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Front Aging Neurosci. 2018 Nov 15;10:341. doi: 10.3389/fnagi.2018.00341. eCollection 2018.

Community-Based Activity and Sedentary Patterns Are Associated With Cognitive Performance in Mobility-Limited Older Adults.

Author information

Johns Hopkins School of Public Health, Baltimore, MD, United States.
Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States.
Division of Public Health Sciences, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States.
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States.
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States.
Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States.
Department of Neurology and Medicine, Albert Einstein of Yeshiva University, Bronx, NY, United States.
Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States.
Department of Internal Medicine (Gerontology/Geriatrics), Wake Forest School of Medicine, Winston-Salem, NC, United States.
Stanford University School of Medicine, Stanford, CA, United States.
School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States.
Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Department of Psychology, Wake Forest University, Winston-Salem, NC, United States.
Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States.
Yale School of Medicine, New Haven, CT, United States.
Center for Visual and Neurocognitive Rehabilitation, Atlanta, GA, United States.
Division of Physical Therapy, Emory University, Atlanta, GA, United States.
Department of Neurology, Emory University, Atlanta, GA, United States.


Over the last few decades, considerable evidence shows that greater levels of aerobic exercise and cardiovascular fitness benefit cognitive performance. However, the degree to which free-living activity in community settings is related to cognitive performance remains unclear, particularly in older adults vulnerable to disability. Also, it is unknown whether the manner in which daily physical activity (PA) and sedentary time are accumulated throughout the day is associated with cognition. Cross-sectional associations between accelerometer-characterized PA and sedentary patterns and cognitive performance were examined in 1,274 mobility-limited older adults. Percent time spent in various bout lengths of PA (≥1, ≥2, and ≥5 min) and sedentary (≥1, ≥30, and ≥60 min) was defined as the number of minutes registered divided by total wear time × 100. Percent time was then tertiled for each bout length. Multiple linear regression models were used to estimate the associations between accelerometer bout variables and separate cognitive domains that included processing speed (Digit Symbol Coding; DSC), immediate and delayed recall (Hopkins Verbal Learning Test; HVLT), information processing and selective attention (Flanker), working memory (n-back), reaction time (switch and non-switch reaction time), and a composite score that averaged results from all cognitive tests. After adjusting for demographics, behavioral factors, and morbid conditions, more time spent in PA was associated with higher DSC for all bout lengths (p < 0.03 for all). Higher PA was associated with higher HVLT and global cognition scores but only for longer bout lengths (p < 0.05 for all). The association was largely driven by participants who spent the lowest amount of time performing activity while awake (p < 0.04). An inverse linear relationship was observed between total sedentary time and DSC (p = 0.02), but not for other measures of cognition. These results suggest that, while higher PA was associated with higher cognitive performance, PA's association with memory was sensitive to bout duration. The time, but not the manner, spent in sedentary behaviors showed a minor association with executive function. Further research is warranted to characterize longitudinal changes in daily activity and sedentary patterns as potential biophysical markers of cognitive status in older adults.


accelerometer; aging; cognition; executive function; physical inactivity; wearables

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