Two-Year Changes in Physical Activity and Concurrent Changes in Cognitive Function in a Cohort of Adults with Metabolic Syndrome

Article type: Research Article

Authors: Rognoni, Teresa^a | Fernández-Matarrubia, Marta^b | Martinez-González, Miguel Ángel^{c; d; e; f} | Salas-Salvadó, Jordi^{e; g; h} | Corella, Dolores^{e; i} | Castañer, Olga^{j; k} | Martínez, J. Alfredo^{e; l; m} | Alonso-Gómez, Ángel M.^{e; n} | Gómez-Gracia, Enrique^o | Vioque, Jesús^{k; p} | Romaguera, Dora^{e; q} | López-Miranda, José^{e; r} | Estruch, Ramón^{e; s} | Tinahones, Francisco J.^{e; t} | Santos-Lozano, José Manuel^{e; u} | Serra-Majem, Lluis^{e; v} | Cano Ibañez, Naomi^{k; w; x} | Tur, Josep A.^{e; y} | Micó Pérez, Rafael^{k; z} | Pintó, Xavier^{e; aa} | Delgado-Rodríguez, Miguel^{k; bb} | Ortiz Ramos, María^cc | Vidal, Josep^{dd; ee} | Vázquez, Clotilde^{e; ff} | Daimiel, Lidia^{e; gg; hh} | Ros, Emilio^{e; dd} | Goñi-Ruiz, Nuria^{e; ii} | Babio, Nancy^{e; g; h} | Sorlí, José V.^{e; i} | Schröder, Helmut^{j; k} | García-Rios, Antonio^{e; r} | Compañ-Gabucio, Laura^p | Warnberg, Julia^{jj; kk} | Zulet, M. Ángeles^{d; e; l} | Chaplin, Alice^{e; q} | Sacanella, Emilio^{e; s} | Bouzalmate-Hajjaj, Amira^{k; w} | Tojal-Sierra, Lucas^{e; n} | Damas-Fuentes, Miguel^{e; t} | Vázquez, Zenaida^{c; e} | Gómez-Martínez, Carlos^{e; g; h} | Saiz, Carmen^{e; i} | Malcampo, Mireia^j | Ortiz-Morales, Ana M.^{e; r} | Martínez-Avilés, Vanessa^ll | García-Gavilan, Jesús^{e; g; h} | Abete, Itziar^{d; e; l} | Fitó, Montserrat^{e; j} | Toledo, Estefanía^{c; d; e; *}

Affiliations: [a] Department of Neurology, Clínica Universidad de Navarra, Madrid, Spain | [b] Department of Neurology, Marqués de Valdecilla University Hospital, Santander, Spain | [c] Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain | [d] IdiSNA, Navarra Institute for Health Research, Pamplona, Spain | [e] Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain | [f] Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA | [g] Universitat Rovira i Vigili, Department de Bioquímica i Biotecnología, Unitat de Nutrició Humana, Reus, Spain | [h] Institut d'Investigació Sanitària Pere i Virgili (IISPV), Hospital San Joan de Reus, Reus, Spain | [i] Department of Preventive Medicine, University of Valencia, Valencia, Spain | [j] Cardiovascular Risk and Nutrition, Hospital del Mar Research Institute (IMIM), Barcelona, Spain | [k] Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain | [l] Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain | [m] Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain | [n] Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain | [o] Department of Preventive Medicine and Public Health, Instituto de Investigación Biomédica de Málaga-IBIMA, School of Medicine, University of Málaga, Málaga, Spain | [p] Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH).Alicante, Spain | [q] Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), HealthResearch Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain | [r] Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain | [s] Department of Internal Medicine, Institut de I’nvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain | [t] Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain | [u] Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain | [v] Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria and Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain | [w] Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain | [x] Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain | [y] Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands-IUNICS, Palma de Mallorca, Spain | [z] Institute of Biomedicine (IBIOMED), University of León, León, Spain | [aa] Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Spain | [bb] Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain | [cc] Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain | [dd] Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain | [ee] CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain | [ff] Department of Endocrinology and Nutrition, Hospital Fundación Jiménez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autónoma, Madrid, Spain | [gg] Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain | [hh] Departamento de Ciencias Farmacéuticas y de la Salud, Faculty de Farmacia, Universidad San Pablo-CEU, CEU Universities, Boadilla del Monte, Spain | [ii] Servicios de Atención Primaria, Navarra Regional Health Service (Osasunbidea), Pamplona, Spain | [jj] Department of Nursing, School of Health Sciences University of Malaga, Spain | [kk] Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain | [ll] Centro de Salud Raval de Elche, Alicante, Spain

Correspondence: [*] Correspondence to: Estefanía Toledo, Department of Preventive Medicine and Public Health, University of Navarra, Irunlarrea, 1, 31008 Pamplona, Spain. Tel.: +34 948425600; E-mail: etoledo@unav.es.

Abstract: Background:It has been proposed that physical activity (PA) could prevent cognitive decline. Objective:To evaluate the association between changes in PA and changes in cognitive function in a cohort of adults with metabolic syndrome. Methods:Longitudinal observational study including 5,500 adults (mean age 65 years, SD = 5; women = 49.3% ) with metabolic syndrome. Participants underwent physical activity measurements and cognitive evaluation at baseline and at two-years of follow-up. PA was quantified using the Minnesota questionnaire-shortened version. Cognitive function was evaluated using a battery of tests: Mini-Mental Test Examination, Clock Drawing Test, Trail Making Test A and B, Verbal Fluency Test, and Digit Span. The primary outcome was two-year change in cognition, measured through the Global Composite Score (GCS) of all neuropsychological tests. Multivariable-adjusted linear regression models were fitted with baseline PA and their changes as the main exposures and changes in cognitive function as the outcome. Results:No significant association was found between PA levels (or their changes) in the GCS of cognitive function. A greater increase in PA levels was associated with a more favorable two-year change in the Trail Making Test A (Q4 versus Q1: b = – 2.24s, 95% CI –4.36 to –0.12s; p-trend = 0.020). No significant association was found for other neuropsychological test. Conclusion:Our results do not support an association between increases in PA and the evolution of the global cognitive function at two-year in an intervention trial which included PA promotion in one of its two randomized arms, but they suggested a possible beneficial effect of PA on attentional function in older adults.

Keywords: Alzheimer’s disease, cognitive function, dementia, metabolic syndrome, physical activity, prevention

DOI: 10.3233/JAD-230105

Journal: Journal of Alzheimer's Disease, vol. 95, no. 3, pp. 887-899, 2023