Yang Chih-Hsiang, Hedeker Donald, Lee Jongwon, Prine Halle, Coffman Donna, Wei Jingkai, Hakun Jonathan George
Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
Department of Public Health Sciences, Biological Sciences Division, The University of Chicago, Chicago, Illinois, USA.
Innov Aging. 2025 Jun 27;9(6):igaf059. doi: 10.1093/geroni/igaf059. eCollection 2025.
BACKGROUND AND OBJECTIVES: Physical inactivity and excessive sedentary time (ST) are associated with poor cognitive health in older adults. However, current literature largely relies on cross-sectional designs or in-lab cognitive assessments, which do not adequately reflect cognitive function in naturalistic settings. Further, existing studies have largely overlooked the variability or the instability in daily cognitive function, which represents a critical marker of cognitive decline. This ambulatory assessment study examined the temporal associations of daily movement behaviors with the mean levels and the variability of cognition among older adults at risk of dementia. RESEARCH DESIGN AND METHODS: 96 older adults from the community (68.3 ± 7.1 years) participated in this 14-day study. They wore an accelerometer and completed smartphone-based cognitive tests up to 4 times per day. The cognitive tests assessed both performance-based and subjective cognition. The movement behaviors collected from the accelerometers include daily light-intensity physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and ST. Mixed-effects location-scale models were applied to estimate the within- and between-person associations of movement behaviors and cognitive outcomes in terms of the mean levels and the degree of variability. A total of 1,269 day-level observations were analyzed. RESULTS: Older adults' between-person levels of daily MVPA and steps were associated with better mean cognitive performance and lower variability across cognitive measures. Older adults' daily LPA was positively associated with subjective cognition in both mean levels and variability. The increases in within-person levels of ST were negatively associated with older adults' variability of all cognitive outcomes. DISCUSSION AND IMPLICATIONS: Study results suggest that moving more and sitting less in day-to-day life may sustain proximal cognitive health. Applying ambulatory assessments can advance aging research by examining the temporal dynamics between daily movement activities and within-person variability of cognition to inform strategies for promoting healthy aging in daily life.
背景与目的：身体活动不足和久坐时间过长与老年人认知健康状况不佳有关。然而，目前的文献主要依赖横断面设计或实验室认知评估，这些并不能充分反映自然环境中的认知功能。此外，现有研究很大程度上忽视了日常认知功能的变异性或不稳定性，而这是认知衰退的一个关键标志。这项动态评估研究考察了有患痴呆症风险的老年人日常运动行为与认知平均水平及变异性之间的时间关联。 研究设计与方法：96名来自社区的老年人（68.3±7.1岁）参与了这项为期14天的研究。他们佩戴加速度计，并每天最多完成4次基于智能手机的认知测试。认知测试评估了基于表现的认知和主观认知。从加速度计收集的运动行为包括日常轻度身体活动（LPA）、中度至剧烈身体活动（MVPA）和久坐时间（ST）。应用混合效应位置尺度模型来估计运动行为与认知结果在平均水平和变异程度方面个体内部和个体之间的关联。总共分析了1269个日水平观测值。 结果：老年人个体之间的每日MVPA水平和步数与更好的平均认知表现以及认知测量指标的较低变异性相关。老年人的每日LPA在平均水平和变异性方面均与主观认知呈正相关。个体内部ST水平的增加与老年人所有认知结果的变异性呈负相关。 讨论与启示：研究结果表明，在日常生活中多活动、少久坐可能有助于维持近期认知健康。应用动态评估可以通过研究日常运动活动与个体内部认知变异性之间的时间动态关系来推进衰老研究，从而为促进日常生活中的健康衰老提供策略。
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