Korean J Sports Med.  2021 Jun;39(2):51-59. 10.5763/kjsm.2021.39.2.51.

Association of Cardiovascular Disease Risk and Physical Fitness with Cognitive Impairment in Korean Elderly Women

• Lee I
• Kang H

• KMID: 2516230
• DOI: http://doi.org/10.5763/kjsm.2021.39.2.51

Abstract

Purpose
This study aimed to investigate the effect of cardiovascular disease (CVD) risk and physical fitness on cognitive impairment in Korean elderly women.
Methods
In a cross-sectional design, a total of 308 Korean elderly women, aged 60 years or older, participated in this study. Measured parameters included the 10-year Framingham risk score (FRS), physical fitness (i.e., upper and lower body strength and flexibility and endurance), and cognitive performance based on Mini-Mental State Examination for dementia screening. The participants were classified as low (＜ 10%) or intermediate and high (≥ 10%) risk groups based on the 10-year FRS and as unfit (lower 50%) or fit (higher 50%) on a composite z-score of physical fitness. Logistic regression was used to estimate the odd ratios (ORs) and confidence intervals (CIs) of cognitive impairment according to the 10-year FRS and physical fitness-based classification.
Results
The low FRS/unfit and intermediate or high FRS/unfit groups had significantly higher risks of cognitive impairment (OR, 3.714; 95% CI, 1.324– 10.418; p=0.013 and OR, 11.345; 95% CI, 4.810– 26.762; p＜ 0.001, respectively) compared with the low FRS/fit group (OR, 1). In particular, the elevated risk of cognitive impairment remained significant (OR, 3.876; 95% CI, 1.400– 10.726; p=0.009) even after adjustments for covariates such as age, body mass index, education, and physical inactivity.
Conclusion
The current findings suggest that an intervention targeting at both CVD risk reduction and physical fitness promotion is urgent as a preventive and/or therapeutic measure against declines in cognitive function in Korean elderly women.

Keyword

Cognitive impairment; Heart disease risk factors; Physical fitness; Elderly

Reference

1. Ministry of Health and Welfare. 2020. Korean dementia observatory 2019. Ministry of Health and Welfare;Sejong, KR:

2. Larrieu S, Letenneur L, Orgogozo JM, et al. 2002; Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology. 59:1594–9. DOI: 10.1212/01.WNL.0000034176.07159.F8. PMID: 12451203.

3. Yaffe K, Hoang TD, Byers AL, Barnes DE, Friedl KE. 2014; Lifestyle and health-related risk factors and risk of cognitive aging among older veterans. Alzheimers Dement. 10(3 Suppl):S111–21. DOI: 10.1016/j.jalz.2014.04.010. PMID: 24924664.

4. Colijn MA, Grossberg GT. 2015; Amyloid and tau biomarkers in subjective cognitive impairment. J Alzheimers Dis. 47:1–8. DOI: 10.3233/JAD-150180. PMID: 26402749.

5. Arntzen KA, Schirmer H, Wilsgaard T, Mathiesen EB. 2011; Impact of cardiovascular risk factors on cognitive function: the Tromsø study. Eur J Neurol. 18:737–43. DOI: 10.1111/j.1468-1331.2010.03263.x. PMID: 21143340.

6. Akinyemi RO, Mukaetova-Ladinska EB, Attems J, Ihara M, Kalaria RN. 2013; Vascular risk factors and neurodegeneration in ageing related dementias: Alzheimer's disease and vascular dementia. Curr Alzheimer Res. 10:642–53. DOI: 10.2174/15672050113109990037. PMID: 23627757.

7. Sisante JV, Vidoni ED, Kirkendoll K, et al. 2019; Blunted cerebrovascular response is associated with elevated beta-amyloid. J Cereb Blood Flow Metab. 39:89–96. DOI: 10.1177/0271678X17732449. PMID: 28914134. PMCID: PMC6311677.

8. Wang R, Fratiglioni L, Kalpouzos G, et al. 2017; Mixed brain lesions mediate the association between cardiovascular risk burden and cognitive decline in old age: a population-based study. Alzheimers Dement. 13:247–56. DOI: 10.1016/j.jalz.2016.06.2363. PMID: 27521789.

9. Viticchi G, Falsetti L, Buratti L, et al. 2017; Framingham risk score and the risk of progression from mild cognitive impairment to dementia. J Alzheimers Dis. 59:67–75. DOI: 10.3233/JAD-170160. PMID: 28582863.

10. Song R, Xu H, Dintica CS, et al. 2020; Associations between cardiovascular risk, structural brain changes, and cognitive decline. J Am Coll Cardiol. 75:2525–34. DOI: 10.1016/j.jacc.2020.03.053. PMID: 32439001.

11. Shim J, Yoo HJ. 2020; Effects of handgrip strength on 10-year cardiovascular risk among the Korean middle-aged population: the Korea National Health and Nutrition Examination Survey 2014. Healthcare (Basel). 8:458. DOI: 10.3390/healthcare8040458. PMID: 33158168. PMCID: PMC7712900.

12. Emerenziani GP, Vaccaro MG, Izzo G, et al. 2020; Prediction equation for estimating cognitive function using physical fitness parameters in older adults. PLoS One. 15:e0232894. DOI: 10.1371/journal.pone.0232894. PMID: 32379838. PMCID: PMC7205244.

13. Tikkanen E, Gustafsson S, Ingelsson E. 2018; Associations of fitness, physical activity, strength, and genetic risk with cardiovascular disease: longitudinal analyses in the UK Biobank Study. Circulation. 137:2583–91. DOI: 10.1161/CIRCULATIONAHA.117.032432. PMID: 29632216. PMCID: PMC5997501.

14. Lee MR, Jung SM, Kim HS, Kim YB. 2018; Association of muscle strength with cardiovascular risk in Korean adults: findings from the Korea National Health and Nutrition Examination Survey (KNHANES) VI to VII (2014-2016). Medicine (Baltimore). 97:e13240. DOI: 10.1097/MD.0000000000013240. PMID: 30461627. PMCID: PMC6392889.

15. Chou MY, Nishita Y, Nakagawa T, et al. 2019; Role of gait speed and grip strength in predicting 10-year cognitive decline among community-dwelling older people. BMC Geriatr. 19:186. DOI: 10.1186/s12877-019-1199-7. PMID: 31277579. PMCID: PMC6612180.

16. Kim KH, Park SK, Lee DR, Lee J. 2019; The relationship between handgrip strength and cognitive function in elderly Koreans over 8 years: a prospective population-based study using Korean longitudinal study of ageing. Korean J Fam Med. 40:9–15. DOI: 10.4082/kjfm.17.0074. PMID: 30369219. PMCID: PMC6351793.

17. Kim TH, Jhoo JH, Park JH, et al. 2010; Korean version of mini mental status examination for dementia screening and its' short form. Psychiatry Investig. 7:102–8. DOI: 10.4306/pi.2010.7.2.102. PMID: 20577618. PMCID: PMC2890863.

18. D'Agostino RB Sr, Vasan RS, Pencina MJ, et al. 2008; General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 117:743–53. DOI: 10.1161/CIRCULATIONAHA.107.699579. PMID: 18212285.

19. Rikli RE, Jones CJ. Senior fitness test manual. Human Kinetics;Champaign (IL):

20. Oh JY, Yang YJ, Kim BS, Kang JH. 2007; Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. J Korean Acad Fam Med. 28:532–41.

21. Chen LK, Liu LK, Woo J, et al. 2014; Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 15:95–101. DOI: 10.1016/j.jamda.2013.11.025. PMID: 24461239.

22. Lyu J, Kim HY. 2016; Gender-specific incidence and predictors of cognitive impairment among older Koreans: findings from a 6-year prospective cohort study. Psychiatry Investig. 13:473–9. DOI: 10.4306/pi.2016.13.5.473. PMID: 27757124. PMCID: PMC5067340.

23. Memel M, Bourassa K, Woolverton C, Sbarra DA. 2016; Body mass and physical activity uniquely predict change in cognition for aging adults. Ann Behav Med. 50:397–408. DOI: 10.1007/s12160-015-9768-2. PMID: 26733191.

24. Zuo M, Gan C, Liu T, Tang J, Dai J, Hu X. 2019; Physical predictors of cognitive function in individuals with hypertension: evidence from the CHARLS Basline Survey. West J Nurs Res. 41:592–614. DOI: 10.1177/0193945918770794. PMID: 29742988.

25. Machii N, Kudo A, Saito H, et al. 2020; Walking speed is the sole determinant criterion of sarcopenia of mild cognitive impairment in Japanese elderly patients with type 2 diabetes mellitus. J Clin Med. 9:2133. DOI: 10.3390/jcm9072133. PMID: 32640726. PMCID: PMC7408848.

26. Chan JS, Yan JH, Payne VG. 2013; The impact of obesity and exercise on cognitive aging. Front Aging Neurosci. 5:97. DOI: 10.3389/fnagi.2013.00097. PMID: 24391586. PMCID: PMC3869042.

27. Kennedy G, Meyer D, Hardman RJ, Macpherson H, Scholey AB, Pipingas A. 2018; Physical fitness and aortic stiffness explain the reduced cognitive performance associated with increasing age in older people. J Alzheimers Dis. 63:1307–16. DOI: 10.3233/JAD-171107. PMID: 29865082.

28. Jeong SM, Choi S, Kim K, Kim SM, Kim S, Park SM. 2018; Association among handgrip strength, body mass index and decline in cognitive function among the elderly women. BMC Geriatr. 18:225. DOI: 10.1186/s12877-018-0918-9. PMID: 30249201. PMCID: PMC6154935.

29. Chang YK, Chu CH, Chen FT, Hung TM, Etnier JL. 2017; Combined effects of physical activity and obesity on cognitive function: independent, overlapping, moderator, and mediator models. Sports Med. 47:449–68. DOI: 10.1007/s40279-016-0589-7. PMID: 27439944.

30. Stewart RAH, Held C, Krug-Gourley S, et al. 2019; Cardiovascular and lifestyle risk factors and cognitive function in patients with stable coronary heart disease. J Am Heart Assoc. 8:e010641. DOI: 10.1161/JAHA.118.010641. PMID: 30897999. PMCID: PMC6509727.