scholarly journals Will We Do If We Can? Habitual Qualitative and Quantitative Physical Activity in Multi-Morbid, Older Persons with Cognitive Impairment

Sensors ◽  
2020 ◽  
Vol 20 (24) ◽  
pp. 7208
Author(s):  
Bastian Abel ◽  
Martin Bongartz ◽  
Tobias Eckert ◽  
Phoebe Ullrich ◽  
Rainer Beurskens ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Older Persons ◽  
Community Dwelling ◽  
Qualitative And Quantitative ◽  
Gait Characteristics ◽  
Gait Quality ◽  
High Incidence ◽  
Health Related ◽  
State Examination

This study aimed to identify determinants of quantitative dimensions of physical activity (PA; duration, frequency, and intensity) in community-dwelling, multi-morbid, older persons with cognitive impairment (CI). In addition, qualitative and quantitative aspects of habitual PA have been described. Quantitative PA and qualitative gait characteristics while walking straight and while walking turns were documented by a validated, sensor-based activity monitor. Univariate and multiple linear regression analyses were performed to delineate associations of quantitative PA dimensions with qualitative characteristics of gait performance and further potential influencing factors (motor capacity measures, demographic, and health-related parameters). In 94 multi-morbid, older adults (82.3 ± 5.9 years) with CI (Mini-Mental State Examination score: 23.3 ± 2.4), analyses of quantitative and qualitative PA documented highly inactive behavior (89.6% inactivity) and a high incidence of gait deficits, respectively. The multiple regression models (adjusted R2 = 0.395–0.679, all p < 0.001) identified specific qualitative gait characteristics as independent determinants for all quantitative PA dimensions, whereas motor capacity was an independent determinant only for the PA dimension duration. Demographic and health-related parameters were not identified as independent determinants. High associations between innovative, qualitative, and established, quantitative PA performances may suggest gait quality as a potential target to increase quantity of PA in multi-morbid, older persons.

Physical activity and cognitive function in older persons

2016 ◽  
Vol 64 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Executive Functions ◽  
Cognitive Aging ◽  
Clinical Studies ◽  
Older Persons ◽  
Positive Effects ◽  
Critical Challenge

Strategies to improve cognitive aging are highly needed. Among those, promotion of exercise and physical activity appears as one of the most attractive and beneficial intervention. Indeed, results from basic and clinical studies suggest that exercise and physical activity have positive effects on cognition in older persons without cognitive impairment, as well as in those with dementia. Despite inconsistent results, aerobic exercise appears to have the strongest potential to enhance cognition. However, even limited periods of walking (45 minutes, three times a week, over a 6-month period) have also been shown to enhance cognition, particularly executive functions. Changing long-term lifestyle habits in these older persons remains a critical challenge and attractive programs susceptible to gain adherence are needed to succeed in achieving improved cognitive aging.

Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Phoebe Ullrich ◽  
Christian Werner ◽  
Martin Bongartz ◽  
Tobias Eckert ◽  
Bastian Abel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older Persons ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Life Space ◽  
Home Based ◽  
Independent Life

Abstract Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17–26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89–13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00–0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

scholarly journals Aerobic or strength training and flexibility activities and mild cognitive impairment: CETI cohort

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Dupré ◽  
B Bongue ◽  
L Fruteau de Laclos ◽  
J Blais ◽  
M-J Sirois
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Neurodegenerative Diseases ◽  
Cognitive Impairments ◽  
Cognitive Status ◽  
Physical Activities ◽  
Community Dwelling ◽  
Different Types ◽  
Initiative Program ◽  
The Impact

Abstract Background Previous studies have been notably criticized for not studying the different types of physical activity. The objective of this work was to examine the association between types of physical activity and cognitive decline in older people. Methods This is a sub-group analysis from the CETI cohort, a multicenter prospective study conducted by the Canadian Emergency Team Initiative Program (CETIE), between 2011 and 2016. Participants were community-dwelling seniors aged ≥ 65 years, consult emergency services for minor injuries with follow-up at 3 and 6 months. Physical activity was assessed by the RAPA (Rapid assessment of Physical activity), which describes the level of aerobic activities and the overall level of muscle strength and flexibility activities. The cognitive status was assessed with the Montreal Cognitive Assessment (MoCA) and the Telephone Interview for Cognitive Status (TICS), using their current cut-offs (MoCA &lt;26/30 and TICS &lt; = 35/50) for mild cognitive impairments (MCI). Logistic regression, COX models and splines were used to examine the association between the type of physical activities and the onset of cognitive impairment. Results At inclusion, 281 individuals were free of MCI, or 43.8% of the total sample, with an average age of 73 years. During follow-ups, MCI appeared in 31.7% of participants initially free of it. The risk of MCI was lower with higher muscular strength & flexibility physical activities (HR = 0.84 [0.70-0.99]), while the relationship with aerobic physical activities was not significant. Conclusions These results showed a potential link between strength & flexibility activities and cognitive impairments, but not with aerobic physical activities. Further analyses are needed to examine whether these relationships persist as a function of the adjustment variables, or statistical methods. This study contributes to the debate on the evaluation of physical activity in the elderly, and its link with neurodegenerative diseases. Key messages This study analyzed the link between types of physical activity and mild cognitive disorders. The aim is to put in place preventive policies of aging, specially in neurodegenerative diseases. The work allowed us to see the effect of the different types of physical activity and the impact of the statistical method on the results.

scholarly journals The Relationship between Chronotype, Physical Activity and the Estimated Risk of Dementia in Community-Dwelling Older Adults

2020 ◽  
Vol 17 (10) ◽  
pp. 3701
Author(s):  
Ngeemasara Thapa ◽  
Boram Kim ◽  
Ja-Gyeong Yang ◽  
Hye-Jin Park ◽  
Minwoo Jang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Community Dwelling ◽  
Daily Physical Activity ◽  
Estimated Risk ◽  
Community Dwelling Older Adults ◽  
The Relationship ◽  
State Examination

Our study examined the association between chronotype, daily physical activity, and the estimated risk of dementia in 170 community-dwelling older adults. Chronotype was assessed with the Horne–Östberg Morningness–Eveningness Questionnaire (MEQ). Daily physical activity (of over 3 METs) was measured with a tri-axial accelerometer. The Korean version of the Mini-Mental State Examination (K-MMSE) was used to measure the estimated risk of dementia. The evening chronotype, low daily physical activity, and dementia were positively associated with each other. The participants with low physical activity alongside evening preference had 3.05 to 3.67 times higher estimated risk of developing dementia, and participants with low physical activity and morning preference had 1.95 to 2.26 times higher estimated risk than those with high physical activity and morning preference. Our study design does not infer causation. Nevertheless, our findings suggest that chronotype and daily physical activity are predictors of the risk of having dementia in older adults aged 70 years and above.

scholarly journals Exploring Cognitively Loaded Physical Activity Compared With Control to Improve Global Cognitive Function in Older Community-Dwelling Adults With Mild Cognitive Impairment: Systematic Review With Meta-Analysis

2019 ◽  
pp. 155982761987688
Author(s):  
Kristina Zawaly ◽  
Richard Fortier ◽  
Stephen Buetow ◽  
Lynette Tippett ◽  
Ngaire Kerse
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Controlled Trials ◽  
Global Cognitive Function ◽  
Global Cognition

Objective. A systematic review with a meta-analysis explored effects of cognitively loaded physical activity interventions on global cognition in community-dwelling older adults (≥65 years of age) experiencing mild cognitive impairment (MCI), compared to any control. Methods. A literature search was conducted in 4 databases (MEDLINE [OvidSP], PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials [Wiley]) from inception until January 30, 2018. The meta-analysis was conducted with Review Manager 5.3. Results. Six randomized controlled trials (RCTs) with 547 participants were identified. The interventions ranged from 4 to 52 weeks. Baseline and initial follow-up assessments were used. The primary pooled analysis of all RCTs demonstrated a nonsignificant trivial effect (standardized mean difference [SMD] 0.07, 95% confidence interval [CI] −0.44 to 0.58) favoring the intervention. In pooled subanalysis of 4 RCTs (n = 405) using the same global cognition measure (Mini-Mental State Examination) and duration of intervention >12 weeks, the intervention group achieved a small but significant improvement for global cognition (SMD 0.45, 95% CI 0.14 to 0.75). Conclusion. When all the RCTs were pooled, the effect of cognitively loaded physical activity intervention on global cognitive function in older adults with MCI remained unclear. The subgroup analysis provides translation evidence for future RCT study designs.

scholarly journals Proximity to Facilities and Its Association with the Health-Related Habits of Functionally Independent Older Adults

2020 ◽  
Vol 17 (22) ◽  
pp. 8677
Author(s):  
Mónica Machón ◽  
Kalliopi Vrotsou ◽  
Isabel Larrañaga ◽  
Itziar Vergara
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Social Life ◽  
Basque Country ◽  
Community Dwelling ◽  
Green Spaces ◽  
Walking Distance ◽  
Residential Areas ◽  
Cross Sectional ◽  
Health Related

The aim was to examine how proximity to facilities, as a component of community determinants, is associated with the health-related habits of functionally independent community-dwelling older adults. This was a cross-sectional study. Data were collected by face-to-face interviews. Participants were >65 years old, living in 15 municipalities of Gipuzkoa (Basque Country, Spain). Proximity to park-green spaces, cultural-sport centers, market-food stores, retirement associations, religious centers, primary care centers and hospitals was explored. Sociodemographic variables and health-related habits (diet, physical activity and self-perceived social life) were collected. Logistic regression models were performed. The sample comprised of 634 individuals (55% women; mean age: 74.8, SD 6.7 years). Older age (odds ratio-OR: 0.94, 95% CI: 0.91–0.97) was associated with lower physical activity, while being male (OR: 1.71, 95% CI: 1.08–2.68) and proximity to park-green spaces (OR: 1.64, 95% CI: 1.03–2.61) were related to more physical activity. Individuals with good self-perceived health (OR: 3.50, 95% CI: 1.82–6.74) and religious centers within walking distance (OR: 2.66, 95% CI: 1.40–5.04) had higher odds of a satisfactory social life. Encouraging the creation of park-green spaces and leisure centers near residential areas can assist in promoting physical activity and improving the social life of older adults.

Prestroke Physical Activity and Poststroke Cognitive Performance

2020 ◽  
Vol 49 (6) ◽  
pp. 632-638
Author(s):  
Andreas Gammelgaard Damsbo ◽  
Janne Kaergaard Mortensen ◽  
Kristian Lundsgaard Kraglund ◽  
Søren Paaske Johnsen ◽  
Grethe Andersen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Functional Outcome ◽  
Cognitive Performance ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
Protective Measure ◽  
Multivariable Analyses ◽  
State Examination ◽  
Physical Activity Scale

<b><i>Introduction:</i></b> Physical activity (PA) is associated with a lower risk of stroke and stroke mortality as well as a favorable stroke outcome. PA may also prevent general cognitive decline. Poststroke cognitive impairment is both common and disabling, and focusing on all possible preventive measures is important. Studies on the effect of PA on poststroke cognitive performance are sparse, however. We therefore aimed to examine the association between prestroke PA and poststroke cognitive performance. <b><i>Methods:</i></b> We studied the correlation between prestroke PA and poststroke cognitive performance in a prespecified analysis in The Efficacy of Citalopram Treatment in Acute Ischemic Stroke (TALOS) trial. We used the Physical Activity Scale for the Elderly (PASE) to collect information on PA during the 7-day period before stroke. PA was quantified, and patients were stratified into quartiles based on their PASE score. Cognitive performance was measured using the Symbol Digit Modalities Test (SDMT) at 1 and 6 months and the Mini-Mental State Examination (MMSE) at 6 months. The functional outcome was assessed using the modified Rankin Scale (mRS). <b><i>Results:</i></b> In total, 625 of 642 patients (97%) completed the PASE questionnaire. The median age was 69 (interquartile range [IQR]: 60–77), and the median PASE score was 137 (82–205). Higher prestroke PASE quartiles (2nd, 3rd, and 4th, each compared to the 1st) were independently associated with a higher SDMT score at 1 month in the both the univariable and multivariable analyses (2nd: 3.99 points, 95% confidence interval [CI]: 1.01–6.97; 3rd: 3.6, CI: 0.6–6.61; 4th: 4.1, CI: 0.95–7.24). This association remained at 6 months. PA was not statistically associated with the MMSE score or mRS. <b><i>Conclusion:</i></b> Higher prestroke PA was associated with a better cognitive performance as measured by the SDMT at 1 and 6 months poststroke. We found no significant association between prestroke PA and functional outcome. Our results are encouraging and support further investigations of PA as a protective measure against poststroke cognitive impairment.

Reliable Individual Change Scores on the 3MS in Older Persons With Dementia: Results From the Canadian Study of Health and Aging

2001 ◽  
Vol 13 (S1) ◽  
pp. 71-78 ◽  
Author(s):  
José Andrés Correa ◽  
Anne Perrault ◽  
Christina Wolfson
Keyword(s):  
Older Persons ◽  
Mini Mental State Examination ◽  
Intraclass Correlation ◽  
Time Frame ◽  
Community Dwelling ◽  
Individual Change ◽  
Change Scores ◽  
Diagnosis Of Dementia ◽  
Severity Of Dementia ◽  
State Examination

We examined the degree of interrater agreement on the Modified Mini-Mental State Examination (3MS), administered both in the home and at the clinical examination, to determine the boundaries of reliable individual changes for 257 community-dwelling older persons who received a diagnosis of dementia at CSHA-1. Individual score differences were approximately normally distributed (mean of differences 0.2; SD 8.0; 95% confidence interval -16 to 16). The intraclass correlation coefficient was 0.85. Except for the language of testing, there was no relationship between score differences and the determinants investigated (i.e., age, education, type and severity of dementia). This study provides evidence that, in a time frame compatible with no change in cognition, the discrepancy between repeat 3MS scores can be as large as ± 16. These limits represent the range of variability consistent with no change and should be considered when interpreting individual change scores.

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