Can we improve cognitive function among adults with osteoarthritis by increasing moderate-to-vigorous physical activity and reducing sedentary behaviour? Secondary analysis of the MONITOR-OA study

Abstract

BackgroundPreliminary evidence suggests osteoarthritis is a risk factor for cognitive decline. One potential reason is 87% of adults with osteoarthritis are inactive, and low moderate-to-vigorous physical activity and high sedentary behaviour are each risk factors for cognitive decline. Thus, we investigated whether a community-based intervention to increase moderate-to-vigorous physical activity and reduce sedentary behaviour could improve cognitive function among adults with osteoarthritis.MethodsThis was a secondary analysis of a six month, proof-of-concept randomized controlled trial of a community-based, technology-enabled counselling program to increase moderate-to-vigorous physical activity and reduce sedentary behaviour among adults with knee osteoarthritis. The Immediate Intervention (n = 30) received a Fitbit® Flex™ and four bi-weekly activity counselling sessions; the Delayed Intervention (n = 31) received the same intervention two months later. We assessed episodic memory and working memory using the National Institutes of Health Toolbox Cognition Battery. Between-group differences (Immediate Intervention vs. Delayed Intervention) in cognitive performance were evaluated following the primary intervention (i.e., Baseline – 2 Months) using intention-to-treat.ResultsThe intervention did not significantly improve cognitive function; however, we estimated small average improvements in episodic memory for the Immediate Intervention vs. Delayed Intervention (estimated mean difference: 1.27; 95% CI [− 9.27, 11.81]; d = 0.10).ConclusionThis small study did not show that a short activity promotion intervention improved cognitive health among adults with osteoarthritis. However, the effects of increased moderate-to-vigorous physical activity and reduced sedentary behaviour are likely to be small and thus we recommend subsequent studies use larger sample sizes and measure changes in cognitive function over longer intervals.Trial registration numberClinicalTrials.gov Protocol Registration System: NCT02315664; registered 12 December, 2014; https://clinicaltrials.gov/ct2/show/NCT02315664?cond=NCT02315664&rank=1Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2369-z) contains supplementary material, which is available to authorized users.

Associations between health‐related quality of life and health behaviors in Australian nursing students

“…Higher physical activity and lower sedentary behaviors are linked to improved HRQoL (Peleias et al, 2017;Pucci et al, 2012;Yasunaga et al, 2018). Unfortunately, due to the nature of online learning, nursing students spend a considerable amount of time undertaking desktop work, with students reporting feelings of guilt if they take time out to exercise (Thwaite et al, 2020 may increase cognitive and have a positive effect on academic outcomes (Falck et al, 2018).…”

“…Unfortunately, due to the nature of online learning, nursing students spend a considerable amount of time undertaking desktop work, with students reporting feelings of guilt if they take time out to exercise (Thwaite et al, 2020). However, recent evidence suggests this could be counterproductive, and taking the time to engage in regular moderate to vigorous physical activity may increase cognitive and have a positive effect on academic outcomes (Falck et al, 2018).…”

Total Sedentary Time and Cognitive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-analysis

“…2. For studies using a device for measurement of sedentary behaviour time, there were 12 studies assessing cognitive flexibility [40-42, 44, 50, 51, 53, 54, 58, 64-66], 16 studies for episodic memory [47,50,53,54,58,59,61,62,[65][66][67][68][69][70][71][72], 11 studies for executive function [40,50,53,54,58,59,62,66,[71][72][73], 16 studies for global cognitive function [35-37, 47, 53-55, 57, 60, 63, 67, 74-78], three studies reporting on the domain of motor skills and construction [35,56,72], 20 studies for processing speed [35, 40, 41, 41, 47, 50, 51, 53, 54, 56, 58, 59, 62, 65-69, 71, 72, 79] and 15 for working memory [40-42, 50, 51, 53, 54, 58, 62, 64-66, 70, 72, 73]. For studies using self-report to measure sedentary behaviour time, there were two studies for cognitive flexibility [49,51], five studies for episodic memory [43,47,49,80,81], seven for global cognitive function…”

Osteoarthritis Progression: Mitigation and Rehabilitation Strategies

“…This should come as no surprise as exercise has been shown to elicit numerous signaling changes to the extent that it has been described as the “real polypill” ( 71 ). Numerous reviews, meta-analyses and primary studies have been conducted since 2016 interrogating the influence of various exercise modalities and physical activity on OA ( 59 – 61 , 63 – 67 , 72 – 90 ), and the American College of Rheumatology/Arthritis Foundation strongly recommend exercise for OA treatment ( 29 ). While strongly recommended, the guidelines for exercise prescription lack specificity due to an underabundance of data ( 29 ).…”