Physical activity complexity, cognition, and risk of cognitive impairment and dementia in the Baltimore Longitudinal Study of Aging

Abstract INTRODUCTION Studies on physical activity (PA) and dementia mainly focus on activity quantity or intensity. Yet PA requires neuro‐coordination of movement, and it is unclear whether complexity of daily activity varies by cognitive status. Thus, we examined the association between PA complex...

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Main Authors: Yurun Cai, Junhong Zhou, Paul W. Scott, Qu Tian, Amal A. Wanigatunga, Lewis Lipsitz, Eleanor M. Simonsick, Susan M. Resnick, Luigi Ferrucci, Dianxu Ren, Jennifer H. Lingler, Jennifer A. Schrack
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Alzheimer’s & Dementia: Translational Research & Clinical Interventions
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Online Access:https://doi.org/10.1002/trc2.70077
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author Yurun Cai
Junhong Zhou
Paul W. Scott
Qu Tian
Amal A. Wanigatunga
Lewis Lipsitz
Eleanor M. Simonsick
Susan M. Resnick
Luigi Ferrucci
Dianxu Ren
Jennifer H. Lingler
Jennifer A. Schrack
author_facet Yurun Cai
Junhong Zhou
Paul W. Scott
Qu Tian
Amal A. Wanigatunga
Lewis Lipsitz
Eleanor M. Simonsick
Susan M. Resnick
Luigi Ferrucci
Dianxu Ren
Jennifer H. Lingler
Jennifer A. Schrack
author_sort Yurun Cai
collection DOAJ
description Abstract INTRODUCTION Studies on physical activity (PA) and dementia mainly focus on activity quantity or intensity. Yet PA requires neuro‐coordination of movement, and it is unclear whether complexity of daily activity varies by cognitive status. Thus, we examined the association between PA complexity, using multiscale entropy, and cognitive function, mild cognitive impairment (MCI), and dementia in older adults in the Baltimore Longitudinal Study of Aging (BLSA). METHODS A total of 637 older adults (age 73.9 ± 11.3 years) in the BLSA completed a 7‐day wrist‐worn accelerometer assessment and neuropsychological tests from 2015 to 2020. Using logistic regression and structural equation modeling, we examined cross‐sectional associations of PA complexity with MCI/dementia and cognition. Cross‐lagged panel models (CLPMs) were used to assess bidirectional associations at baseline and 2‐year follow‐up. Multivariable models were adjusted for age, sex, race, education years, body mass index, and comorbidities. RESULTS Participants in the lowest tertile of PA complexity had over double the odds of MCI/dementia (odds ratio = 2.63, 95% confidence interval [CI]: 1.02 to 6.79, p = 0.045) compared to those in the highest tertile in the fully adjusted model. Structural equation modeling showed that PA complexity was associated with global cognitive function (standardized B [SB] = 0.102, 95% CI: 0.033 to 0.171, p = 0.004), executive function (SB = 0.119, 95% CI: 0.049 to 0.189, p = 0.001), and visuospatial ability (SB = 0.096, 95% CI: 0.026 to 0.167, p = 0.008). CLPMs showed bidirectional associations between lower PA complexity and poorer executive function. DISCUSSION Lower complexity of accelerometry‐detected movement is associated with poorer cognition and higher risk of MCI/dementia. Future studies should explore whether low PA complexity is an early indicator of dementia. Highlights Prior studies mainly focused on quantity or intensity of physical activity. Poorer cognitive function was associated with lower complexity of daily activity. Lower complexity of physical activity may be an early indicator of dementia.
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spelling doaj-art-5bcdbfd946234fe398e7201369eaf7bc2025-08-20T02:22:09ZengWileyAlzheimer’s & Dementia: Translational Research & Clinical Interventions2352-87372025-04-01112n/an/a10.1002/trc2.70077Physical activity complexity, cognition, and risk of cognitive impairment and dementia in the Baltimore Longitudinal Study of AgingYurun Cai0Junhong Zhou1Paul W. Scott2Qu Tian3Amal A. Wanigatunga4Lewis Lipsitz5Eleanor M. Simonsick6Susan M. Resnick7Luigi Ferrucci8Dianxu Ren9Jennifer H. Lingler10Jennifer A. Schrack11Department of Health and Community Systems University of Pittsburgh School of Nursing Pittsburgh Pennsylvania USAHinda and Arthur Marcus Institute for Aging Research Harvard Medical School Boston Massachusetts USADepartment of Health and Community Systems University of Pittsburgh School of Nursing Pittsburgh Pennsylvania USAIntramural Research Program National Institute on Aging Baltimore Maryland USADepartment of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USAHinda and Arthur Marcus Institute for Aging Research Harvard Medical School Boston Massachusetts USAIntramural Research Program National Institute on Aging Baltimore Maryland USAIntramural Research Program National Institute on Aging Baltimore Maryland USAIntramural Research Program National Institute on Aging Baltimore Maryland USADepartment of Health and Community Systems University of Pittsburgh School of Nursing Pittsburgh Pennsylvania USADepartment of Health and Community Systems University of Pittsburgh School of Nursing Pittsburgh Pennsylvania USADepartment of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USAAbstract INTRODUCTION Studies on physical activity (PA) and dementia mainly focus on activity quantity or intensity. Yet PA requires neuro‐coordination of movement, and it is unclear whether complexity of daily activity varies by cognitive status. Thus, we examined the association between PA complexity, using multiscale entropy, and cognitive function, mild cognitive impairment (MCI), and dementia in older adults in the Baltimore Longitudinal Study of Aging (BLSA). METHODS A total of 637 older adults (age 73.9 ± 11.3 years) in the BLSA completed a 7‐day wrist‐worn accelerometer assessment and neuropsychological tests from 2015 to 2020. Using logistic regression and structural equation modeling, we examined cross‐sectional associations of PA complexity with MCI/dementia and cognition. Cross‐lagged panel models (CLPMs) were used to assess bidirectional associations at baseline and 2‐year follow‐up. Multivariable models were adjusted for age, sex, race, education years, body mass index, and comorbidities. RESULTS Participants in the lowest tertile of PA complexity had over double the odds of MCI/dementia (odds ratio = 2.63, 95% confidence interval [CI]: 1.02 to 6.79, p = 0.045) compared to those in the highest tertile in the fully adjusted model. Structural equation modeling showed that PA complexity was associated with global cognitive function (standardized B [SB] = 0.102, 95% CI: 0.033 to 0.171, p = 0.004), executive function (SB = 0.119, 95% CI: 0.049 to 0.189, p = 0.001), and visuospatial ability (SB = 0.096, 95% CI: 0.026 to 0.167, p = 0.008). CLPMs showed bidirectional associations between lower PA complexity and poorer executive function. DISCUSSION Lower complexity of accelerometry‐detected movement is associated with poorer cognition and higher risk of MCI/dementia. Future studies should explore whether low PA complexity is an early indicator of dementia. Highlights Prior studies mainly focused on quantity or intensity of physical activity. Poorer cognitive function was associated with lower complexity of daily activity. Lower complexity of physical activity may be an early indicator of dementia.https://doi.org/10.1002/trc2.70077cognitive functioncognitive impairmentdementiaphysical activitystructural equation modeling
spellingShingle Yurun Cai
Junhong Zhou
Paul W. Scott
Qu Tian
Amal A. Wanigatunga
Lewis Lipsitz
Eleanor M. Simonsick
Susan M. Resnick
Luigi Ferrucci
Dianxu Ren
Jennifer H. Lingler
Jennifer A. Schrack
Physical activity complexity, cognition, and risk of cognitive impairment and dementia in the Baltimore Longitudinal Study of Aging
Alzheimer’s & Dementia: Translational Research & Clinical Interventions
cognitive function
cognitive impairment
dementia
physical activity
structural equation modeling
title Physical activity complexity, cognition, and risk of cognitive impairment and dementia in the Baltimore Longitudinal Study of Aging
title_full Physical activity complexity, cognition, and risk of cognitive impairment and dementia in the Baltimore Longitudinal Study of Aging
title_fullStr Physical activity complexity, cognition, and risk of cognitive impairment and dementia in the Baltimore Longitudinal Study of Aging
title_full_unstemmed Physical activity complexity, cognition, and risk of cognitive impairment and dementia in the Baltimore Longitudinal Study of Aging
title_short Physical activity complexity, cognition, and risk of cognitive impairment and dementia in the Baltimore Longitudinal Study of Aging
title_sort physical activity complexity cognition and risk of cognitive impairment and dementia in the baltimore longitudinal study of aging
topic cognitive function
cognitive impairment
dementia
physical activity
structural equation modeling
url https://doi.org/10.1002/trc2.70077
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