Cognitive performance and engagement in physical, social and intellectual activities in older adults: The FIBRA study

Sposito, Giovana; Neri, Anita Liberalesso; Yassuda, Mônica Sanches

doi:10.1590/1980-57642015DN93000010

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Brasil

Dementia & Neuropsychologia

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Original Articles • Dement. neuropsychol. 9 (3) • Jul-Sep 2015 • https://doi.org/10.1590/1980-57642015DN93000010 copy

Cognitive performance and engagement in physical, social and intellectual activities in older adults: The FIBRA study

DESEMPENHO COGNITIVO E ENVOLVIMENTO EM ATIVIDADES FÍSICAS, SOCIAIS E INTELECTUAIS EM IDOSOS: ESTUDO FIBRA

Authorship SCIMAGO INSTITUTIONS RANKINGS

Cognitive decline in aging can negatively impact quality of life in the elderly. However, studies have shown that elderly engaged in advanced activities of daily living (AADLs) can maintain or enhance global cognitive function or specific domains.

Objective:

To investigate the relationship between engagement in AADLs and domains of cognition in elderly from seven different locations in Brazil.

Methods:

A cross-sectional study involving 2,549 elderly without cognitive deficits suggestive of dementia was conducted. Data were collected on sociodemographic characteristics, health status, the Mini-Mental State Exam (MMSE) by subdomain (orientation, memory, attention/calculus, language and constructional praxis), and engagement in AADL grouped under physical, social and intellectual activities.

Results:

Multivariate linear regression analysis revealed an association, albeit modest, between intellectual AADLs and the domains orientation, attention/calculus, language and constructional praxis (R²=0.005, 0.008, 0.021, and 0.021 respectively). Social AADLs were correlated with memory (R²=0.002) and language (R²=0.004) domains. No association was found between physical AADLs and MMSE domains. Schooling and family income were the sociodemographic variables exhibiting the strongest relationship with cognitive domains.

Conclusion:

The study found associations between intellectual and social AADLs with higher cognitive performance, suggesting that active aging can provide opportunities to attenuate cognitive decline in aging.

activities of daily living; social participation; motor activity; cognition; elderly

Characteristics	n	Mean (±SD)	Minimum	Maximum
Gender	2549
Women (%)	1675 (65.71)
Age	2549	72.32 (5.55)	65.00	96.00
Years of schooling	2547	4.37 (3.99)	0.00	27.00
Family Income (MW)	2202	3.97 (4.92)	0.00	72.00
Number of diseases	2549	2.02 (1.33)	0.00	7.00
GDS	2542	3.53 (2.68)	0.00	15.00
< 6 (%)	2022 (79.54)
Total AADLs	2549	11.67 (4.03)	1.00	27.00
Physical AADLs	2549	3.94 (2.15)	0.00	14.00
Social AADLs	2549	5.53 (2.21)	0.00	12.00
Intellectual AADLs	2549	2.19 (1.04)	0,00	6.00
Total MMSE	2549	24.98 (3.08)	17.00	30.00
MMSE Orientation	2549	9.47 (0.86)	4.00	10.00
MMSE Memory	2549	4.84 (0.98)	0.00	6,00
MMSE Atten/Calc	2549	2.83 (1.74)	0.00	5.00
MMSE Language	2549	7.25 (0.96)	4.00	8.00
MMSE Praxis	2549	0.58 (0.49)	0.00	1.00

		MMSE Orientation		MMSE Memory		MMSE Attention/Calc		MMSE Language		MMSE Praxis
		Mean (±SD)	p-value	Mean (±SD)	p-value	Mean (±SD)	p-value	Mean (±SD)	p-value	Mean (±SD)	p-value
Gender			0.430		<0.001		<0.001		<0.001		<0.001
	Female	9.47 (0.85)		4.89 (0.95)		2.48 (1.75)		7.30 (0.94)		0.60 (0.49)
	Male	9.48 (0.86)		4.74 (1.02)		3.49 (1.52)		7.15 (0.99)		0.53 (0.50)
Age (years)			<0.001^*		<0.001^**		0.419		<0.001***		<0.001^****
	65-69	9.58 (0.74)		5.01 (0.89)		2.88 (1.74)		7.34 (0.92)		0.61 (0.49)
	70-74	9.50 (0.86)		4.84 (0.96)		2.85 (1.72)		7.23 (0.97)		0.61 (0.49)
	75-79	9.34 (0.97)		4.71 (1.05)		2.78 (1.80)		7.19 (0.99)		0.51 (0.50)
	≥80	9.28 (0.95)		4.54 (1.06)		2.70 (1.72)		7.11 (0.98)		0.49 (0.50)
Years of schooling			<0.001⁺		<0.001⁺⁺		<0.001⁺⁺⁺		<0.001⁺⁺⁺		<0.001⁺⁺⁺
	0	8.80 (1.18)		4.62 (1.14)		1.36 (0.91)		6.08 (0.91)		0.21 (0.41)
	1-4	9.58 (0.71)		4.83 (0.96)		2.79 (1.62)		7.39 (0.80)		0.60 (0.49)
	5-8	9.67 (0.61)		4.96 (0.87)		3.51 (1.38)		7.69 (0.54)		0.70 (0.46)
	≥9	9.81 (0.45)		5.05 (0.85)		4.29 (0.94)		7.88 (0.34)		0.87 (0.34)
Family Income (MW)			<0.001^§		0.537		<0.001^§§		<0.001^§§§		<0.001^§§§§
	<1.0	9.17 (1.05)		4.77 (1.10)		2.14 (1.72)		6.93 (1.05)		0.47 (0.50)
	1.1-3.0	9.37 (0.94)		4.82 (1.00)		2.47 (1.75)		7.05 }(1.02)		0.49 (0.50)
	3.1-5.0	9.61 (0.71)		4.82 (0.91)		3.20 (1.93)		7.45 (0.85)		0.65 (0.48)
	5.1-10.0	9.69 (0.64)		4.88 (0.96)		3.69 (1.42)		7.39 (0.63)		0.74 (0.44)
	>10.0	9.77 (0.50)		4.95 (0.88)		4.26 (1.04)		7.77 (0.52)		0.86 (0.35)
Number of diseases			0.722		0.309		<0.001^\|\|		0.016^\|\|		0.063
	0	9,52 (0.78)		4.77 (1.00)		3.14 (1.68)		7.16 (0.98)		0.54 (0.50)
	1-2	9,48 (0.86)		4.87 (0.95)		2.87 (1.73)		7.29 (0.96)		0.60 (0.49)
	3	9,45 (0.88)		4.82 (1.01)		2.64 (1.77)		7.22 (0.95)		0.55 (0.50)
GDS			<0.001		0.053		<0.001		<0.001		<0.001
	< 6	9,51 (0.83)		4.86 (0.96)		2.96 (1.71)		7.31 (0.93)		0.60 (0.49)
	≥ 6	9,33 (0.95)		4.76 (1.04)		2.31 (1.79)		7.03 (1.03)		0.50 (0.50)

Variables		Categories	Beta (SE)*	p–value	R²(partial)
MMSE Orientation					0.1165
	Schooling		0.21 (0.02)	<0.001	0.0987
	Age		–0.08 (0.02)	<0.001	0.0087
	Family Income		0.07 (0.02)	0.002	0.0046
	Intellectual AADLs	Not very active	107.65 (32.84)	0.001
		Very active	88.96 (37.33)	0.017
		Extremely Active	86.76 (49.98)	0.083	0.0045
MMSE Memory					0.0351
	Age		–0.13 (0.02)	<0.001	0.0226
	Schooling		0.07 (0.02)	0.001	0.0066
	Gender	Female	86.17 (30.60)	0.005	0.0036
	Social AADLs	Not very active	35.66 (36.22)	0.325
		Very active	12.18 (47.19)	0.796
		Extremely Active	96.77 (42.80)	0.024	0.0023
MMSE Attention/Calculus					0.3510
	Schooling		0.43 (0.02)	<0.001	0.2606
	Gender	Female	–405.05 (26.77)	<0.001	0.0745
	Family Income		0.09 (0.02)	<0.001	0.0062
	Intellectual AADLs	Not very active	88.10 (32.88)	0.007
		Very active	180.75 (37.59)	<0.001
		Extremely Active	102.5054)	0.042	0.0076
	Depressive Symptoms	≥6	–84.47 (31.94)	0.008	0.0021
MMSE Language					0.3816
	Schooling		0.47 (0.02)	<0.001	0.3445
	Gender	Female	127.41 (24.18)	<0.001	0.0085
	Intellectual AADLs	Not very active	213.42 (29.88)	<0.001
		Very active	238.58 (34.49)	<0.001
		Extremely Active	267.41 (46.72)	<0.001	0.0212
	Social AADLs	Not very active	64.70 (28.36)	0.023
		Very active	42.63 (37.40)	0.254
		Extremely Active	48.34 (34.90)	0.166	0.0037
	GDS	≥6	–60.61 (29.27)	0.039	0.0013
	Age		–0.03 (0.02)	0.034	0.0012
	Family Income		0.04 (0.02)	0.037	0.0012
MMSE Praxis					0.2082
	Schooling		0.29 (0.02)	<0.001	0.1800
	Intellectual AADLs	Not very active	128.37 (31.35)	<0.001
		Very active	227.06 (35.76)	<0.001
		Extremely Active	253.07 (48.15)	<0.001	0.0214
	Gender	Female	98.64 (25.48)	<0.001	0.0047
	Family Income		0.05 (0.02)	0.015	0.0021

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] Mônica Sanches Yassuda. Rua Tessália Vieira de Camargo 126 / Cidade Universitária Zeferino Vaz - 13083-887 Campinas SP- Brasil. E-mail: yassuda@usp.br