Court Tatyana, Čapková Naděžda, Pająk Andrzej, Pikhart Hynek, Bobák Martin
RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.
National Institute of Public Health, Prague, Czech Republic.
Eur J Neurol. 2025 Sep;32(9):e70325. doi: 10.1111/ene.70325.
Evidence on the relationship between physical and cognitive functions remains inconsistent, and the role of sex differences is underexplored. This study examines the predictive value of a composite Physical Functioning Score (PFS) for cognitive function and assesses sex-specific associations in an Eastern European population.
Data from 7309 participants (mean age 59 ± 7.3 years) from the Czech Republic and Poland arms of the HAPIEE study were analyzed. PFS was derived from a 23-item measure including activity of daily living (ADL/IADL), grip strength, functional limitations, and physical activity. Cognitive function was assessed using standardized tests of memory, verbal fluency, and speed/concentration. Logistic regression, adjusted for demographic, lifestyle, and health factors, was used to examine the association between PFS and cognitive status. Model performance was evaluated using AUC-ROC and cross-validation.
PFS exhibited a dose-dependent association with cognitive impairment (adjusted odds ratios: 1.15 for moderate, 1.79 for low PFS, compared with higher PFS). PFS demonstrated robust predictive ability for cognition (AUC = 0.75). Sex differences were significant: women with moderate PFS had a 44% higher risk of cognitive impairment (OR: 1.44, 95% CI: 1.15-1.79), while those with low PFS had double the risk (OR: 2.28, 95% CI: 1.69-3.08). Associations were weaker in men, even at very low PFS (OR: 1.32, 95% CI: 0.91-1.92).
PFS is a practical tool for predicting cognitive decline, with stronger associations in women. Interventions to improve PF may preserve cognitive health, particularly in older women. Longitudinal studies are needed to confirm these findings.
关于身体功能与认知功能之间关系的证据仍然不一致，且性别差异的作用尚未得到充分研究。本研究考察了综合身体功能评分（PFS）对认知功能的预测价值，并评估了东欧人群中特定性别的关联。
分析了来自HAPIEE研究捷克和波兰部分的7309名参与者（平均年龄59±7.3岁）的数据。PFS源自一项包含23个条目的测量，包括日常生活活动（ADL/IADL）、握力、功能受限和身体活动。使用记忆、语言流畅性和速度/注意力的标准化测试评估认知功能。采用经人口统计学、生活方式和健康因素调整的逻辑回归来考察PFS与认知状态之间的关联。使用AUC-ROC和交叉验证评估模型性能。
PFS与认知障碍呈剂量依赖性关联（调整后的优势比：中度PFS为1.15，低PFS为1.79，与高PFS相比）。PFS对认知具有强大的预测能力（AUC = 0.75）。性别差异显著：中度PFS的女性认知障碍风险高44%（OR：1.44，95% CI：1.15 - 1.79），而低PFS的女性风险翻倍（OR：2.28，95% CI：1.69 - 3.08）。男性的关联较弱，即使在PFS非常低时也是如此（OR：1.32，95% CI：0.91 - 1.92）。
PFS是预测认知衰退的实用工具，在女性中关联更强。改善身体功能的干预措施可能有助于保持认知健康，尤其是在老年女性中。需要进行纵向研究来证实这些发现。
