Physical performance across the cognitive spectrum and between dementia subtypes in a population-based sample of older adults: The HUNT study
•Gait speed declined in older adults across the cognitive spectrum.•Mild cognitive impairment was also associated with strength and balance deficits.•Older adults with dementia had substantial limitations in physical performance.•Older adults with Alzheimer's performed better than other dementi...
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| Published in | Archives of gerontology and geriatrics Vol. 95; p. 104400 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English Norwegian |
| Published |
Netherlands
Elsevier B.V
01.07.2021
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| Abstract | •Gait speed declined in older adults across the cognitive spectrum.•Mild cognitive impairment was also associated with strength and balance deficits.•Older adults with dementia had substantial limitations in physical performance.•Older adults with Alzheimer's performed better than other dementia subtypes.•Older adults with Lewy body and Vascular dementias had worst physical performance.
Literature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between dementia subtypes is lacking. We aim to identify distinct physical-performance deficits across the cognitive spectrum and between dementia subtypes.
11,466 persons were included from the 70-year-and-older cohort in the fourth wave of the Trøndelag Health Study (HUNT4 70+). Physical performance was assessed with the Short Physical Performance Battery (SPPB), 4-meter gait speed, five-times-sit-to-stand (FTSS), grip strength and one-leg-standing (OLS). Clinical experts diagnosed dementia per DSM-5 criteria. Multiple linear and logistic regression were performed to analyze differences between groups. Age, sex, education, somatic comorbidity, physical activity and smoking status were used as covariates.
Gait speed declined across the cognitive spectrum, beginning in people with subjective cognitive decline (SCD). Participants with mild cognitive impairment (MCI) additionally showed reduced lower-limb muscle strength, balance and grip strength. Those with dementia scored lowest on all physical-performance measures. Participants with Alzheimer's disease (AD) had a higher SPPB sum score and faster gait speed than participants with vascular dementia (VaD) and Lewy body dementia (LBD); participants with VaD and LBD had lower odds of being able to perform FTSS and OLS than participants with AD.
Physical performance declined across the spectrum from cognitively healthy to SCD to MCI and to dementia. Participants with AD performed better on all assessments except grip strength than participants with VaD and LBD. Stage of cognitive impairment and dementia subtype should guide exercise interventions to prevent mobility decline and dependency. |
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| AbstractList | Literature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between dementia subtypes is lacking. We aim to identify distinct physical-performance deficits across the cognitive spectrum and between dementia subtypes.
11,466 persons were included from the 70-year-and-older cohort in the fourth wave of the Trøndelag Health Study (HUNT4 70+). Physical performance was assessed with the Short Physical Performance Battery (SPPB), 4-meter gait speed, five-times-sit-to-stand (FTSS), grip strength and one-leg-standing (OLS). Clinical experts diagnosed dementia per DSM-5 criteria. Multiple linear and logistic regression were performed to analyze differences between groups. Age, sex, education, somatic comorbidity, physical activity and smoking status were used as covariates.
Gait speed declined across the cognitive spectrum, beginning in people with subjective cognitive decline (SCD). Participants with mild cognitive impairment (MCI) additionally showed reduced lower-limb muscle strength, balance and grip strength. Those with dementia scored lowest on all physical-performance measures. Participants with Alzheimer's disease (AD) had a higher SPPB sum score and faster gait speed than participants with vascular dementia (VaD) and Lewy body dementia (LBD); participants with VaD and LBD had lower odds of being able to perform FTSS and OLS than participants with AD.
Physical performance declined across the spectrum from cognitively healthy to SCD to MCI and to dementia. Participants with AD performed better on all assessments except grip strength than participants with VaD and LBD. Stage of cognitive impairment and dementia subtype should guide exercise interventions to prevent mobility decline and dependency. Background: Literature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between dementia subtypes is lacking. We aim to identify distinct physical-performance deficits across the cognitive spectrum and between dementia subtypes. Methods: 11,466 persons were included from the 70-year-and-older cohort in the fourth wave of the Trøndelag Health Study (HUNT4 70+). Physical performance was assessed with the Short Physical Performance Battery (SPPB), 4-meter gait speed, five-times-sit-to-stand (FTSS), grip strength and one-leg-standing (OLS). Clinical experts diagnosed dementia per DSM-5 criteria. Multiple linear and logistic regression were performed to analyze differences between groups. Age, sex, education, somatic comorbidity, physical activity and smoking status were used as covariates. Results: Gait speed declined across the cognitive spectrum, beginning in people with subjective cognitive decline (SCD). Participants with mild cognitive impairment (MCI) additionally showed reduced lower-limb muscle strength, balance and grip strength. Those with dementia scored lowest on all physical-performance measures. Participants with Alzheimer's disease (AD) had a higher SPPB sum score and faster gait speed than participants with vascular dementia (VaD) and Lewy body dementia (LBD); participants with VaD and LBD had lower odds of being able to perform FTSS and OLS than participants with AD. Conclusions: Physical performance declined across the spectrum from cognitively healthy to SCD to MCI and to dementia. Participants with AD performed better on all assessments except grip strength than participants with VaD and LBD. Stage of cognitive impairment and dementia subtype should guide exercise interventions to prevent mobility decline and dependency. •Gait speed declined in older adults across the cognitive spectrum.•Mild cognitive impairment was also associated with strength and balance deficits.•Older adults with dementia had substantial limitations in physical performance.•Older adults with Alzheimer's performed better than other dementia subtypes.•Older adults with Lewy body and Vascular dementias had worst physical performance. Literature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between dementia subtypes is lacking. We aim to identify distinct physical-performance deficits across the cognitive spectrum and between dementia subtypes. 11,466 persons were included from the 70-year-and-older cohort in the fourth wave of the Trøndelag Health Study (HUNT4 70+). Physical performance was assessed with the Short Physical Performance Battery (SPPB), 4-meter gait speed, five-times-sit-to-stand (FTSS), grip strength and one-leg-standing (OLS). Clinical experts diagnosed dementia per DSM-5 criteria. Multiple linear and logistic regression were performed to analyze differences between groups. Age, sex, education, somatic comorbidity, physical activity and smoking status were used as covariates. Gait speed declined across the cognitive spectrum, beginning in people with subjective cognitive decline (SCD). Participants with mild cognitive impairment (MCI) additionally showed reduced lower-limb muscle strength, balance and grip strength. Those with dementia scored lowest on all physical-performance measures. Participants with Alzheimer's disease (AD) had a higher SPPB sum score and faster gait speed than participants with vascular dementia (VaD) and Lewy body dementia (LBD); participants with VaD and LBD had lower odds of being able to perform FTSS and OLS than participants with AD. Physical performance declined across the spectrum from cognitively healthy to SCD to MCI and to dementia. Participants with AD performed better on all assessments except grip strength than participants with VaD and LBD. Stage of cognitive impairment and dementia subtype should guide exercise interventions to prevent mobility decline and dependency. BACKGROUNDLiterature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between dementia subtypes is lacking. We aim to identify distinct physical-performance deficits across the cognitive spectrum and between dementia subtypes. METHODS11,466 persons were included from the 70-year-and-older cohort in the fourth wave of the Trøndelag Health Study (HUNT4 70+). Physical performance was assessed with the Short Physical Performance Battery (SPPB), 4-meter gait speed, five-times-sit-to-stand (FTSS), grip strength and one-leg-standing (OLS). Clinical experts diagnosed dementia per DSM-5 criteria. Multiple linear and logistic regression were performed to analyze differences between groups. Age, sex, education, somatic comorbidity, physical activity and smoking status were used as covariates. RESULTSGait speed declined across the cognitive spectrum, beginning in people with subjective cognitive decline (SCD). Participants with mild cognitive impairment (MCI) additionally showed reduced lower-limb muscle strength, balance and grip strength. Those with dementia scored lowest on all physical-performance measures. Participants with Alzheimer's disease (AD) had a higher SPPB sum score and faster gait speed than participants with vascular dementia (VaD) and Lewy body dementia (LBD); participants with VaD and LBD had lower odds of being able to perform FTSS and OLS than participants with AD. CONCLUSIONSPhysical performance declined across the spectrum from cognitively healthy to SCD to MCI and to dementia. Participants with AD performed better on all assessments except grip strength than participants with VaD and LBD. Stage of cognitive impairment and dementia subtype should guide exercise interventions to prevent mobility decline and dependency. |
| ArticleNumber | 104400 |
| Author | Strand, Bjørn Heine Sverdrup, Karen Thingstad, Pernille Selbæk, Geir Skjerve, Kjerstin Næss Tangen, Gro Gujord Bergh, Sverre Skjellegrind, Håvard Kjesbu |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33798998$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3389_fnagi_2023_1092990 crossref_primary_10_7600_jspfsm_72_305 crossref_primary_10_1093_ptj_pzad092 crossref_primary_10_3390_ijerph20032628 crossref_primary_10_3389_fnagi_2021_766884 crossref_primary_10_1016_j_archger_2022_104841 crossref_primary_10_1016_j_clnesp_2023_08_016 crossref_primary_10_3390_bs13110913 crossref_primary_10_1016_j_jamda_2022_12_020 crossref_primary_10_1159_000532131 crossref_primary_10_15857_ksep_2022_00521 crossref_primary_10_1093_gerona_glac169 crossref_primary_10_1093_ije_dyac095 crossref_primary_10_1016_j_gerinurse_2024_04_004 crossref_primary_10_1016_j_neures_2022_08_004 crossref_primary_10_1097_WNF_0000000000000586 crossref_primary_10_1007_s41999_022_00713_6 |
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| Keywords | HUNT Gait speed Physical performance Cognitive impairment Dementia |
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| Snippet | •Gait speed declined in older adults across the cognitive spectrum.•Mild cognitive impairment was also associated with strength and balance deficits.•Older... Literature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between dementia subtypes... BACKGROUNDLiterature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between dementia... Background: Literature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between... |
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| SubjectTerms | Cognitive impairment Dementia Gait speed HUNT Physical performance |
| Title | Physical performance across the cognitive spectrum and between dementia subtypes in a population-based sample of older adults: The HUNT study |
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