UK Society for Behavioural Medicine 9 th Annual Scientific Meeting

Transcription

1 UK Society for Behavioural Medicine 9 th Annual Scientific Meeting Behavioural Medicine: From Laboratory to Policy University of Oxford Examination Schools Monday 9 and Tuesday 10 December 2013 NPRI

2 UK Society for Behavioural Medicine 9 th Annual Scientific Meeting Behavioural Medicine: From Laboratory to Policy Parallel Session D Ageing and emotional wellbeing Chaired by Pauline Adair NPRI

3 UK Society for Behavioural Medicine 9 th Annual Scientific Meeting Behavioural Medicine: From Laboratory to Policy A reciprocal relationship between physical activity and executive function in older adults Julia Allan NPRI

4 A Reciprocal Relationship between Physical Activity and Executive Function in Older Adults Julia Allan, David McMinn & Michael Daly

5 Ageing Population Age associated with declines in physical and cognitive function Maintaining intact cognitive function; Longer working lives Active retirement Improved health/qol Delayed onset of Alzheimers Cognitive function benefits from a healthy lifestyle, and particularly from physical activity (Ku et al, 2012, Plassman et al, 2010, Netz et al, 2011, Kemoun et al, 2010; Barber et al, 2011; Fratiglioni, Paillard-Borg, Winblad, 2004; Hertzog, Kramer, Wilson, & Lindenberger, 2009).

6 Higher Level Cognitive Function Executive Functions Attention, inhibition Cognitive control and flexibility Planning Problem solving Decision making. those capacities that enable a person to engage successfully in independent, purposive, self-serving behaviour (p42, Lezak, 1995)

7 Executive Function & Physical Activity Physical Activity linked to; Childhood cog function predicts later activity(gow et al, 2012) Physical Robust activity improvement requires in individuals cog function, to overcome particularly short EF (Colcombe term & Kramer, 2003; meta-analysis 18interventions) costs (e.g. inconvenience, discomfort) for long term gain, i.e. Modest will require but consistent EF (Hall & improvement Fong, 2003) in EF (Smith et al, 2010; metaanalysis, 29 RCTs) Individuals with weak EF less likely to; Attenuated decline in EF over time (Barnes, Yaffe, Satariano, & Tager, Act on physical activity intentions (Hall, Fong, Epp & Elias, 2008, Hall, Elias, 2003; Fong, Singh-Manoux, Harrison, Borowsky Hillsdon, & Brunner, Sarty, 2008) & Marmot, 2005; Weuve, Hee Kang, Manson, Breteler, Ware, & Grodstein, 2004) Adhere to regular exercise regimes (McAuley et al, 2011)

8 Aim To investigate whether there is a bidirectional relationship between executive function and physical activity

9 Sample/Data Large multi-wave longitudinal study of health and QoL in adults aged 50+ living in England Current data from 5 waves (2002/04/06/08/10) 49,716 observations from 16,082 participants collected over 10 years

10 Measures I: Executive Function Verbal fluency task (semantic category) Flexible, goal directed searching of memory, error monitoring and inhibition Letter cancellation task Selective/sustained attention, visual search, processing speed EF index=summed z-scores from each task to create composite and then standardised

11 Measures II: Physical Activity Self-reported frequency of mild, moderate and vigorous sports and activities 1= hardly ever or never 2=one to three times per month 3=once a week 4= more than once a week Responses summed to create composite measure reflecting total activity and standardised (high scores = high level of activity)

12 Measures III: Co-variates Age in years Sex Highest educational qualification (1= no qualifications to 7= degree) Self rated health (1=very bad to 5=very good) Long standing illness (present / not present)

13 Analysis: Approach Multi-level random coefficient analyses Participant EF/PA 2002 EF/PA 2004 EF/PA 2006 EF/PA 2008 EF/PA 2010 ML approach particularly appropriate as; -the number of observations differs between people -allows examination of repeated measures within participants

14 Research Questions 1) Is there a cross-sectional association between PA and EF across the five waves examined after controlling for age, self-rated health, and presence of long-standing illness at each wave, and stable characteristics sex and education? 2) How do changes in physical activity relate to changes in executive function (fixed effects analysis). Analysis tests whether within-person variation in physical activity predicts within-person variation in executive functioning over time. 3) Does PA in a given wave predict EF in the subsequent wave after adjusting for the participant s executive functioning score and age at baseline and gender, education, and health? 4) Does EF at baseline predict longitudinal change in PA

15 Results

16 Sample Characteristics

17 Results Q1 Is there a cross-sectional association between PA / EF? Yes: higher levels of physical activity associated with better executive functioning 1SD increase in PA = a.085 SD increase in EF

18 Results Q2 Do within-person changes in physical activity relate to changes in executive function? Yes: within-person changes in executive function were associated with within-person changes in physical activity levels 1SD increase in PA associated with 0.04SD increase in EF

19 Results Q3/4 Does PA predict EF or does EF predict PA? Both: High PA was linked to an increase in EF over time and high EF predicted longitudinal increases in PA

20 Discussion In more than 16,000 older adults; Robust association between EF and PA (r=.27) after controlling for demographics / health Changes in EF associated with changes in PA within people Dynamic, bidirectional relationship between EF and PA

21 Discussion -Extends evidence that PA can counteract age related declines in EF (Agrigoroaei and Lachman, 2011; Weinstein et al., 2012) -Relationship is strongest in the direction EF to PA: in line with the idea that EF is required to enact effortful health behaviours (Temporal Self Regulation Theory; Hall & Fong, 2007) -Bidirectionality is encouraging as both PA and EF amenable to intervention and benefits may be reciprocal

22 Conclusion There is a dynamic, mutually enhancing relationship between executive function and physical activity over time. To maximise potential benefit, interventions should target both concurrently

23 Thank You

24 Extra Slides

25 Question1 (Model 1) Is there a cross-sectional association between PA and EF (i) across the five waves examined (t) after controlling for age, self-rated health, and presence of long-standing illness at each wave, and stable characteristics sex and education?

26 Question 2 (Model 2) How do changes in physical activity relate to changes in executive function (fixed effects analysis). Analysis tests whether within-person variation in physical activity predicts withinperson variation in executive functioning over time.

27 Question 3 (Model 3) Does PA in a given wave (t) predict EF in the subsequent wave (t + 1) after adjusting for the participant s executive functioning score and age at baseline (t) and gender, education, and health?

28 Question 4 (Model 4) Does EF at baseline (t) predict longitudinal change in PA (from t to t+1)

29 NPRI UK Society for Behavioural Medicine 9 th Annual Scientific Meeting Behavioural Medicine: From Laboratory to Policy