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J Cardiol. 2019 Jan 2. pii: S0914-5087(18)30368-X. doi: 10.1016/j.jjcc.2018.12.015. [Epub ahead of print]

Association of locomotive activity with sleep latency and cognitive function of elderly patients with cardiovascular disease in the maintenance phase of cardiac rehabilitation.

Author information

1
Department of Health Science, Kansai Medical University, Hirakata, Japan. Electronic address: kurosesa@hirakata.kmu.ac.jp.
2
Health Science Center, Kansai Medical University Hospital, Hirakata, Japan.
3
Kumamoto Institute of Total Fitness, Kumamoto, Japan.
4
Department of Rehabilitation, Taira Hospital, Wake, Japan.
5
Department of Health Fitness Program, Koseikai Clinic, Kyoto, Japan.
6
Disease Prevention Center, Ijinkai Takeda General Hospital, Kyoto, Japan.
7
Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan.
8
Faculty of Sport and Health Sciences, Osaka Sangyo University, Daito, Japan.
9
Department of Health Science, Kansai Medical University, Hirakata, Japan; Health Science Center, Kansai Medical University Hospital, Hirakata, Japan.
10
EBM Center for Preventive Medicine, Takeda Hospital Group, Kyoto, Japan.

Abstract

BACKGROUND:

Because of the advanced age of patients with cardiovascular disease (CVD), prevention of sleep disorder and dementia is a priority for cardiac rehabilitation (CR) during their long-term care. This study aimed to investigate the association of physical activity with sleep quality and cognitive function in elderly patients with CVD in the CR maintenance phase.

METHODS:

We conducted a multicenter study through the Clinical Exercise Physiology Association Japan network, which included 102 elderly patients (mean age, 74.1±7.4 years) with CVD undergoing phase III CR at 6 institutions. Physical activity was assessed using a triaxial accelerometer for 7 consecutive days and was classified as locomotive and household activities. Physical fitness was assessed via 6-min walking distance (6MD), hand grip power, 10-m walking speed, one leg standing time with eyes open, and 10 times sit-to-stand tests. Sleep quality and cognitive function were evaluated using the Pittsburgh sleep quality index (PSQI) and mini-mental state examination (MMSE) scores, respectively.

RESULTS:

The patients performed 5506.8±3743.6 steps/day and scored 5.8±3.5 points in the PSQI and 28.4±1.7 points in the MMSE. Sleep latency and MMSE scores correlated with locomotive activity, but not with household activity. Locomotive activity and 6MD were independent predictors of sleep latency and MMSE score, respectively. When patients with heart failure were excluded, the relationship between sleep latency and locomotive activity was preserved, but the relationship between exercise tolerance and cognitive function disappeared.

CONCLUSION:

Locomotive activity and exercise tolerance are associated with sleep latency and cognitive function in elderly patients with CVD continuing phase III CR. However, in this study, the relationship between exercise tolerance and cognitive function was offset by the presence of heart failure.

KEYWORDS:

Cardiac rehabilitation; Cardiovascular disease; Cognitive function; Elderly; Physical activity; Sleep latency

PMID:
30611685
DOI:
10.1016/j.jjcc.2018.12.015

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