The beneficial effect of physical activity on cognitive function in community-dwelling older persons with locomotive syndrome

Misa Nakamura; Masakazu Imaoka; Hiroshi Hashizume; Fumie Tazaki; Mitsumasa Hida; Hidetoshi Nakao; Tomoko Omizu; Hideki Kanemoto; Masatoshi Takeda

doi:10.7717/peerj.12292

The beneficial effect of physical activity on cognitive function in community-dwelling older persons with locomotive syndrome

PeerJ. 2021 Oct 15:9:e12292. doi: 10.7717/peerj.12292. eCollection 2021.

Authors

Misa Nakamura^{1

2}, Masakazu Imaoka^{1

2}, Hiroshi Hashizume^{3

4}, Fumie Tazaki^{1

2}, Mitsumasa Hida^{1

2}, Hidetoshi Nakao^{1

2}, Tomoko Omizu⁵, Hideki Kanemoto^{1

6}, Masatoshi Takeda¹

Affiliations

¹ Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.
² Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.
³ Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan.
⁴ School of Health and Nursing Science, Wakayama Medical University, Wakayama, Wakayama, Japan.
⁵ Department of Health and Medical Science, Kansai University of Welfare Sciences, Kashiwara, Osaka, Japan.
⁶ Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Abstract

Background: Cognitive decline is closely related to motor decline. Locomotive syndrome (LS) is defined as a state associated with a high risk of requiring support because of locomotive organ disorders, and can be evaluated using a questionnaire. This study aimed to clarify the effectiveness of daily goal-targeted exercise on cognitive function in two different populations classified by scores on the Locomo 25 questionnaire.

Methods: Seventy community-dwelling older people who participated in a 13-week health class were divided into two populations based on Locomo 25 scores: <7 (non-LS) and ≥7 (LS). Participants were presented with a daily target steps and worked towards that goal. Cognitive function was evaluated using the Japanese version of Addenbrooke's Cognitive Examination-Revised (ACE-R). Average daily physical activity (exercise [Ex]) for 13 weeks was measured using a portable activity meter. Depression status was assessed using the Geriatric Depression Scale (GDS-15).

Results: No significant differences were observed in age, years of education, body mass index, smooth muscle mass index, GDS-15 scores, or ACE-R scores between the non-LS and LS populations. Multiple logistic regression analysis showed that Ex (odds ratio = 5.01, p = 0.002) for 13 weeks was significantly associated with increased cognitive function in the LS population. The Ex threshold for the increase in cognitive function based on receiver operating curve analysis was 2.29 metabolic equivalents of task (METs) × h (METs · h/day) (p = 0.047) in the LS population. After 13 weeks, ACE-R scores were significantly higher in the Ex ≥ 2.29 than in the Ex < 2.29 METs · h/day group (p = 0.024, η_p ² = 0.241) in the LS population based on two-way analysis of covariance. Furthermore, a significant increase in the ACE-R memory domain was seen in the Ex ≥ 2.29 group (p = 0.035, η_p ² = 0.213).

Conclusions: These results suggest that Ex ≥ 2.29 METs · h/day is important for improving cognitive function in LS populations.

Keywords: Cognitive function; Locomotive syndrome; Older person; Physical activity.

Grants and funding

This work was supported by JSPS KAKENHI (Grant No. 18K10800) and The Research Foundation for Dementia of Osaka. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.