Physical performance is more strongly associated with cognition in schizophrenia than psychiatric symptoms

Abstract

Background: Although neurocognitive dysfunction and physical performance are known to be impaired in patients with schizophrenia, evidence regarding the relationship between these two domains remains insufficient. Thus, we aimed to investigate the relationship between various physical performance domains and cognitive domains in individuals with schizophrenia, while considering other disorderrelated clinical symptoms. Methods: Sixty patients with schizophrenia participated in the study. Cardiorespiratory fitness and functional mobility were evaluated using the step test and supine-to-standing (STS) test, respectively. Executive function and working memory were assessed using the Stroop task and Sternberg working memory (SWM) task, respectively. Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory. Multivariate analyses were performed to adjust for relevant covariates and identify predictive factors associated with neurocognition. Results: Multiple regression analysis revealed that the step test index was most strongly associated with reaction time in the Stroop task (β = 0.434, p = 0.001) and SWM task (β = 0.331, p = 0.026), while STS test time was most strongly associated with accuracy on the Stoop task (β=À0.418, p = 0.001) and SWM task (β=À0.383, p = 0.007). Total cholesterol levels were positively associated with Stroop task accuracy (β=À0.307, p = 0.018) after controlling for other clinical correlates. However, clinical symptoms were not associated with any variables in Stroop or SWM task. Conclusions: The present findings demonstrate the relationship between physical performance and neurocognition in patients with schizophrenia. Considering that these factors are modifiable, exercise intervention may help to improve cognitive symptoms in patients with schizophrenia, thereby leading to improvements in function and prognosis.

Get up! Functional mobility and metabolic syndrome in chronic schizophrenia: Effects on cognition and quality of life

“…Furthermore, our study innovatively modeled the effects of FM and MetS on both global cognition and QoL through mediation analyses. Indeed, these factors, fundamental in schizophrenia because they can directly influence both cognition and QoL ( Bora et al, 2017 ; Malhotra et al, 2016 ; Kim et al, 2019 ), especially in affected elderly people ( Leutwyler et al, 2014 ), are rarely considered together. Our findings suggest that FM has not only a direct relationship with MetS, cognition and QoL, but it also mediates the indirect relationship between MetS on one side and both cognition and QoL on the other.…”