Associating Gait Phase and Physical Fitness with Global Cognitive Function in the Aged
Abstract
:1. Introduction
- Classifier variables for identifying declines in physical function in adults aged over 75 years by assessing gait and physical fitness variables;
- Domain parameters of the gait at three different walking speeds and physical fitness that are strongly associated with lower global cognitive function in older adults.
2. Materials and Methods
2.1. Participants
2.2. Instrumentation
2.3. Test Procedures
2.3.1. Global Cognitive Function
2.3.2. Physical Fitness Test
- Grip strength (dominant hand) was measured with an isometric digital handgrip dynamometer (TKK 5401 Grip-D, Takei Scientific Instruments, Tokyo, Japan) to assess the upper body strength;
- Bicep curls were performed with a dumbbell (3 kg for men, 2 kg for women) to assess the upper body strength;
- Sit-to-stand was performed five times to assess the lower body strength;
- Standing time (ST) from a long sitting position (LSP) was measured to assess the lower body strength;
- Back scratching to assess the upper body flexibility;
- Chair sit and reach to assess the lower body flexibility;
- Single-leg balance (dominant leg) to assess the static balance;
- A 3 m timed-up-and-go test to assess the dynamic balance; and
- A 6 min walk test to assess the functional (or cardiorespiratory) endurance.
2.3.3. Over-Ground Walking Test at Different Speeds
2.4. Data Analysis
Covariates
2.5. Statistical Analyses
3. Results
3.1. Demographics and Characteristics of Physical Performance
3.2. Gait Classifiers with Three Different Speed and Physical Fitness Variables to Identify Participants Aged Above 75 Years
3.3. Association of Gait with the MMSE Score
4. Discussion
- The gait and nine physical fitness variables indicated that the variability in the stance phase and the strength, balance, and functional endurance showed a strong dependence on the age being over 75 years.
- The stance phase at the slower walking speed and grip strength and five times sit-to-stand were associated with the global cognitive function in older adults.
4.1. Gait and Physical Fitness Domain Parameters Reflecting Age over 75 Years
4.2. Identifying Cognitive Function Decline According to Gait and Physical Fitness Variables
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | All Participants (n = 735) | Older Men (n = 253) | Older Women (n = 482) | p-Value |
---|---|---|---|---|
Age (years) | 73.1 ± 5.1 | 74.2 ± 5.2 | 72.6 ± 5.0 | <0.001 |
Height (cm) | 157.3 ± 8.1 | 165.6 ± 5.9 | 152.9 ± 5.2 | <0.001 |
Body weight (kg) | 61.1 ± 8.7 | 66.7 ± 7.6 | 58.3 ± 7.9 | <0.001 |
Body mass index (kg/m2) | 24.7 ± 2.9 | 24.3 ± 2.4 | 24.9 ± 3.1 | 0.003 |
Total PA (MET-min/week) | 1873.7 ± 1792.7 | 2225.2 ± 1771.7 | 1689.2 ± 1777.8 | <0.001 |
Education (years) | 9.1 ± 3.9 | 10.5 ± 4.0 | 8.4 ± 3.7 | <0.001 |
0 year | 36 (4.9%) | 7 (2.8%) | 29 (6.0%) | |
1–6 years | 249 (33.9%) | 57 (22.5%) | 192 (39.8%) | |
7–12 years | 373 (50.7%) | 142 (56.1%) | 231 (47.9%) | |
>13 years | 77 (10.5%) | 47 (18.5%) | 30 (6.2%) | |
MMSE score | 26.4 ± 2.9 | 26.8 ± 2.7 | 26.3 ± 3.0 | 0.023 |
<24 | 100 (13.6%) | 27 (10.7%) | 73 (15.1%) | |
Slower speed | ||||
Stance phase (%) | 59.2 ± 1.6 | 58.9 ± 1.6 | 59.4 ± 1.6 | <0.001 |
CV of stance phase (%) | 4.5 ± 2.2 | 4.4 ± 2.2 | 4.6 ±2.2 | 0.279 |
Preferred speed | ||||
Stance phase (%) | 57.5 ± 1.7 | 57.1 ± 1.7 | 57.7 ± 1.7 | <0.001 |
CV of stance phase (%) | 3.0 ± 1.7 | 3.1 ± 1.7 | 2.9 ± 1.7 | 0.379 |
Faster speed | ||||
Stance phase (%) | 55.7 ± 1.8 | 55.2 ± 1.9 | 55.9 ± 1.8 | <0.001 |
CV of stance phase (%) | 2.4 ± 1.3 | 2.3 ± 1.3 | 2.4 ± 1.3 | 0.691 |
Physical fitness | ||||
Grip strength (kg) | 25.9 ± 7.4 | 33.4 ± 6.1 | 22.0 ± 4.3 | <0.001 |
Biceps curl (no. of reps.) | 25.9 ± 7.7 | 28.5 ± 8.2 | 24.6 ± 7.1 | <0.001 |
Five times sit-to-stand (s) | 9.7 ± 3.7 | 9.1 ± 3.2 | 10.0 ± 3.9 | <0.001 |
ST from an LSP (s) | 3.6 ± 2.1 | 3.2 ± 1.8 | 3.8 ± 2.2 | <0.001 |
Back scratch (cm) | −12.7 ± 13.5 | −20.1 ± 14.0 | −8.8 ± 11.5 | <0.001 |
Chair sit and reach (cm) | 18.4 ± 10.5 | 11.3 ± 10.8 | 22.1 ± 8.2 | <0.001 |
Single-leg balance (s) | 18.2 ± 20.3 | 17.9 ± 19.1 | 18.4 ± 20.9 | 0.735 |
3 m timed-up-and-go (s) | 7.8 ± 2.3 | 7.2 ± 2.3 | 8.1 ± 2.2 | <0.001 |
6-min walk (m) | 463.6 ± 105.6 | 495.8 ± 110.4 | 446.7 ± 99.0 | <0.001 |
Predictors | β (SE) | Odds Ratio | 95% CI | p-Value |
---|---|---|---|---|
MMSE score | −0.503 (0.092) | 0.605 | 0.505–0.724 | <0.001 |
Over-ground walking | ||||
CV of stance phase (preferred) | 0.486 (0.216) | 1.626 | 1.065–2.483 | 0.024 |
Physical fitness | ||||
Grip strength | −0.614 (0.162) | 0.541 | 0.394–0.744 | <0.001 |
Single-leg balance | −0.712 (0.138) | 0.491 | 0.375–0.642 | <0.001 |
6-min walk | −0.797 (0.173) | 0.451 | 0.321–0.633 | <0.001 |
Variables | MMSE Score | ||
---|---|---|---|
β (SE) | t | p-Value | |
Overground walking | R2 = 0.191 | ||
Stance phase (slow) | 0.088 (0.039) | 2.276 | 0.023 |
Physical fitness | R2 = 0.236 | ||
Grip strength | 0.148 (0.036) | 4.076 | <0.001 |
Five times sit-to-stand | −0.111 (0.037) | −3.025 | 0.003 |
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Noh, B.; Youm, C.; Lee, M.; Park, H. Associating Gait Phase and Physical Fitness with Global Cognitive Function in the Aged. Int. J. Environ. Res. Public Health 2020, 17, 4786. https://doi.org/10.3390/ijerph17134786
Noh B, Youm C, Lee M, Park H. Associating Gait Phase and Physical Fitness with Global Cognitive Function in the Aged. International Journal of Environmental Research and Public Health. 2020; 17(13):4786. https://doi.org/10.3390/ijerph17134786
Chicago/Turabian StyleNoh, Byungjoo, Changhong Youm, Myeounggon Lee, and Hwayoung Park. 2020. "Associating Gait Phase and Physical Fitness with Global Cognitive Function in the Aged" International Journal of Environmental Research and Public Health 17, no. 13: 4786. https://doi.org/10.3390/ijerph17134786