scholarly journals Association between physical performance and cognitive function in older adults across multiple studies: A pooled analysis study

2020 ◽  
Author(s):  
Elizabeth P Handing ◽  
Xiaoyan Iris Leng ◽  
Stephen B Kritchevsky ◽  
Suzanne Craft

Abstract Background and Objectives While several studies have examined the association between cognitive and physical function, the consistency of these associations across functional contexts is unclear. The consistency of association between cognitive and physical function performance was examined at baseline across 17 clinical studies with diverse and heterogeneous conditions such as overweight/obese, sedentary, at risk for a mobility disability, osteoarthritis, low vitamin D, or had signs of cognitive impairment. Research Design and Methods Data are from 1,388 adults 50 years and older who completed a cognitive and physical function assessment as part of a research study at the Wake Forest Alzheimer’s Disease Research Center or the Wake Forest Older Americans Independence Center. Linear regression models were used to relate cognitive measures [Mini Mental Status Exam (MMSE), Montreal Cognitive Assessment (MoCA), and the Digit Symbol Substitution Task (DSST)], and physical measures [the Short Physical Performance Battery (SPPB) and hand grip strength] for the whole sample and treat each study as a fixed effect. All models controlled for age, sex, race, and body mass index (BMI). Results Overall, there was a significant association between higher scores on the MMSE (per standard deviation) and better physical function performance (SPPB score b= 0.24, p <0.001) and its components (gait speed, chair rise, and standing balance; p’s <0.05). Higher scores on the MoCA produced similar results (SPPB score b= 0.31, p= <0.001) and higher scores on the DSST were also significantly associated with a better SPPB score (b= 0.75, p <0.001). The relationship between DSST and physical function performance demonstrated a stronger magnitude of association compared to the MMSE or MoCA. Discussion and Implications Older adults with heterogenous health conditions showed a consistent pattern between better cognitive function and better physical function performance with the strongest association among DSST scores.

2021 ◽  
Vol 12 ◽  
pp. 204209862110303
Author(s):  
Elizabeth Manias ◽  
Md Zunayed Kabir ◽  
Andrea B. Maier

Background and aims: Inappropriate medication prescription is highly prevalent in older adults and is associated with adverse health outcomes. The aim of this study was to examine the associations between potentially inappropriate medications (PIMS) and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: A systematic search was completed using the following databases: MEDLINE, CINAHL, PsycINFO, EMBASE and COCHRANE. Results were extracted from the included studies. Results: In total, 55 studies reported on 2,767,594 participants with a mean age of 77.1 years (63.5% women). Study designs comprised 26 retrospective cohort studies, 21 prospective cohort studies and 8 cross-sectional studies. Inappropriate medications in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), impaired activities of daily living (ADL; 8 out of 10 studies) and impaired instrumental ADL (IADL) score (4 out of 6 studies). Five out of seven studies also showed that PIMs were associated with poorer physical performance comprising the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many medication classes were implicated as PIMs in falls, fractures and impairment in physical performance including antipsychotic, sedative, anti-anxiety, anticholinergic, antidiabetic, opioid and antihypertensive medications. For patients not receiving musculoskeletal medications, such as calcium, vitamin D and bisphosphonates, older adults were found to be at risk of a hospital admission for a fall or fracture. Conclusion: Inappropriate medication prescriptions are associated with impaired physical function across longitudinal and cross-sectional studies in older adults situated in diverse settings. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions. Plain language summary Inappropriate medications and physical function Background and aims: The use of inappropriate medications is very common in older adults and is associated with harmful health problems. The aim was to examine associations between potentially inappropriate medications and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: Library databases were examined for possible studies to include and a systematic search was completed. Relevant information was obtained from the included studies. Results: In total, 55 studies reported on 2,767,594 participants who were an average age of 77.1 years and about 6 out of 10 were women. A variety of different study designs were used. Inappropriate medication prescriptions in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), problems with activities of daily living (ADL), such as eating, bathing, dressing, grooming, walking and toileting (8 out of 10 studies) and problems with instrumental ADL such as managing medications, house cleaning and shopping (4 out of 6 studies). Five out of seven studies also showed that inappropriate medications were associated with poorer physical performance involving the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many types of medication classes were shown to be associated with a risk of falls, fractures and problems with physical performance. Omitted medications were also associated with falls and fractures. Conclusion: Inappropriate medication prescriptions are associated with problems relating to physical function. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions.


Author(s):  
Mikel L. Sáez de Asteasu ◽  
Nicolás Martínez-Velilla ◽  
Fabricio Zambom-Ferraresi ◽  
Robinson Ramírez-Vélez ◽  
Antonio García-Hermoso ◽  
...  

2010 ◽  
Vol 59 (3) ◽  
pp. 313-322 ◽  
Author(s):  
JI-YEONG YOON ◽  
TOMOHIRO OKURA ◽  
KENJI TSUNODA ◽  
TAISHI TSUJI ◽  
YOSHIE KOHDA ◽  
...  

2019 ◽  
Vol 19 (4) ◽  
pp. 789-796
Author(s):  
Stina Lilje ◽  
Johan Sanmartin Berglund ◽  
Peter Anderberg ◽  
Lina Palmlöf ◽  
Eva Skillgate

Abstract Background and aims There are associations between pain, comorbidity and risk of falling, and falling increases the risk of mortality in older persons, but few studies have investigated the development of pain as a result of impaired physical function. The aim of this study was to examine possible associations between weak physical performance and the development of musculoskeletal pain that interferes with normal life in a sample of older adults. The sample derived from a national, longitudinal multicenter study; the Swedish National Study on Ageing and Care; SNAC-B. Methods The participants (n = 490) were between 60 and 78 years at the baseline examinations. Three variables were chosen for the exposure physical function, from the baseline examinations; One Leg Stand, Grip strength and Sit-to-Stand. The outcome musculoskeletal pain that interferes with normal life was measured using EQ5D and SF-12 6 years later, and logistic regression was used to investigate possible associations between the exposures and the outcome. Results Maximum grip strength (Grippit) was inversely associated with musculoskeletal pain that interferes with normal life (OR 2.31; 95% CI 1.15–4.61), and One-Leg Stand and Sit-to-Stand were not associated with the development of pain (OR 1.30; 95% CI 0.64–2.64) and (OR 0.91; 95% CI 0.45–1.86), respectively. Conclusions Weak grip strength was inversely associated with the development of musculoskeletal pain that interferes with normal life in older adults. Implications Impaired proprioceptive function, strength and mobility in elderly with pain have been found in earlier research. Since pain increases the risk of falling, it is important to investigate if it may develop as a function of an impaired physical function. The results of the present study could be of importance for future prevention programs aiming to protect elderly from falling.


PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0119075 ◽  
Author(s):  
Niousha Bolandzadeh ◽  
Konrad Kording ◽  
Nicole Salowitz ◽  
Jennifer C. Davis ◽  
Liang Hsu ◽  
...  

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 530-531
Author(s):  
Yaqun Yuan ◽  
Zhehui Luo ◽  
Chenxi Li ◽  
Eleanor Simonsick ◽  
Eric Shiroma ◽  
...  

Abstract The present study aims to investigate poor olfaction in relation to physical functioning in community-dwelling older adults and potential sex and race disparities. The analysis included 2511 participants aged 71-82 years (51.7% women and 38.4% blacks) from the Health Aging, and Body Composition (Health ABC) study. Olfaction was tested with the 12-item Brief Smell Identification Test (BSIT). Physical function measures included the Short Physical Performance Battery (SPPB), the Health ABC Physical Performance Battery (HABCPPB), gait speed of 20-meter walk, fast 400-meter walking time, grip strength, and knee extensor strength, repeatedly assessed annually or biennially for a follow-up of seven years. We analyzed each of these physical function measures using mixed models, adjusting for demographics, lifestyle, and comorbidities. For all measures except grip and knee extensor strength, poor olfaction was clearly associated with poorer physical performance at baseline and a faster decline over time. For example, at baseline, the multivariate adjusted SPPB was 8.23 ± 0.09 for participants with poor olfaction and 8.55 ± 0.09 for those with good olfaction (P = 0.02), after seven years of follow-up, the corresponding scores decreased to 6.46 ± 0.12 and 7.36 ± 0.10 respectively (cross-sectional P<0.001, and P for olfaction-by-year interaction < 0.001). For grip and knee extensor strength, similar differences were suggested but didn’t reach statistical significance. The overall results were similar by sex and race. In summary, poor olfaction is clearly associated with faster decline in physical functioning in older adults and future studies should investigate its potential health implications.


Author(s):  
Caterina Trevisan ◽  
Enrico Ripamonti ◽  
Giulia Grande ◽  
Federico Triolo ◽  
Stina Ek ◽  
...  

Abstract Background The impact of falls on cognitive function is unclear. We explored whether injurious falls are associated with cognitive decline in older adults, and evaluated the role of changes in psychological and physical health as mediators of such association. Methods This prospective study involved 2,267 community-dwelling participants in the Swedish National study on Aging and Care in Kungsholmen (≥60 years). Data on injurious falls (i.e., falls requiring medical attention) during each 3-year time interval of follow-up were obtained from national registers. Assessment of cognitive function (Mini-Mental State Examination[MMSE]), depressive mood (Montgomery-Åsberg Depression Rating Scale), and physical performance (walking speed) were carried out every 3 or 6 years over a 12-year follow-up. The association between falls and cognition was estimated through linear mixed effects models, and the mediating role of changes in depressive mood and physical performance was tested using mediation analysis. Results After adjusting for potential confounders, individuals who experienced injurious falls had a greater annual decline in MMSE in the subsequent time interval (β=-1.49, 95%CI:-1.84;-1.13), than those who did not. The association increased with the occurrence of ≥2 falls (β=-2.13, 95%CI:-2.70;-1.56). Worsening of walking speed and depressive mood explained around 26% and 8%, respectively, of the association between falls and cognitive decline. Conclusions Injurious falls are associated with greater cognitive decline, and this association is partly mediated by worsening of physical performance and, in a lesser extent, of depressive mood. These findings suggest that physical deficits and low mood are potential therapeutic targets for mitigating the association between falls and cognitive decline.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Resshaya Murukesu ◽  
Devinder Kaur Ajit Singh ◽  
Suzana Shahar ◽  
Ponnusamy Subramaniam

Abstract Introduction Older adults with frailty and cognitive impairment are more susceptible to falls. The risk factor of falls and faller profiles among older adults in general has been established. However, information regarding potential risk factors and faller patterns among older adults with cognitive frailty is limited. Objective To examine the sociodemographic, cognitive and physical function characteristics of fallers with and without cognitive frailty. Methods A total of 133 community dwelling older adults aged 60 years and above were screened at three older adult activity centres in Kuala Lumpur. Sociodemographic details were obtained via interview. Cognitive Frailty was identified using the Clinical Dementia Rating Scale and Fried Frailty Index. Cognitive function was assessed using the Mini Mental State Examination (MMSE), Digit Span (DS) test and Ray Auditory Verbal Learning Test (RAVLT). The Senior Fitness test was used to asses physical function. Characteristics of falls were documented using a self-administered questionnaire. Data was descriptively analysed; independent T-test was used for continuous variables and chi-square test was used for categorical variables. Results Prevalence of falls was 21.1% (n=28). Within fallers, 42.9% (n=12) were cognitively frail and 57.1% (n=16) were not. Fallers with cognitive frailty were significantly older (mean age = 72.31±5.29) (p<0.001), had lower MMSE scores (p<0.01), lower 2 Minute Step test scores (p<0.001) and lower Lawton Instrumental Activities of Daily Living scores (p<0.05). Descriptively, fallers with cognitive frailty were mostly recurrent fallers (67%), sustained falls outdoors due to ‘slip and fall’ and majority sought medical attention after the fall(s). Conclusion Fallers with cognitive frailty were older and had lower physical and cognitive function as compared to those without. There is a need to further understand the relationship between falls and cognitive frailty in order to provide holistic fall prevention and management strategies. Acknowledgement of grant UKM(DCP-2017-002/2) and Ministry of Higher Education(LRGS/BU/2012/UKM-UKM/K/01).


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S392-S392
Author(s):  
Connie W Bales ◽  
Kathryn N Porter Starr ◽  
Marshall Miller

Abstract Nutritional status is a strong determinant of both body composition and physical function (PF), parameters that are closely interrelated but rarely evaluated in the clinical setting due to cost, access, and lack of agreement on best approaches in older adults. Recent evidence that changes in muscle mass do not closely correspond to changes in muscle function will be reviewed in the context of our studies of higher protein obesity interventions. PF assessments, including indices for older adults (Short Physical Performance Battery and Physical Performance Test), as well as specific tests like gait speed and handgrip strength, will be explained as nutrition outcomes and in relation to body composition from air displacement (BodPod) and dual energy x-ray absorptiometry (DXA). These results, along with new studies of muscle quality, will bring a better understanding of the complexity of responses to nutritional interventions designed to optimize body mass and composition in older adults.


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