David Shari, Hohenfeld Christian, Haberl Luisa, Pahl Jennifer, Costa Ana S, Kilders Axel, Hildebrand Frank, Schulz Jörg B, Reetz Kathrin, Haeger Alexa
Department of Neurology, RWTH Aachen University, Aachen, Germany.
Institute of Neuroscience and Medicine (INM-11), Forschungszentrum Jülich GmbH, Jülich, Germany.
Front Neurol. 2023 Sep 22;14:1195694. doi: 10.3389/fneur.2023.1195694. eCollection 2023.
Assessment methods for physical activity and fitness are of upmost importance due to the possible beneficial effect of physical conditioning on neurodegenerative diseases. The implementation of these methods can be challenging when examining elderly or cognitively impaired participants. In the presented study, we compared three different assessment methods for physical activity from the Dementia-MOVE trial, a 6-months intervention study on physical activity in Alzheimer's disease. The aim was to determine the comparability of physical activity assessments in elderly participants with cognitive impairment due to Alzheimer's disease.
38 participants (mean age 70 ± 7 years) with early-stage Alzheimer's disease (mean MoCA 18.84 ± 4.87) were assessed with (1) fitness trackers for an average of 12 (± 6) days, (2) a written diary on daily activities and (3) a questionnaire on physical activity at three intervention timepoints. For comparison purposes, we present a transformation and harmonization method of the physical assessment output parameters: Metabolic equivalent of task (MET) scores, activity intensity minutes, calorie expenditure and moderate-to-vigorous physical activity (MVPA) scores were derived from all three modalities. The resulting parameters were compared for absolute differences, correlation, and their influence by possible mediating factors such as cognitive state and markers from cerebrospinal fluid.
Participants showed high acceptance and compliance to all three assessment methods. MET scores and MVPA from fitness trackers and diaries showed high overlap, whilst results from the questionnaire suggest that participants tended to overestimate their physical activity in the long-term retrospective assessment. All activity parameters were independent of the tested Alzheimer's disease parameters, showing that not only fitness trackers, but also diaries can be successfully applied for physical activity assessment in a sample affected by early-stage Alzheimer's disease.
Our results show that fitness trackers and physical activity diaries have the highest robustness, leading to a highly comparable estimation of physical activity in people with Alzheimer's disease. As assessed parameters, it is recommendable to focus on MET, MVPA and on accelerometric sensor data such as step count, and less on activity calories and different activity intensities which are dependent on different variables and point to a lower reliability.
由于体能锻炼对神经退行性疾病可能具有有益作用，身体活动和体能的评估方法至关重要。在对老年人或认知受损参与者进行检查时，实施这些方法可能具有挑战性。在本研究中，我们比较了痴呆症 - 运动试验中三种不同的身体活动评估方法，该试验是一项针对阿尔茨海默病患者身体活动的为期6个月的干预研究。目的是确定在患有因阿尔茨海默病导致认知障碍的老年参与者中身体活动评估的可比性。
对38名患有早期阿尔茨海默病（平均蒙特利尔认知评估量表[MoCA]为18.84±4.87）的参与者（平均年龄70±7岁）在三个干预时间点进行了如下评估：（1）使用健身追踪器平均12（±6）天；（2）记录日常活动的书面日记；（3）一份关于身体活动的问卷。为了进行比较，我们提出了一种身体评估输出参数的转换和协调方法：从所有三种方式中得出任务代谢当量（MET）得分、活动强度分钟数、卡路里消耗以及中等到剧烈身体活动（MVPA）得分。对所得参数进行绝对差异、相关性以及可能的中介因素（如认知状态和脑脊液标志物）影响方面的比较。
参与者对所有三种评估方法都表现出高度接受和依从性。健身追踪器和日记得出的MET得分和MVPA显示出高度重叠，而问卷结果表明参与者在长期回顾性评估中往往高估自己的身体活动。所有活动参数均独立于所测试的阿尔茨海默病参数，这表明不仅健身追踪器，日记也可成功应用于对受早期阿尔茨海默病影响的样本进行身体活动评估。
我们的结果表明，健身追踪器和身体活动日记具有最高的稳健性，能够对阿尔茨海默病患者的身体活动进行高度可比的估计。作为评估参数，建议关注MET、MVPA以及加速度传感器数据（如步数），而较少关注依赖不同变量且可靠性较低的活动卡路里和不同活动强度。
