Abstract
Background: Reduced engagement with habitual activity (HA) is associated with greater risk and progression of cognitive decline and falls in older adults and people with dementia. Understanding external and intrinsic factors that affect HA may provide novel targets for non-pharmacologic interventions. Objective: This study primarily aims to identify factors that influence HA in normal ageing and cognitive impairment, such as cognitive and motor problems and disease subtype. Methods: 108 older adults participated in this study; 36 with cognitive impairment due to Alzheimer’s disease (AD), 30 with dementia with Lewy bodies (DLB), 16 with Parkinson’s disease dementia (PDD), and 26 controls. A tri-axial accelerometer recorded continuous data of volume, variability, and pattern of HA over 7 days. Participants undertook a battery of cognitive and neuropsychological assessments. Results: One-way analysis of variance controlling for age and gender shows that people with DLB and PDD engage less with HA than controls (p ≤ 0.01), but there were no significant differences between AD and controls (p ≥ 0.01). Multivariate analysis demonstrated motor disease and impairments in activities of daily living (ADLs) independently explained 10–26% of volume, variability, and pattern of HA in people with cognitive impairment. Conclusion: People with cognitive impairment have reduced HA engagement compared to controls. Motor disease and impairments in ADLs most strongly contribute to these findings and may be important to consider for disease management. Wearable technology can provide a personalised picture of an individual’s daily behaviours and may be a useful tool for person-centred care.
References
1.
Hallal
PC
, Bauman
AE
, Heath
GW
, Kohl
HW
3rd, Lee
IM
, Pratt
M
. Physical activity: more of the same is not enough
. Lancet
. 2012
Jul
;380
(9838
):190
–1
.
[PubMed]
0140-67362.
Livingston
G
, Sommerlad
A
, Orgeta
V
, Costafreda
SG
, Huntley
J
, Ames
D
, et al. Dementia prevention, intervention, and care
. Lancet
. 2017
Dec
;390
(10113
):2673
–734
.
[PubMed]
0140-67363.
Farina
N
, Tabet
N
, Rusted
J
. Habitual physical activity (HPA) as a factor in sustained executive function in Alzheimer-type dementia: a cohort study
. Arch Gerontol Geriatr
. 2014
Jul-Aug
;59
(1
):91
–7
.
[PubMed]
0167-49434.
Whitehead
BR
, Blaxton
JM
. Daily Well-Being Benefits of Physical Activity in Older Adults: Does Time or Type Matter?
Gerontologist
. 2017
Nov
;57
(6
):1062
–71
.
[PubMed]
0016-90135.
Buchman
AS
, Wilson
RS
, Bennett
DA
. Total daily activity is associated with cognition in older persons
. Am J Geriatr Psychiatry
. 2008
Aug
;16
(8
):697
–701
.
[PubMed]
1064-74816.
Buchman
AS
, Boyle
PA
, Yu
L
, Shah
RC
, Wilson
RS
, Bennett
DA
. Total daily physical activity and the risk of AD and cognitive decline in older adults
. Neurology
. 2012
Apr
;78
(17
):1323
–9
.
[PubMed]
0028-38787.
Buchman
AS
, Yu
L
, Wilson
RS
, Lim
A
, Dawe
RJ
, Gaiteri
C
, et al. Physical activity, common brain pathologies, and cognition in community-dwelling older adults
. Neurology
. 2019
Feb
;92
(8
):e811
–22
.
[PubMed]
0028-38788.
Lord
S
, Godfrey
A
, Galna
B
, Mhiripiri
D
, Burn
D
, Rochester
L
. Ambulatory activity in incident Parkinson’s: more than meets the eye?
J Neurol
. 2013
Dec
;260
(12
):2964
–72
.
[PubMed]
0340-53549.
Del Din
S
, Galna
B
, Godfrey
A
, Bekkers
EM
, Pelosin
E
, Nieuwhof
F
, Mirelman
A
, Hausdorff
JM
, Rochester
L
: Analysis of free-living gait in older adults with and without Parkinson’s disease and with and without a history of falls: identifying generic and disease specific characteristics.
The Journals of Gerontology: Series A 2017
:glx254.10.
Schwenk
M
, Mohler
J
, Wendel
C
, D’Huyvetter
K
, Fain
M
, Taylor-Piliae
R
, et al. Wearable sensor-based in-home assessment of gait, balance, and physical activity for discrimination of frailty status: baseline results of the Arizona frailty cohort study
. Gerontology
. 2015
;61
(3
):258
–67
.
[PubMed]
0304-324X11.
Srulijes
K
, Klenk
J
, Schwenk
M
, Schatton
C
, Schwickert
L
, Teubner-Liepert
K
, et al. Fall Risk in Relation to Individual Physical Activity Exposure in Patients with Different Neurodegenerative Diseases: a Pilot Study
. Cerebellum
. 2019
Jun
;18
(3
):340
–8
.
[PubMed]
1473-422212.
Schwenk
M
, Hauer
K
, Zieschang
T
, Englert
S
, Mohler
J
, Najafi
B
. Sensor-derived physical activity parameters can predict future falls in people with dementia
. Gerontology
. 2014
;60
(6
):483
–92
.
[PubMed]
0304-324X13.
Urwyler
P
, Stucki
R
, Rampa
L
, Müri
R
, Mosimann
UP
, Nef
T
. Cognitive impairment categorized in community-dwelling older adults with and without dementia using in-home sensors that recognise activities of daily living
. Sci Rep
. 2017
Feb
;7
(1
):42084
.
[PubMed]
2045-232214.
Mc Ardle
R
, Morris
R
, Hickey
A
, Del Din
S
, Koychev
I
, Gunn
RN
, et al.; Deep and Frequent Phenotyping study team (
. Gait in Mild Alzheimer’s Disease: Feasibility of Multi-Center Measurement in the Clinic and Home with Body-Worn Sensors: A Pilot Study
. J Alzheimers Dis
. 2018
;63
(1
):331
–41
.
[PubMed]
1387-287715.
Weiss
A
, Brozgol
M
, Dorfman
M
, Herman
T
, Shema
S
, Giladi
N
, et al. Does the evaluation of gait quality during daily life provide insight into fall risk? A novel approach using 3-day accelerometer recordings
. Neurorehabil Neural Repair
. 2013
Oct
;27
(8
):742
–52
.
[PubMed]
1545-968316.
Del Din
S
, Godfrey
A
, Galna
B
, Lord
S
, Rochester
L
. Free-living gait characteristics in ageing and Parkinson’s disease: impact of environment and ambulatory bout length
. J Neuroeng Rehabil
. 2016
May
;13
(1
):46
.
[PubMed]
1743-000317.
Moyle
W
, Jones
C
, Murfield
J
, Draper
B
, Beattie
E
, Shum
D
, et al. Levels of physical activity and sleep patterns among older people with dementia living in long-term care facilities: A 24-h snapshot
. Maturitas
. 2017
Aug
;102
:62
–8
.
[PubMed]
0378-512218.
Marmeleira
J
, Ferreira
S
, Raimundo
A
. Physical activity and physical fitness of nursing home residents with cognitive impairment: A pilot study
. Exp Gerontol
. 2017
Dec
;100
:63
–9
.
[PubMed]
0531-556519.
Hartman
YA
, Karssemeijer
EG
, van Diepen
LA
, Olde Rikkert
MG
, Thijssen
DH
. Dementia Patients Are More Sedentary and Less Physically Active than Age- and Sex-Matched Cognitively Healthy Older Adults
. Dement Geriatr Cogn Disord
. 2018
;46
(1-2
):81
–9
.
[PubMed]
1420-800820.
Farina
N
, Sherlock
G
, Thomas
S
, Lowry
RG
, Banerjee
S
. Acceptability and feasibility of wearing activity monitors in community-dwelling older adults with dementia
. Int J Geriatr Psychiatry
. 2019
Apr
;34
(4
):617
–24
.
[PubMed]
0885-623021.
van Alphen
HJ
, Volkers
KM
, Blankevoort
CG
, Scherder
EJ
, Hortobágyi
T
, van Heuvelen
MJ
. Older adults with dementia are sedentary for most of the day
. PLoS One
. 2016
Mar
;11
(3
):e0152457
.
[PubMed]
1932-620322.
McKeith
IG
, Boeve
BF
, Dickson
DW
, Halliday
G
, Taylor
JP
, Weintraub
D
, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium
. Neurology
. 2017
Jul
;89
(1
):88
–100
.
[PubMed]
0028-387823.
McKhann
GM
, Knopman
DS
, Chertkow
H
, Hyman
BT
, Jack
CR
Jr, Kawas
CH
, et al. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease
. Alzheimers Dement
. 2011
May
;7
(3
):263
–9
.
[PubMed]
1552-526024.
Dubois
B
, Burn
D
, Goetz
C
, Aarsland
D
, Brown
RG
, Broe
GA
, et al. Diagnostic procedures for Parkinson’s disease dementia: recommendations from the movement disorder society task force
. Mov Disord
. 2007
Dec
;22
(16
):2314
–24
.
[PubMed]
0885-318525.
Albert
M
, De Kosky
S
, Dickson
D
, Dubois
B
, Feldman
H
, Fox
N
. The diagnosis of mild cognitive impairment due to Alzheimers disease: recommendations from the NIAAA workgroups on diagnostic guidelines for Alzheimers disease
. Alzheimers Dement
. 2011
;7
:270
–9
.
[PubMed]
1552-526026.
Litvan
I
, Goldman
JG
, Tröster
AI
, Schmand
BA
, Weintraub
D
, Petersen
RC
, et al. Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines
. Mov Disord
. 2012
Mar
;27
(3
):349
–56
.
[PubMed]
0885-318527.
Donaghy
PC
, Taylor
JP
, O’Brien
JT
, Barnett
N
, Olsen
K
, Colloby
SJ
, et al. Neuropsychiatric symptoms and cognitive profile in mild cognitive impairment with Lewy bodies
. Psychol Med
. 2018
Oct
;48
(14
):2384
–90
.
[PubMed]
0033-291728.
Thomas
AJ
, Donaghy
P
, Roberts
G
, Colloby
SJ
, Barnett
NA
, Petrides
G
, et al. Diagnostic accuracy of dopaminergic imaging in prodromal dementia with Lewy bodies
. Psychol Med
. 2019
Feb
;49
(3
):396
–402
.
[PubMed]
0033-291729.
King
E
, O’Brien
JT
, Donaghy
P
, Morris
C
, Barnett
N
, Olsen
K
, Martin-Ruiz
C
, Taylor
J-P
, Thomas
AJ
: Peripheral inflammation in prodromal Alzheimer’s and Lewy body dementias. J Neurol Neurosurg Psychiatry 2017
:jnnp-2017-317134.30.
31.
Linn
BS
, Linn
MW
, Gurel
L
. Cumulative illness rating scale
. J Am Geriatr Soc
. 1968
May
;16
(5
):622
–6
.
[PubMed]
0002-861432.
Movement Disorder Society Task Force on Rating Scales for Parkinson’s Disease
. The Unified Parkinson’s Disease Rating Scale (UPDRS): status and recommendations
. Mov Disord
. 2003
Jul
;18
(7
):738
–50
.
[PubMed]
0885-318533.
Morris
JC
. The Clinical Dementia Rating (CDR): current version and scoring rules
. Neurology
. 1993
Nov
;43
(11
):2412
–4
.
[PubMed]
0028-387834.
Powell
LE
, Myers
AM
. The Activities-specific Balance Confidence (ABC) Scale
. J Gerontol A Biol Sci Med Sci
. 1995
Jan
;50A
(1
):M28
–34
.
[PubMed]
1079-500635.
Johns
MW
. Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale
. Chest
. 1993
Jan
;103
(1
):30
–6
.
[PubMed]
0012-369236.
Brink
TL
, Yesavage
JA
, Lum
O
. Geriatric depression scale.
Evidence-Based Diagnosis: A Handbook of Clinical Prediction Rules 2013
:297.37.
Fish
J
. Bristol Activities of Daily Living Scale; Encyclopedia of Clinical Neuropsychology
. Springer
; 2011
. pp. 452
–3
. 38.
Molloy
DW
, Standish
TI
. A guide to the standardized Mini-Mental State Examination
. Int Psychogeriatr
. 1997
;9
(S1
Suppl 1
):87
–94
.
[PubMed]
1041-610239.
Noone
P
. Addenbrooke’s cognitive examination-III
. Occup Med (Lond)
. 2015
Jul
;65
(5
):418
–20
.
[PubMed]
0962-748040.
Reitan
RM
. Trail Making Test: Manual for administration and scoring
. Reitan Neuropsychology Laboratory
; 1992
.41.
42.
Hickey
A
, Del Din
S
, Rochester
L
, Godfrey
A
. Detecting free-living steps and walking bouts: validating an algorithm for macro gait analysis
. Physiol Meas
. 2017
Jan
;38
(1
):N1
–15
.
[PubMed]
0967-333443.
Rochester
L
, Chastin
SF
, Lord
S
, Baker
K
, Burn
DJ
. Understanding the impact of deep brain stimulation on ambulatory activity in advanced Parkinson’s disease
. J Neurol
. 2012
Jun
;259
(6
):1081
–6
.
[PubMed]
0340-535444.
Chastin
SF
, Baker
K
, Jones
D
, Burn
D
, Granat
MH
, Rochester
L
. The pattern of habitual sedentary behavior is different in advanced Parkinson’s disease
. Mov Disord
. 2010
Oct
;25
(13
):2114
–20
.
[PubMed]
0885-318545.
Lord
S
, Chastin
SF
, McInnes
L
, Little
L
, Briggs
P
, Rochester
L
. Exploring patterns of daily physical and sedentary behaviour in community-dwelling older adults
. Age Ageing
. 2011
Mar
;40
(2
):205
–10
.
[PubMed]
0002-072946.
Richardson
JT
. Eta squared and partial eta squared as measures of effect size in educational research
. Educ Res Rev
. 2011
;6
(2
):135
–47
. 1747-938X47.
Del Din
S
, Godfrey
A
, Mazzà
C
, Lord
S
, Rochester
L
. Free-living monitoring of Parkinson’s disease: lessons from the field
. Mov Disord
. 2016
Sep
;31
(9
):1293
–313
.
[PubMed]
0885-318548.
Block
VA
, Pitsch
E
, Tahir
P
, Cree
BA
, Allen
DD
, Gelfand
JM
. Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review
. PLoS One
. 2016
Apr
;11
(4
):e0154335
.
[PubMed]
1932-620349.
Lee
YS
. Gender differences in physical activity and walking among older adults
. J Women Aging
. 2005
;17
(1-2
):55
–70
.
[PubMed]
0895-284150.
Hariz
GM
, Forsgren
L
. Activities of daily living and quality of life in persons with newly diagnosed Parkinson’s disease according to subtype of disease, and in comparison to healthy controls
. Acta Neurol Scand
. 2011
Jan
;123
(1
):20
–7
.
[PubMed]
0001-631451.
Rogers
G
, Davies
D
, Pink
J
, Cooper
P
. Parkinson’s disease: summary of updated NICE guidance
. BMJ
. 2017
Jul
;358
:j1951
.
[PubMed]
0959-813852.
Bherer
L
, Erickson
KI
, Liu-Ambrose
T
. A review of the effects of physical activity and exercise on cognitive and brain functions in older adults
. J Aging Res
. 2013
;2013
:657508
.
[PubMed]
2090-220453.
Orgeta
V
, Regan
C
, Orrell
M
. Physical activity for improving cognition in older people with mild cognitive impairment
. Cochrane Database Syst Rev
. 2010
. 1469-493X54.
Bize
R
, Johnson
JA
, Plotnikoff
RC
. Physical activity level and health-related quality of life in the general adult population: a systematic review
. Prev Med
. 2007
Dec
;45
(6
):401
–15
.
[PubMed]
0091-743555.
Giebel
CM
, Sutcliffe
C
, Challis
D
. Activities of daily living and quality of life across different stages of dementia: a UK study
. Aging Ment Health
. 2015
Jan
;19
(1
):63
–71
.
[PubMed]
1360-786356.
Giebel
C
, Zwakhalen
S
, Louise Sutcliffe
C
, Verbeek
H
. Exploring the abilities of performing complex daily activities in dementia: the effects of supervision on remaining independent
. Aging Ment Health
. 2019
Apr
;•••
:1
–7
.
[PubMed]
1360-786357.
Prizer
LP
, Zimmerman
S
. Progressive Support for Activities of Daily Living for Persons Living With Dementia
. Gerontologist
. 2018
Jan
;58
suppl_1
:S74
–87
.
[PubMed]
0016-901358.
van Alphen
HJ
, Hortobágyi
T
, van Heuvelen
MJ
. Barriers, motivators, and facilitators of physical activity in dementia patients: A systematic review
. Arch Gerontol Geriatr
. 2016
Sep-Oct
;66
:109
–18
.
[PubMed]
0167-494359.
Kaye
J
, Mattek
N
, Dodge
H
, Buracchio
T
, Austin
D
, Hagler
S
, et al. One walk a year to 1000 within a year: continuous in-home unobtrusive gait assessment of older adults
. Gait Posture
. 2012
Feb
;35
(2
):197
–202
.
[PubMed]
0966-636260.
Fox
SH
, Katzenschlager
R
, Lim
SY
, Barton
B
, de Bie
RM
, Seppi
K
, et al.; Movement Disorder Society Evidence-Based Medicine Committee
. International Parkinson and movement disorder society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson’s disease
. Mov Disord
. 2018
Aug
;33
(8
):1248
–66
.
[PubMed]
0885-318561.
Pavel
M
, Jimison
HB
, Wactlar
HD
, Hayes
TL
, Barkis
W
, Skapik
J
, et al. The role of technology and engineering models in transforming healthcare
. IEEE Rev Biomed Eng
. 2013
;6
:156
–77
.
[PubMed]
1937-333362.
Arnerić
SP
, Cedarbaum
JM
, Khozin
S
, Papapetropoulos
S
, Hill
DL
, Ropacki
M
, et al. Biometric monitoring devices for assessing end points in clinical trials: developing an ecosystem
. Nat Rev Drug Discov
. 2017
Oct
;16
(10
):736
.
[PubMed]
1474-177663.
Teipel
S
, König
A
, Hoey
J
, Kaye
J
, Krüger
F
, Robillard
JM
, et al. Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia
. Alzheimers Dement
. 2018
Sep
;14
(9
):1216
–31
.
[PubMed]
1552-526064.
Samus
QM
, Black
BS
, Bovenkamp
D
, Buckley
M
, Callahan
C
, Davis
K
, et al. Home is where the future is: the BrightFocus Foundation consensus panel on dementia care
. Alzheimers Dement
. 2018
Jan
;14
(1
):104
–14
.
[PubMed]
1552-526065.
Espay
AJ
, Bonato
P
, Nahab
FB
, Maetzler
W
, Dean
JM
, Klucken
J
, et al.; Movement Disorders Society Task Force on Technology
. Technology in Parkinson’s disease: challenges and opportunities
. Mov Disord
. 2016
Sep
;31
(9
):1272
–82
.
[PubMed]
0885-3185© 2019 S. Karger AG, Basel
2019
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
