Executive Function and Physical Function Among Community-Dwelling Egyptian Older Adults

Abstract

Background: The ongoing scientific debate regarding the association between physical function and cognitive impairment has focused mainly on global cognitive performance rather than specific cognitive functions tests and the importance of recognition of its associations and any factors that could play a role later in the prevention of such decline. Objective: This study examined the association between physical function, using handgrip strength (HGS) and Timed Up-and-Go test (TUGT), and executive function (EF), using Clock Drawing Test (CDT), among community-dwelling Egyptian elderly. Methods: A cross-sectional study was conducted in 5 social clubs in Cairo, Egypt and included a sample of 136 elderly males and females aged≥55 years old. All participants had their physical function assessed using TUGT, and measurement of HGS using a pneumatic hand-held dynamometer. Assessment of EF using CDT was also done. Results: Higher CDT scores were significantly associated with both better HGS, and lower TUGT (OR = 3.77, and 0.65 respectively). This persisted even after adjustment for age and gender (OR = 2.56, and 0.71 respectively) and after further adjustment for weight, systolic blood pressure, education, smoking, hyperlipidemia, hypothyroidism, and physical activity (O.R. = 4.79, and 0.76 respectively). Adjustment for both male and female genders showed an association between physical (HGS and TUGT) and EF was stronger among men. Conclusion: A strong association between CDT score and both of HGS and TUGT was found among the studied sample. Higher HGS and lower TUGT was significantly associated with better performance in the CDT. This association is stronger in males than in females for both HGS and TUGT.

Exploring the Associations between Functional Capacity, Cognitive Function and Well-Being in Older Adults

“…The symbol cancellation test, the measure of executive function examined in the current study, requires abilities such as neglect, visuospatial function, organizational process and selective attention [ 30 , 32 , 33 ], which are important for performing activities of daily living (ADL) [ 59 ] and instrumental activities of daily living (IADL) [ 22 ]. Even though only a few studies have examined the executive function–functional capacity relationship, the findings of the present study are consistent with previous results showing a positive association of aspects of executive function with various functional capacity parameters in older adults, such as cardiorespiratory fitness [ 49 , 53 , 60 ], handgrip and lower extremity strength [ 49 , 61 , 62 ]. Interestingly, in the present study, the observed association of functional capacity with executive function was higher than global cognition in almost all measured parameters, with the HGS presenting the strongest association.…”

Differential associations between simple physical performance tests with global and specific cognitive functions in cognitively normal and mild cognitive impairment: a cross-sectional cohort study of Asian community-dwelling older adults

“…All three physical performance tests were strongly associated with the CTT tests. These findings align with previous studies showing that low physical performances were strongly associated with low EF scores [20,27,50,51], implying diminished executive controls involving motor-controls and speed components. Amongst the three physical performance tests, TUG was significantly and strongly associated with the highest number of EF-based neurocognitive tests.…”

“…Amongst the very few studies examining physical performance measures and cognition in older adults with MCI/ Alzheimer's disease (AD) and compared them with CN, they were limited by small sample sizes, were conducted in the clinical settings, and in Western countries/populations, thus limiting the generalizability of the findings [6,25,26]. Third, most extant studies focused on examining the associations between physical performance measures with either the global cognition score [27], such as the Mini-Mental State Examination (MMSE), or a limited battery of neurocognitive tests exclusively assessing executive functions [16,28,29]. This issue raised the question on whether cognitive processes other than executive functions are also associated with simple physical performance measures.…”

Bridging Reduced Grip Strength and Altered Executive Function: Specific Brain White Matter Structural Changes in Patients with Alzheimer’s Disease

“…A recent study found a positive correlation between stronger grip strength and higher CDT scores in older adults, particularly in men. 34 Weaker grip strength in patients with subjective cognitive decline and MCI was associated with worse baseline information processing speed and executive function but no longitudinal association was observed. 35 However, previous studies lack a mechanistic explanation for the correlation between grip strength and executive function.…”