Association Between Physical Fitness and Cognitive Function Among Community-Dwelling Older Adults With Different Exercise Risks in Taiwan

Physical fitness training can improve cognition in older adults. Chronic diseases are commonly prevalent in older adults. However, evidence of the impact of chronic diseases on the association of physical fitness and cognition remains insufficient for older adults. Prior to community-based health promotion programs, pre-participation health screening is an essential and recommended procedure for both safety and benefits. The risk stratification of exercise participation can illustrate the health conditions for each participant. This study aimed to investigate the major physical fitness factors related to cognitive function in older adults with different exercise risks. This cross-sectional study was a secondary analysis of baseline data from the Project of Taipei Advanced Center for Aging and Health by the Taipei City Government. According to the American College of Sports Medicine guidelines, the high-risk group (HG) for exercise participation were participants with a history and symptoms of cardiovascular, metabolic, or renal disease, otherwise were classified as non-high-risk group (NHG). Cognitive function was assessed by Montreal Cognitive Assessment-Taiwan version. A cutoff point of 26 was used to categorize participants in either the high or low cognitive function group. The Senior Fitness Test was used to measure physical fitness. Sociodemographic data were extracted as cofactors. A total of 214 subjects were included, among which, 56.6% were HG. Results showed that among community-dwelling older adults, the adjusted odds ratio of physical fitness in muscle strength and balance control were significantly related to cognitive function. After stratification of exercise risk, timed up-and-go, single leg standing, and grip strength were found to have a significant association with cognitive function in the HG; whereas arm curls, repeated chair stands, timed up-and-go, and grip strength were found to have a significant association with cognitive function in the NHG. We conclude that the exercise risk may impact the association of physical fitness and cognitive function among community-dwelling older adults. The grip strength and timed up-and-go may be the major fitness factors related to cognitive function. But there is some disparity of physical fitness related to cognition of older adults with different exercise risks. That may highlight the fitness program for older adults with different health conditions should be considered.

關鍵字

chronic disease ； Montreal Cognitive Assessment ； muscle strength ； balance ； grip strength

並列摘要

體適能訓練可提高長者認知表現，而多數長者都有慢性病，慢性病對體適能與認知之相關性的影響仍缺乏足夠證據。長者在參與社區運動健康促進前，為了安全及效益，事前健康篩檢是建議的必要程序，且會依參與者的健康狀態加以運動參與風險分層。本研究旨在探討不同運動風險的長者與認知相關之主要體適能因子。以臺北市高齡健康前瞻中心計畫資料檔進行橫斷式次級資料分析，根據美國運動醫學會指南，運動參與高風險組為有心血管、代謝或腎臟疾病病史和症狀者，若無者則為非高風險組。認知功能採用臺灣版蒙特利爾認知評估，以切點26分作為認知高低分組依據；長者體適能則使用「銀髮族體適能」進行評估，並擷取社會人口學資料納入分析。共214名參與者，其中56.6%為高風險組。分析結果顯示：社區長者的肌力及平衡等體適能，經調控下與認知有顯著相關性。運動風險分層後，動靜態平衡及握力與認知在高風險組達顯著相關；上下肢肌力、握力及動態平衡與認知在非高風險組具顯著相關。本研究結論認為運動風險分層會影響長者體適能與認知之相關性，握力及起身往返走的敏捷動態平衡力可能是與社區長者認知相關的主要體適能因子，而在不同運動風險或健康狀態的社區長者與其認知相關的不同體適能特性，也可納入運動計畫的參考。

並列關鍵字

慢性病；蒙特利爾認知評估；肌力；平衡；握力

參考文獻

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