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=1
Highlights
Preliminary evidence suggests osteoarthritis is a risk factor for cognitive decline
We examined time spent in Moderate-to-Vigorous Physical Activity (MVPA) in periods of 10 or more minutes, and time spent in Sedentary Behaviour (SB) in periods of 20 or more minutes
Secondary analyses We examined whether changes in MVPA or SB during the intervention were associated with changes in cognitive function
Summary
Preliminary 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. 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. One new diagnosis of osteoarthritis (OA) occurs every 60 s, such that 9.6% of all men and 18.0% of all women over age 60 have symptomatic OA [1, 2] Of those living with OA, 80% will have limitations in movement and 25% cannot perform their major daily activities of life [2]. Preliminary evidence suggests OA is associated with an increased risk of cognitive decline and dementia [7]. Given that the number of cases of OA and dementia are each increasing as the population of older adults continues to grow [10, 11], there is an urgent need for effective treatment strategies for OA symptoms since this may help reduce dementia prevalence
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