Legdeur Nienke, Badissi Maryam, Venkatraghavan Vikram, Woodworth Davis C, Orlhac Fanny, Vidal Jean-Sébastien, Barkhof Frederik, Kawas Claudia H, Visser Pieter Jelle, Corrada María M, Muller Majon, Rhodius-Meester Hanneke F M
Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.
Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands.
Gerontology. 2025;71(1):13-27. doi: 10.1159/000542395. Epub 2024 Nov 6.
Physical function and cognition seem to be interrelated, especially in the oldest-old. However, the temporal order in which they are related and the role of brain health remain uncertain.
We included 338 participants (mean age 93.1 years) from two longitudinal cohorts: the UCI 90+ Study and EMIF-AD 90+ Study. We tested the association between physical function (Short Physical Performance Battery, gait speed, and handgrip strength) at baseline with cognitive decline (MMSE, memory tests, animal fluency, Trail Making Test (TMT-) A, and digit span backward) and the association between cognition at baseline with physical decline (mean follow-up 3.3 years). We also tested whether measures for brain health (hippocampal, white matter lesion, and gray matter volume) were related to physical function and cognition and whether brain health was a common driver of the association between physical function and cognition by adding it as confounder (if applicable).
Better performance on all physical tests at baseline was associated with less decline on MMSE, memory, and TMT-A. Conversely, fewer associations were significant, but better scores on memory, TMT-A, and digit span backward were associated with less physical decline. When adding measures for brain health as confounder, all associations stayed significant except for memory with gait speed decline.
In the oldest-old, physical function and cognition are strongly related, independently of brain health. Also, the association between physical function and cognitive decline is more pronounced than the other way around, suggesting a potential for slowing cognitive decline by optimizing physical function.
Physical function and cognition seem to be interrelated, especially in the oldest-old. However, the temporal order in which they are related and the role of brain health remain uncertain.
We included 338 participants (mean age 93.1 years) from two longitudinal cohorts: the UCI 90+ Study and EMIF-AD 90+ Study. We tested the association between physical function (Short Physical Performance Battery, gait speed, and handgrip strength) at baseline with cognitive decline (MMSE, memory tests, animal fluency, Trail Making Test (TMT-) A, and digit span backward) and the association between cognition at baseline with physical decline (mean follow-up 3.3 years). We also tested whether measures for brain health (hippocampal, white matter lesion, and gray matter volume) were related to physical function and cognition and whether brain health was a common driver of the association between physical function and cognition by adding it as confounder (if applicable).
Better performance on all physical tests at baseline was associated with less decline on MMSE, memory, and TMT-A. Conversely, fewer associations were significant, but better scores on memory, TMT-A, and digit span backward were associated with less physical decline. When adding measures for brain health as confounder, all associations stayed significant except for memory with gait speed decline.
In the oldest-old, physical function and cognition are strongly related, independently of brain health. Also, the association between physical function and cognitive decline is more pronounced than the other way around, suggesting a potential for slowing cognitive decline by optimizing physical function.
身体功能与认知似乎相互关联，在高龄老人中尤为如此。然而，它们之间关联的时间顺序以及脑健康的作用仍不明确。
我们纳入了来自两个纵向队列的338名参与者（平均年龄93.1岁）：加州大学欧文分校90岁以上研究和欧洲医学影像与认知研究联盟-阿尔茨海默病90岁以上研究。我们测试了基线时身体功能（简短身体表现量表、步速和握力）与认知衰退（简易精神状态检查表、记忆测试、动物流畅性测试、连线测验A和倒背数字广度）之间的关联，以及基线时认知与身体衰退之间的关联（平均随访3.3年）。我们还测试了脑健康指标（海马体、白质病变和灰质体积）是否与身体功能和认知相关，以及通过将脑健康作为混杂因素纳入（如适用），脑健康是否是身体功能与认知之间关联的共同驱动因素。
基线时所有身体测试表现较好与简易精神状态检查表、记忆和连线测验A的衰退较少相关。相反，显著的关联较少，但记忆、连线测验A和倒背数字广度得分较高与身体衰退较少相关。当将脑健康指标作为混杂因素纳入时，除了记忆与步速下降之间的关联外，所有关联仍然显著。
在高龄老人中，身体功能与认知密切相关，与脑健康无关。此外，身体功能与认知衰退之间的关联比相反方向的关联更为明显，这表明通过优化身体功能有可能减缓认知衰退。
身体功能与认知似乎相互关联，在高龄老人中尤为如此。然而，它们之间关联的时间顺序以及脑健康的作用仍不明确。
我们纳入了来自两个纵向队列的338名参与者（平均年龄93.1岁）：加州大学欧文分校90岁以上研究和欧洲医学影像与认知研究联盟-阿尔茨海默病90岁以上研究。我们测试了基线时身体功能（简短身体表现量表、步速和握力）与认知衰退（简易精神状态检查表、记忆测试、动物流畅性测试、连线测验A和倒背数字广度）之间的关联，以及基线时认知与身体衰退之间的关联（平均随访3.3年）。我们还测试了脑健康指标（海马体、白质病变和灰质体积）是否与身体功能和认知相关，以及通过将脑健康作为混杂因素纳入（如适用），脑健康是否是身体功能与认知之间关联的共同驱动因素。
基线时所有身体测试表现较好与简易精神状态检查表、记忆和连线测验A的衰退较少相关。相反，显著的关联较少，但记忆、连线测验A和倒背数字广度得分较高与身体衰退较少相关。当将脑健康指标作为混杂因素纳入时，除了记忆与步速下降之间的关联外，所有关联仍然显著。
在高龄老人中，身体功能与认知密切相关，与脑健康无关。此外，身体功能与认知衰退之间的关联比相反方向的关联更为明显，这表明通过优化身体功能有可能减缓认知衰退。
