Department of Health, Human Function, and Rehabilitation Sciences, The George Washington University, Washington, District of Columbia.
Department of Neurology, Division of Cerebrovascular Diseases, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
J Geriatr Phys Ther. 2021;44(1):51-59. doi: 10.1519/JPT.0000000000000244.
Executive function in normal aging may be modulated by body habitus and adiposity, both factors modified by physical therapist prescriptions. This study measured between-day reliability of executive function metrics in young and older individuals and examined associations between cognition, adiposity, and physical activity.
Forty-three young and 24 older participants underwent executive function assessment via the National Institutes of Health Toolbox Cognition Battery (Dimensional Change Card Sort, Flanker Inhibitory Control and Attention [Flanker], and List Sorting Working Memory [List Sorting]) at 7-day intervals. Between-day reliability was assessed via intraclass correlation (ICC). Responsiveness was assessed via between-day effect size and Cohen's d. Forward stepwise linear regression examined associations between cognition and age, body mass index, percent body fat, and a self-report measure of physical activity (International Physical Activity Questionnaire Short Form).
Executive function scores were higher for young participants than for older participants (all P < .002), consistent with typical age-related cognitive decline. Reliability of cognitive metrics was higher for older participants (ICC = 0.483-0.917) than for young participants (ICC = 0.386-0.730). Between-day effect sizes were approximately 50% smaller for older participants. Percent body fat significantly correlated with the Flanker Unadjusted Scale (P = .004, R2 = 0.0772). Neither vigorous nor total physical activity correlated with any cognitive metric.
Older participants demonstrated greater between-day reliability for executive function measures, while young participants showed greater capacity to improve performance upon repeat exposure to a cognitive test (especially Flanker). Percent body fat correlated significantly with Flanker scores, while body mass index (an indirect measure of body fat) did not. Self-reported physical activity did not correlate with executive function. Cognitive response to physical therapist-prescribed exercise is a fertile ground for future research.
身体形态和肥胖会影响正常老化过程中的执行功能，这两个因素都可以通过物理治疗师的处方进行调整。本研究测量了年轻和老年个体执行功能指标的日内变异性，并探讨了认知、肥胖和身体活动之间的关联。
43 名年轻参与者和 24 名老年参与者在 7 天的间隔内接受了国家卫生研究院工具包认知电池（维度变化卡片分类、侧抑制控制和注意力[侧抑制]、列表排序工作记忆[列表排序]）的执行功能评估。通过组内相关系数（ICC）评估日内可靠性。通过日内效应大小和 Cohen's d 评估响应能力。向前逐步线性回归分析了认知与年龄、体重指数、体脂百分比以及身体活动自我报告测量值（国际体力活动问卷短表）之间的关联。
年轻参与者的执行功能得分高于老年参与者（均 P<.002），与典型的与年龄相关的认知下降一致。认知指标的可靠性在老年参与者中更高（ICC=0.483-0.917），而在年轻参与者中更低（ICC=0.386-0.730）。老年参与者的日内效应大小约小 50%。侧抑制未调整量表与体脂百分比显著相关（P=.004，R2=0.0772）。剧烈运动和总身体活动均与任何认知指标均无相关性。
老年参与者的执行功能测量日内可靠性更高，而年轻参与者在重复接触认知测试时表现出更大的提高表现的能力（尤其是侧抑制）。体脂百分比与侧抑制评分显著相关，而体重指数（体脂的间接测量值）则没有。自我报告的身体活动与执行功能无关。物理治疗师处方运动对认知的反应是未来研究的一个有前途的领域。
