Physical activity in adults with epilepsy: clinical aspects and relationship with cognition and quality of life

Tedrus, Glória Maria de Almeida Souza; Leandro-Merhi, Vania Aparecida

doi:10.1590/1980-5764-DN-2022-0107

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Dementia & Neuropsychologia

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Original Article • Dement. neuropsychol. 17 • 2023 • https://doi.org/10.1590/1980-5764-DN-2022-0107 copy

Physical activity in adults with epilepsy: clinical aspects and relationship with cognition and quality of life

Atividade física em pessoas adultas com epilepsia: aspectos clínicos e as relações com a cognição e a qualidade de vida

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

There are several factors associated with lower participation in regular physical activity (PA) in adult patients with epilepsy (PWEs).

Objective:

To assess the relationship between the regular practice of PA with clinical and cognitive variables and quality of life (QoL) in PWEs.

Methods:

Habitual Physical Activity Questionnaire (HPAQ) was related to clinical variables, scores on the Mini-Mental State Examination (MMSE), on the Brief Cognitive Battery-Edu (BCB-Edu), on the Satisfaction Scale for Physical Activity (SSPA), and on the Quality of Life in Epilepsy Inventory (QOLIE)-31 in 60 PWEs, with a significance level of p<0.05.

Results:

The PWEs had a mean age of 42.4±13.6 years, 50% of whom were female. Longer length of epilepsy correlated with lower PA in leisure time (Pearson correlation [r]= -0.276; p-value [p]=0.036). The occupational physical activity scores of the HPAQ correlated positively with perception (r=0.300; p=0.021), memory (r=0.381; p=0.003), semantic verbal fluency test (SVF) (r=0.427; p=0.001), and with the total score in the MMSE (r=0.327; p=0.012). The total HPAQ score correlated with the SVF (r=0.336; p=0.009) and with the MMSE (r=0.254; p=0.049). There was no correlation among the QOLIE–31, the HPAQ, and the SSPA.

Conclusions:

Longer duration of epilepsy was associated with the lower practice of PA. Physical activity was associated with better performance in aspects of cognition. There was no relationship between QoL and practice and satisfaction with PA, suggesting different psychosocial aspects involved.

Keywords:
Physical Exercise; Epilepsy; Cognition; Quality of Life

		PWEs (n=60)	CG (n=30)	p
Age, years (SD)		42.4 (±13.6)	40.3 (±10.5)	0.415^* * t test;
Sex: female/male		30/30	15/15	1.000^† † chi-square;
Educational level, years (SD)		7.1 (±4.0)	6.6 (±2.6)	0.486^* * t test;
Age of onset, years (SD)		19.5 (±13.9)
Length of epilepsy, years (SD)		22.9 (±14.7)
QOLIE-31, score total (SD)		68.8 (±17.4)
Seizure frequency in the past year	≥once/month; 1–11 times/year; <once/year	22/10/28
Seizure type	Focal/generalized	34/26
Number of ASMs	1/≥2	41/19
Epileptic syndrome: focal	Unknown etiology/structural	19/41
QOLIE-31, score total (SD)		68.8 (±17.4)
MMSE, score total (SD)		24.7 (±4.0)	25.1 (±2.3)	0.608^* * t test;
BCB-Edu, score (SD)	Naming	9.6 (±1.0)	9.9 (±0.1)	0.333^* * t test;
	Incidental memory	5.8 (±1.8)	6.2 (±1.4)	0.472^* * t test;
	Immediate memory	7.2 (±1.9)	7.5 (±1.9)	0.152^* * t test;
	Learning	7.7 (±1.9)	8.1 (±1.4)	0.012^* * t test; ^‡ ‡ p<0.05.
	Delay recall	6.7 (±2.1)	8.3 (±1.5)	<0.001^* * t test; ^‡ ‡ p<0.05.
	Recognition	7.9 (±2.1)	9.9 (±0.5)	0.038^* * t test; ^‡ ‡ p<0.05.
SVF, score (SD)		9.1 (±1.6)	14.0 (±3.9)	0.013^* * t test; ^‡ ‡ p<0.05.
Clock drawing test, score (SD)		5.6 (±2.8)	5.6 (±2.8)	0.427^* * t test;
HPAQ, score (SD)	Occupational PA	2.0 (±1.4)	3.3 (±0.4)	<0.001^* * t test; ^‡ ‡ p<0.05.
	PA in sport	1.7 (±1.2)	3.0 (±0.7)	0.003^* * t test; ^‡ ‡ p<0.05.
	PA in leisure time	1.7 (±1.1)	2.3 (±0.6)	0.075^* * t test;
	Total score	5.9 (±3.0)	8.9 (±1.4)	<0.001^* * t test; ^‡ ‡ p<0.05.
SSPA, score (SD)	The individual regularly walks	4.43 (±2.18)	5.0 (±1.5)	0.154^* * t test;
	PA with moderate and vigorous intensity	2.88 (±2.66)	4.53 (±1.67)	0.003^* * t test; ^‡ ‡ p<0.05.
	Total score	7.32 (±4.19)	9.53 (±2.76)	0.001^* * t test; ^‡ ‡ p<0.05.

		HPAQ
		Occupational	Sport	Leisure time	Score total
		r	r	r	r
Age		0.003	-0.179	-0.290^* * p<0.05;	-0.226
Educational level		0.097	0.291^* * p<0.05;	0.064	0.250
Age of onset		-0.032	0.118	-0.137	-0.024
Length of seizure disorder		0.800	-0.276^* * p<0.05;	-0.134	-0.185
SSPA	Walking	0.144	0.406^† † p<0.001.	0.115	0.334^† † p<0.001.
	Moderate and vigorous	0100	0.312^* * p<0.05;	0.100	0.278^* * p<0.05;
	Total score	0.138	0.410^† † p<0.001.	0.124	0.351^* * p<0.05;
MMSE		0.327^* * p<0.05;	0,131	-0.072	0.254^* * p<0.05;
Identification		0.300^* * p<0.05;	-0.026	-0.078	0.149
Naming		0.085	-0.108	0.138	0.057
Incidental memory		0.047	0.057	0.046	0.069
Immediate memory		0.381^† † p<0.001.	-0.100	0.001	0.188
Delayed recall		0.096	-0.082	0.064	0.065
Recognition		-0.058	0.073	0.123	0.067
SVF test		0.427^† † p<0.001.	0.108	0.029	0.336^† † p<0.001.
Clock drawing test		-0.021	0.081	0.113	0.095
QOLIE-31 (total score)		0.198	-0.081	0.116	0.136

		Variables in the equation	Beta coefficient	SE	t	p
HPAQ	Total score^* * R2= 118;	Semantic verbal fluency test	0.207	0.075	2.766	0.009
	Occupational^† † R2=427;	Semantic verbal fluency test	0.164	0.046	3.534	0.001
	Sport^‡ ‡ R2=262;	Duration of epilepsy	-0.021	0.010	-2.011	0.049
	Leisure time^§ § R2=282.	Age	-0.019	0.009	-2.179	0.034

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Correspondence: Gloria Maria de Almeida Souza Tedrus; Email: gmtedrus@uol.com.br.