility in the 10 (d = -0.96) and 30-min (d = -0.52) groups and inhibition in the 20-min group (d = 0.75). On the processing speed task, women performed significantly faster after walking compared with after sitting in the 20-min group (d = -0.24).

CONCLUSIONS

For select cognitive domains, walking anywhere from 10 to 30 min is associated with significant benefits. Our findings suggest the need for further research into the mechanisms and dose-response relationships between acute exercise and cognition as well as how such acute bouts may be accumulated for larger, lasting cognitive benefits after breast cancer.

CLINICAL TRIAL REGISTRATION

www.ClinicalTrials.gov, identifier NCT04255225.

Influence of sitting behaviors on sleep disturbance and memory impairment in breast cancer survivors

Background

The purpose was to prospectively examine the effects of sedentary behaviors on subjective memory impairment in breast cancer survivors (BCS) and the extent to which sleep disturbances mediated this pathway.

Methods

BCS (N = 380; M_age = 57.38 ± 9.25 years) completed questionnaires assessing demographics, health history, sitting behaviors, sleep disturbance, subjective memory impairment, and moderate‐to‐vigorous physical activity (MVPA) at baseline and 6‐month follow‐up. A subsample (N = 300) wore an accelerometer to objectively estimate sedentary time and MVPA. Structural equation modeling was used to test direct and indirect effects of self‐reported and objectively estimated sedentary behaviors on memory impairment (through sleep disturbance) across time. Models were adjusted for demographic, clinical, and MVPA covariates.

Results

At baseline, more total daily sitting (γ = 0.23), occupational sitting (γ = 0.11), television viewing (γ = 0.15), and computer use (γ = 0.22) were associated with greater sleep disturbance, which was associated with greater memory impairment (γ = −0.22). Indirect effects of self‐reported sitting on memory were significant. At follow‐up, increased total daily sitting (γ = 0.08) and computer use (γ = 0.14) predicted increased sleep disturbance, which predicted increased memory impairment (γ = −0.09). The indirect path from increased computer use to memory impairment was significant (β = −0.01). In the accelerometer subsample, greater daily sedentary time at baseline was associated with less sleep disturbance (γ = −0.14) and memory impairment (indirect effect: β = 0.03).

Conclusions

Findings provide early evidence that sedentary contexts may differentially influence sleep disturbance and memory impairment in BCS. Computer use and television viewing may pose the strongest risks to cognitive health. Disparate findings between objective and subjective sedentary measures warrant further research.

Physical Activity, Sleep and Quality of Life in Older Adults: Influence of Physical, Mental and Social Well-being

Introduction: Physical activity and sleep quality have been consistently associated with quality of life (QOL) in a number of clinical and non-clinical populations. However, mechanisms underlying this relationship are not well understood. The purpose of this study was to longitudinally test a model examining how changes in physical activity and sleep quality, predict physical, mental and social well-being and global QoL across a 6-month exercise trial in a sample of healthy older adults. Methods: Participants (N = 247, mean age 65.4 ± 4.6) wore an accelerometer to assess objective levels of physical activity and completed measures of sleep, physical and mental well-being, social well-being and QOL at baseline and following a 6-month physical activity intervention. Relationships among model constructs were examined over time using panel analysis within a covariance-modeling framework. Results: The hypothesized model provided a good model-data fit (χ² = 58.77, df = 41, p = .036); CFI = 0.98; SRMR = 0.05; RMSEA = 0.04). At both time-points, physical activity and sleep quality were significantly correlated. Sleep quality indirectly influenced QOL via physical, mental and social well-being (QOL R² = .47, p < .001). These relationships were also supported across time at month 6 (QOL R² = .50, p < .001). Neither physical activity nor sleep quality directly influenced QOL. Conclusion: Our results support a novel sleep and QOL model that may inform the design of health interventions to promote sleep quality, and thereby influencing QOL by targeting physical activity and modifiable mediators of physical, mental and social health. Our findings may have significant implications for older adults as well as clinical populations that report compromised sleep, impaired health related and global QOL.

Investigating Gains in Neurocognition in an Intervention Trial of Exercise (IGNITE): Protocol

Despite the ubiquity of normal age-related cognitive decline there is an absence of effective approaches for improving neurocognitive health. Fortunately, moderate intensity exercise is a promising method for improving brain and cognitive health in late life, but its effectiveness remains a matter of skepticism and debate because of the absence of large, comprehensive, Phase III clinical trials. Here we describe the protocol for such a randomized clinical trial called IGNITE (Investigating Gains in Neurocognition in an Intervention Trial of Exercise), a study capable of more definitively addressing whether exercise influences cognitive and brain health in cognitively normal older adults. We are conducting a 12-month, multi-site, randomized dose-response exercise trial in 639 cognitively normal adults between 65 and 80 years of age. Participants are randomized to (1) a moderate intensity aerobic exercise condition of 150 min/week (N = 213), (2) a moderate intensity aerobic exercise condition at 225 min/week (N = 213), or (3) a light intensity stretching-and-toning control condition for 150 min/week (N = 213). Participants are engaging in 3 days/week of supervised exercise and two more days per week of unsupervised exercise for 12 months. A comprehensive cognitive battery, blood biomarkers and battery of psychosocial questionnaires is assessed at baseline, 6 and 12-months. In addition, brain magnetic resonance imaging, physiological biomarkers, cardiorespiratory fitness, physical function, and positron emission tomography of amyloid deposition are assessed at baseline and at the 12-month follow-up. The results from this trial could transform scientific-based policy and health care recommendations for approaches to improve cognitive function in cognitively normal older adults.

Estimation of physical activity intensity cut-points using accelerometry in breast cancer survivors and age-matched controls

OBJECTIVE

To examine the association between accelerometer activity counts and energy expenditure during walking in breast cancer survivors (BCS) compared with age-matched healthy controls, and differences in moderate-to-vigorous physical activity (MVPA) cut-points.

METHODS

Using a case-control design, 19 BCS and 19 age-matched women completed 6 min of resting energy expenditure and 6-min periods of treadmill walking in Midwestern United States. Accelerometers and an open-circuit spirometry system were used to measure activity counts and energy expenditure (VO₂ ). A mixed-factor analysis of variance was conducted on activity counts and VO₂ . Independent samples t tests compared the magnitude of associations between groups.

RESULTS

There were group by speed interactions on energy expenditure (p < 0.001) and counts (p < 0.001). The linear association did not differ between BCS and controls for the R² (p = 0.62) nor the slope (p = 0.43), but there was a difference in the intercept (p = 0.01). This resulted in different MVPA cut-points between groups: 1,439 ± 761 counts·min^-1 in BCS and 1,937 ± 639 counts·min^-1 in controls.

CONCLUSION

The findings support the use of different cut-points to quantify time spent in MVPA for BCS. Application of these cut-points is warranted to accurately assess physical activity (PA) patterns for better prescription and health outcomes in PA programmes for BCS.

Effects of reallocating sedentary time with physical activity on quality of life indicators in breast cancer survivors

OBJECTIVES

Physical activity is associated with better quality of life (QOL) among breast cancer survivors. However, it is unknown the extent to which time spent sedentary or replacing this time with active behaviors may affect QOL. Our aim was to determine the effect of substituting time between sedentary and active behaviors on QOL indicators in breast cancer survivors.

METHODS

An isotemporal substitution approach was used to examine the associations of reallocating time to sedentary and active behaviors measured by accelerometry with Functional Assessment of Cancer Treatment-Breast (FACT-B; total, physical, social, emotional, functional well-being, and breast cancer-specific concerns) and the Hospital Anxiety and Depression Scale (HADS) scores in a pooled analysis of breast cancer survivors (n = 753; M_age  = 56.9 ± 9.5 y) from two observational studies.

RESULTS

Reallocating 30 minutes of sedentary time to 30 minutes of moderate-to-vigorous intensity physical activity (MVPA) was associated with improved FACT-B total (B = 3.0; 95% CI, 0.6-4.5), physical well-being (B = 0.8; 95% CI, 0.33-1.2), and functional well-being (B = 0.6; 95% CI, 0.03-1.2) scores. Reallocating 30 minutes of light activity to 30 minutes of MVPA was associated with improved FACT-B total (B = 2.4; 95% CI, 0.3-6.0) and physical well-being (B = 0.72; 95% CI, 0.27-1.2) scores. There was no significant substitution of time effects on HADS scores.

CONCLUSIONS

Substituting sedentary time with MVPA showed the greatest range of effects across QOL indicators. These results can inform intervention development interventions and more comprehensive activity recommendations for breast cancer survivors.

Acute aerobic exercise effects on cognitive function in breast cancer survivors: a randomized crossover trial

Background

Many breast cancer survivors (BCS) report deficits in cognitive function. Physical activity (PA) has been associated with better processing speed and memory in healthy adults and thus may be a useful method for improving cognition in BCS. The purpose of this study was to examine the effects of an acute bout of PA on processing speed and spatial working memory in a sample of BCS.

Methods

Using a repeated measures, crossover design, BCS [N = 27; M_age (SD) = 49.11(8.05)] completed two sessions in counterbalanced order: 30 min of moderate-intensity treadmill walking and 30 min of seated rest. Women completed cognitive tasks immediately before and after each session.

Results

Within-subjects repeated measures analyses of variance revealed a significant time by session effect for processing speed reaction time [F (1,25) = 5.02, p = .03, η2 = 0.17]. This interaction was driven by significantly reduced reaction time (e.g., faster response) post-exercise and no change post-rest. Further between-subjects analyses indicated a significant time by session by moderate to vigorous physical activity (MVPA) split [F (1,25) = 5.23, p = .03, η2 = 0.17], such that women who engaged in ≥45 min of average daily MVPA reduced their reaction time post-exercise (p = .01) and increased RT post-rest (p = .06). Time by session effects for spatial working memory 3-item accuracy and 4-item reaction time trended towards significance, p = 0.08 and p = 0.10, respectively, again driven by better performance post-exercise.

Conclusions

The moderate effect of acute exercise on domains of memory and processing speed in BCS is encouraging. Cancer-related cognitive impairment remains largely misunderstood; however, the results from the present study offer preliminary evidence for the positive relationship between acute exercise and cognition in BCS.

Trial registration

ClinicalTrials.gov NCT02592070. Registered 30 October 2015. Retroactively registered.