title: What physical performance measures predict incident cognitive decline among intact older adults? A 4.4year follow up study.
abstract: Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigated whether reduced physical performance and low handgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older community-dwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participants without CI at the baseline were included (mean age 72.2years, 59.5% females). Physical performance measures included the Short Physical Performance Battery (SPPB), 4m gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), categorized in gender-specific tertiles. CI was defined as a Mini-Mental State Examination (MMSE) score below 24; CD a decline of 3 or more points in the MMSE without CI. At baseline, participants developing CI during follow-up scored significantly worse across all physical performance measures compared to those that retained normal cognitive status. After adjusting for potential confounders, a significant trend for MMSE changes was noted for all physical performance tests, except for the SPPB and chair stands time. Multinomial logistic regression revealed that slow gait speed at baseline significantly predicted CD at follow up. Poor SPPB performance and slower gait speed predicted the onset of CI at the follow-up. In conclusion, slow walking speed appears to be the best independent predictor of poor cognitive status over a 4.4-year follow-up, while other items of SPPB were also significantly associated with CI.
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Italy; Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy. Electronic address: ilmannato@gmail.com.
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience King's College London, De Crespigny Park, London SE5 8AF, United Kingdom.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Trevisan
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bolzetta
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: De Rui
authors.affiliation: Department of Neurosciences, University of Padova, Padova, Italy; National Health Care System, Padua Local Unit ULSS 17, Italy; Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Solmi
authors.affiliation: Department of Medicine DIMED, Clinica Medica I, University of Padova, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Sartori
authors.affiliation: Department of Medicine DIMED, Clinica Medica I, University of Padova, Italy.
authors.forename: Estella
authors.initials: E
authors.lastname: Musacchio
authors.affiliation: Department of Medicine DIMED, Clinica Medica I, University of Padova, Italy; National Research Council, Neuroscience Institute, Padova, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Zambon
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences - Biostatistics, Epidemiology and Public Health Unit, University of Padova, Padova, Italy.
authors.forename: Egle
authors.initials: E
authors.lastname: Perissinotto
authors.affiliation: National Research Council, Neuroscience Institute, Padova, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Italy; National Research Council, Neuroscience Institute, Padova, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology* / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D018737:Hand Strength; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D016138:Walking
keywords: Cognition; Muscle strength; Physical performance