The relationship between habitual physical activity status and executive function in individuals with Alzheimer’s disease: a longitudinal, cross-lagged panel analysis

To determine whether habitual physical activity status specifically influences executive function change in Alzheimer’s disease (AD) over 1 year. In this longitudinal cohort study, 45 participants with AD were recruited and provided follow-up data approximately 1 year later. Executive function measures (map search task, digit symbol substitution task, controlled oral word association task, verbal fluency task) and habitual physical activity measures (Physical Activity Scale for the Elderly (PASE) and handgrip strength) were taken at baseline and follow-up. Individual composites were subsequently created. Additional demographic, lifestyle, and neuropsychiatric measures were also taken. In a structural equation model (χ2(26) = 9.84, p = .998, comparative fit index = 1.00, root mean square error of approximation = .00), a significant association was found between habitual physical activity and executive function change (β = .27, p = .04). In a cross-lagged panel analysis, a significant path was found between the PASE score and executive change (β = .22, p = .01). As higher habitual physical activity levels were associated with reduced executive function change, the promotion of low-intensity habitual physical activities in individuals with a diagnosis of AD may be warranted. Further research is needed, however, to explore the impact of habitual physical activity on the trajectory of change across cognitive domains, and how this relates to the progression of the underlying pathology associated with this disease

Habitual physical activity (HPA) as a factor in sustained executive function in Alzheimer-type dementia: a cohort study

Evidence from studies on healthy older adults and mild cognitive impairment (MCI) populations suggests that physical activity interventions have a positive effect on executive function. In this study, we consider whether HPA is positively associated with executive function in Alzheimer's disease (AD). Eighty-two participants with a diagnosis of mild to moderate AD completed six measures of executive function. Objective measures of physical status were taken. In addition, informants completed questionnaires on the participants’ HPA and other lifestyle factors. A composite measure of executive function was the primary outcome. A multistage multiple regression was used to determine how much variance HPA accounted for. The final model comprised disease severity, cognitive reserve, cognitive activities, neuropsychiatric status and HPA status. The final model accounted for a total of 57% of the variance of executive performance, of which HPA itself accounted for 8% of the variance. HPA status is associated executive performance in an AD population even after controlling for key covariates. The findings encourage clinicians to recommend HPA and its cognitive benefits to AD patients and their carers

Is insomnia associated with deficits in neuropsychological functioning? Evidence from a population-based study

Study Objectives: People with insomnia complain of cognitive deficits in daily life. Results from empirical studies examining associations between insomnia and cognitive impairment, however, are mixed. Research is needed that compares treatment-seeking and community-based insomnia study samples, measures subjective as well as objective cognitive functioning, and considers participants' pre-insomnia cognitive function. Design and Participants: We used data from the Dunedin Study, a representative birth cohort of 1,037 individuals, to examine whether insomnia in early midlife was associated with subjective and objective cognitive functioning. We also tested whether individuals with insomnia who reported seeking treatment for their sleep problems (treatment-seekers) showed greater impairment than other individuals with insomnia (non-treatment-seekers). The role of key confounders, including childhood cognitive ability and comorbid health conditions, was evaluated. Measurements: Insomnia was diagnosed at age 38 according to DSM-IV criteria. Objective neuropsychological assessments at age 38 included the WAIS-IV IQ test, the Wechsler Memory Scale, and the Trail-Making Test. Childhood cognitive functioning was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R). Results: A total of 949 cohort members were assessed for insomnia symptoms and other study measures at age 38. Although cohort members with insomnia (n = 186, 19.6%) had greater subjective cognitive impairment than their peers at age 38, they did not exhibit greater objective impairment on formal testing. Treatment-seekers, however, exhibited significant objective impairment compared to non-treatment-seekers. Controlling for comorbidity, daytime impairment, and medications slightly decreased this association. Childhood cognitive deficits antedated the adult cognitive deficits of treatment-seekers. Conclusions: Links between insomnia and cognitive impairment may be strongest among individuals who seek clinical treatment. Clinicians should take into account the presence of complex health problems and lower premorbid cognitive function when planning treatment for insomnia patients

Adult cognitive outcomes in phenylketonuria:explaining causes of variability beyond average Phe levels

OBJECTIVE: The objective was to deepen the understanding of the causes of individual variability in phenylketonuria (PKU) by investigating which metabolic variables are most important for predicting cognitive outcomes (Phe average vs Phe variation) and by assessing the risk of cognitive impairment associated with adopting a more relaxed approach to the diet than is currently recommended. METHOD: We analysed associations between metabolic and cognitive measures in a mixed sample of English and Italian early-treated adults with PKU (N = 56). Metabolic measures were collected through childhood, adolescence and adulthood; cognitive measures were collected in adulthood. Metabolic measures included average Phe levels (average of median values for each year in a given period) and average Phe variations (average yearly standard deviations). Cognition was measured with IQ and a battery of cognitive tasks. RESULTS: Phe variation was as important, if not more important, than Phe average in predicting adult outcomes and contributed independently. Phe variation was particularly detrimental in childhood. Together, childhood Phe variation and adult Phe average predicted around 40% of the variation in cognitive scores. Poor cognitive scores (> 1 SD from controls) occurred almost exclusively in individuals with poor metabolic control and the risk of poor scores was about 30% higher in individuals with Phe values exceeding recommended thresholds. CONCLUSIONS: Our results provide support for current European guidelines (average Phe value = < 360 μmol/l in childhood; = < 600 μmo/l from 12 years onwards), but they suggest an additional recommendation to maintain stable levels (possibly Phe SD = < 180 μmol/l throughout life). PUBLIC SIGNIFICANCE STATEMENTS: We investigated the relationship between how well people with phenylketonuria control blood Phe throughout their life and their ability to carry out cognitive tasks in adulthood. We found that avoiding blood Phe peaks was as important if not more important that maintaining average low Phe levels. This was particularly essential in childhood. We also found that blood Phe levels above recommended European guidelines was associated with around 30% increase in the risk of poor cognitive outcomes

Exploratory Study of Executive Function Abilities Across the Adult Lifespan in Individuals Receiving an ASD Diagnosis in Adulthood

The few studies of autism spectrum disorder (ASD) across adulthood suggest different age-related associations in different aspects of executive function (EF). In this exploratory study we examined EF abilities and self-report autism traits in 134 adults (aged 18-75 years; mean=31 years) with abilities in the normal range, receiving a first diagnosis of ASD. Results suggest that in some EF relying on speed and sequencing (Trails A and B; Digit Symbol), late-diagnosed ASD individuals may demonstrate better performance than typical age-norms. On other EF (Digit Span, Hayling, Brixton tests) age-related correlations were similar to typical age-norms. Different domains of EF may demonstrate different trajectories for ageing with ASD, with patterns of slower, accelerated or equivalent age-related change observed across different measures

Exploratory Study of Executive Function Abilities Across the Adult Lifespan in Individuals Receiving an ASD Diagnosis in Adulthood

The few studies of autism spectrum disorder (ASD) across adulthood suggest different age-related associations in different aspects of executive function (EF). In this exploratory study we examined EF abilities and self-report autism traits in 134 adults (aged 18-75 years; mean=31 years) with abilities in the normal range, receiving a first diagnosis of ASD. Results suggest that in some EF relying on speed and sequencing (Trails A and B; Digit Symbol), late-diagnosed ASD individuals may demonstrate better performance than typical age-norms. On other EF (Digit Span, Hayling, Brixton tests) age-related correlations were similar to typical age-norms. Different domains of EF may demonstrate different trajectories for ageing with ASD, with patterns of slower, accelerated or equivalent age-related change observed across different measures