Wei Yi-Chia, Hsu Chih-Chin Heather, Huang Wen-Yi, Chen Yao-Liang, Lin Chemin, Chen Chih-Ken, Lin Chen, Shyu Yu-Chiau, Lin Ching-Po
Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
Front Aging Neurosci. 2021 Aug 2;13:700764. doi: 10.3389/fnagi.2021.700764. eCollection 2021.
Although previous studies postulated that physical and cognitive decline codeveloped in preclinical dementia, the interconnected relationship among subjective cognitive complaints (SCCs), objective cognitive performance, and physical activity remained hazy. We investigated the mediating roles of physical activity between subjective and objective cognition. Diffusion tensor imaging (DTI) was utilized to test our hypothesis that brain white matter microstructural changes underlie the physical-cognitive decline in subjective cognitive decline (SCD). We enrolled cognitively normal older adults aged > 50 years in the Community Medicine Research Center of Keelung Chang Gung Memorial Hospital during 2017-2020. Regression models analyzed mediation effects of physical activity between subjective and objective cognition. The self-reported AD8 questionnaire assessed SCCs. The SCD group, defined by AD8 score ≥ 2, further underwent diffusion MRI scans. Those who agreed to record actigraphy also wore the SOMNOwatch™ for 72 h. Spearman's correlation coefficients evaluated the associations of diffusion indices with physical activity and cognitive performance. In 95 cognitively normal older adults, the AD8 score and the Montreal Cognitive Assessment (MoCA) score were mediated partially by the metabolic equivalent of the International Physical Activity Questionnaire-Short Form (IPAQ-SF MET) and fully by the sarcopenia score SARC-F. That is, the relation between SCCs and poorer cognitive performance was mediated by physical inactivity. The DTI analysis of 31 SCD participants found that the MoCA score correlated with mean diffusivity at bilateral inferior cerebellar peduncles and the pyramids segment of right corticospinal tract [ < 0.05, false discovery rate (FDR) corrected]. The IPAQ-SF MET was associated with fractional anisotropy (FA) at the right posterior corona radiata (PCR) ( < 0.05, FDR corrected). In 15 SCD participants who completed actigraphy recording, the patterns of physical activity in terms of intradaily variability and interdaily stability highly correlated with FA of bilateral PCR and left superior corona radiata ( < 0.05, FDR corrected). This study addressed the role of physical activity in preclinical dementia. Physical inactivity mediated the relation between higher SCCs and poorer cognitive performance. The degeneration of specific white matter tracts underlay the co-development process of physical-cognitive decline in SCD.
尽管先前的研究推测身体和认知功能衰退在临床前痴呆中共同发展，但主观认知主诉（SCCs）、客观认知表现和身体活动之间的相互联系仍不明确。我们研究了身体活动在主观和客观认知之间的中介作用。利用扩散张量成像（DTI）来检验我们的假设，即脑白质微观结构变化是主观认知衰退（SCD）中身体 - 认知衰退的基础。2017 - 2020年期间，我们在基隆长庚纪念医院社区医学研究中心招募了年龄大于50岁的认知正常的老年人。回归模型分析了身体活动在主观和客观认知之间的中介作用。通过自我报告的AD8问卷评估SCCs。AD8评分≥2定义的SCD组进一步接受扩散磁共振成像扫描。那些同意记录活动记录仪数据的人还佩戴了SOMNOwatch™ 72小时。Spearman相关系数评估扩散指数与身体活动和认知表现的关联。在95名认知正常的老年人中，AD8评分与蒙特利尔认知评估（MoCA）评分部分由国际体力活动问卷简表（IPAQ - SF MET）的代谢当量介导，完全由肌肉减少症评分SARC - F介导。也就是说，SCCs与较差认知表现之间的关系由身体活动不足介导。对31名SCD参与者的DTI分析发现，MoCA评分与双侧小脑下脚和右侧皮质脊髓束锥体段的平均扩散率相关[<0.05，错误发现率（FDR）校正]。IPAQ - SF MET与右侧后放射冠（PCR）的分数各向异性（FA）相关（<0.05，FDR校正）。在15名完成活动记录仪记录的SCD参与者中，日内变异性和日间稳定性方面的身体活动模式与双侧PCR和左侧上放射冠的FA高度相关（<0.05，FDR校正）。本研究探讨了身体活动在临床前痴呆中的作用。身体活动不足介导了较高的SCCs与较差认知表现之间的关系。特定白质束的退化是SCD中身体 - 认知衰退共同发展过程的基础。
