Morag E Taylor1,2,3, Sirinun Boripuntakul4, Barbara Toson1, Jacqueline C T Close1,2, Stephen R Lord1, Nicole A Kochan5,6, Perminder S Sachdev5,6,7, Henry Brodaty6,7, Kim Delbaere1. 1. a Falls, Balance and Injury Research Centre, Neuroscience Research Australia , University of New South Wales , Sydney , Australia. 2. b Prince of Wales Clinical School, Medicine , University of New South Wales , Sydney , Australia. 3. c Cognitive Decline Partnership Centre, Sydney Medical School , The University of Sydney , Sydney , Australia. 4. d Department of Physical Therapy , Chiang Mai University , Chiang Mai , Thailand. 5. e Neuropsychiatric Institute , Prince of Wales Hospital , Randwick , New South Wales , Australia. 6. f Centre For Healthy Brain Ageing (CHeBA), School of Psychiatry, Medicine , University of New South Wales , Sydney , Australia. 7. g Dementia Centre for Research Collaboration, School of Psychiatry, Medicine , University of New South Wales , Sydney , Australia.
Abstract
OBJECTIVES: The aim of this study was to investigate physical decline over 1-year in a cohort of older people across the cognitive spectrum. METHODS: Physical function was assessed using the Physiological Profile Assessment (PPA) in 593 participants (cognitively normal [CN]: n = 342, mild cognitive impairment [MCI]: n = 77, dementia: n = 174) at baseline and in 490 participants available for reassessment 1-year later. Neuropsychological performance and physical activity (PA) were assessed at baseline. RESULTS: Median baseline PPA scores for CN, MCI and dementia groups were 0.41 (IQR = -0.09-1.02), 0.66 (IQR = -0.06-1.15) and 2.37 (IQR = 0.93-3.78) respectively. All baseline neuropsychological domains and PA were significantly associated with baseline PPA. There were significant interaction terms (Time × Cognitive Group, Global Cognition, Processing Speed, Executive Function and PA) in the models investigating PPA decline. In multivariate analysis the Time × Executive Function and PA interaction terms were significant, indicating that participants with poorer baseline executive function and reduced PA demonstrated greater physical decline when compared to individuals with better executive function and PA respectively. DISCUSSION: Having MCI or dementia is associated with greater physical decline compared to CN older people. Physical inactivity and executive dysfunction were associated with physical decline in this sample, which included participants with MCI and dementia. Both factors influencing physical decline are potentially amenable to interventions e.g. exercise.
OBJECTIVES: The aim of this study was to investigate physical decline over 1-year in a cohort of older people across the cognitive spectrum. METHODS: Physical function was assessed using the Physiological Profile Assessment (PPA) in 593 participants (cognitively normal [CN]: n = 342, mild cognitive impairment [MCI]: n = 77, dementia: n = 174) at baseline and in 490 participants available for reassessment 1-year later. Neuropsychological performance and physical activity (PA) were assessed at baseline. RESULTS: Median baseline PPA scores for CN, MCI and dementia groups were 0.41 (IQR = -0.09-1.02), 0.66 (IQR = -0.06-1.15) and 2.37 (IQR = 0.93-3.78) respectively. All baseline neuropsychological domains and PA were significantly associated with baseline PPA. There were significant interaction terms (Time × Cognitive Group, Global Cognition, Processing Speed, Executive Function and PA) in the models investigating PPA decline. In multivariate analysis the Time × Executive Function and PA interaction terms were significant, indicating that participants with poorer baseline executive function and reduced PA demonstrated greater physical decline when compared to individuals with better executive function and PA respectively. DISCUSSION: Having MCI or dementia is associated with greater physical decline compared to CN older people. Physical inactivity and executive dysfunction were associated with physical decline in this sample, which included participants with MCI and dementia. Both factors influencing physical decline are potentially amenable to interventions e.g. exercise.