TY - JOUR
T1 - Physical Activity as a Predictor of Cognitive Decline in an Elderly Essential Tremor Cohort
T2 - A Prospective, Longitudinal Study
AU - Radler, Keith H.
AU - Chapman, Silvia
AU - Zdrodowska, Maria Anna
AU - Dowd, Hollie N.
AU - Liu, Xinhua
AU - Huey, Edward D.
AU - Cosentino, Stephanie
AU - Louis, Elan D.
N1 - Funding Information:
This work was supported by the National Institutes of Health R01NS086736.
Publisher Copyright:
© Copyright © 2021 Radler, Chapman, Zdrodowska, Dowd, Liu, Huey, Cosentino and Louis.
PY - 2021/5/20
Y1 - 2021/5/20
N2 - Background: Essential tremor (ET), one of the most common neurological diseases, is associated with cognitive impairment. Surprisingly, predictors of cognitive decline in ET remain largely unidentified, as longitudinal studies are rare. In the general population, however, lower physical activity has been linked to cognitive decline. Objectives: To determine whether baseline physical activity level is a predictor of cognitive decline in ET. Methods: One hundred and twenty-seven ET cases (78.1 ± 9.5 years, range = 55–95), enrolled in a prospective, longitudinal study of cognition. At baseline, each completed the Physical Activity Scale for the Elderly (PASE), a validated, self-rated assessment of physical activity. Cases underwent an extensive battery of motor-free neuropsychological testing at baseline, 1.5 years, and 3 years, which incorporated assessments of cognitive subdomains. Generalized estimating equations (GEEs) were used to assess the predictive utility of baseline physical activity for cognitive change. Results: Mean follow-up was 2.9 ± 0.4 years (range = 1.3–3.5). In cross-sectional analyses using baseline data, lower physical activity was associated with lower overall cognitive function as well as lower cognitive scores in numerous cognitive domains (memory, language, executive function, visuospatial function and attention, all p < 0.05). In adjusted GEE models, lower baseline physical activity level significantly predicted overall cognitive decline over time (p=0.047), and declines in the subdomains of memory (p = 0.001) and executive function (p = 0.03). Conclusions: We identified reduced physical activity as a predictor of greater cognitive decline in ET. The identification of risk factors often assists clinicians in determining which patients are at higher risk of cognitive decline over time. Interventional studies, to determine whether increasing physical activity could modify the risk of developing cognitive decline in ET, may be warranted.
AB - Background: Essential tremor (ET), one of the most common neurological diseases, is associated with cognitive impairment. Surprisingly, predictors of cognitive decline in ET remain largely unidentified, as longitudinal studies are rare. In the general population, however, lower physical activity has been linked to cognitive decline. Objectives: To determine whether baseline physical activity level is a predictor of cognitive decline in ET. Methods: One hundred and twenty-seven ET cases (78.1 ± 9.5 years, range = 55–95), enrolled in a prospective, longitudinal study of cognition. At baseline, each completed the Physical Activity Scale for the Elderly (PASE), a validated, self-rated assessment of physical activity. Cases underwent an extensive battery of motor-free neuropsychological testing at baseline, 1.5 years, and 3 years, which incorporated assessments of cognitive subdomains. Generalized estimating equations (GEEs) were used to assess the predictive utility of baseline physical activity for cognitive change. Results: Mean follow-up was 2.9 ± 0.4 years (range = 1.3–3.5). In cross-sectional analyses using baseline data, lower physical activity was associated with lower overall cognitive function as well as lower cognitive scores in numerous cognitive domains (memory, language, executive function, visuospatial function and attention, all p < 0.05). In adjusted GEE models, lower baseline physical activity level significantly predicted overall cognitive decline over time (p=0.047), and declines in the subdomains of memory (p = 0.001) and executive function (p = 0.03). Conclusions: We identified reduced physical activity as a predictor of greater cognitive decline in ET. The identification of risk factors often assists clinicians in determining which patients are at higher risk of cognitive decline over time. Interventional studies, to determine whether increasing physical activity could modify the risk of developing cognitive decline in ET, may be warranted.
KW - cerebellar diseases
KW - cognitive aging
KW - essential tremor
KW - movement disorders
KW - physical activity
UR - http://www.scopus.com/inward/record.url?scp=85107226157&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107226157&partnerID=8YFLogxK
U2 - 10.3389/fneur.2021.658527
DO - 10.3389/fneur.2021.658527
M3 - Article
C2 - 34093407
AN - SCOPUS:85107226157
SN - 1664-2295
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 658527
ER -