Daily Physical Activity Patterns as a Window on Cognitive Diagnosis in the Baltimore Longitudinal Study of Aging (BLSA)

Article type: Research Article

Authors: Wanigatunga, Amal A.^{a; b; *} | Liu, Fangyu^a | Wang, Hang^a | Urbanek, Jacek K.^{b; c} | An, Yang^d | Spira, Adam P.^{b; e; f} | Dougherty, Ryan J.^a | Tian, Qu^d | Moghekar, Abhay^g | Ferrucci, Luigi^d | Simonsick, Eleanor M.^d | Resnick, Susan M.^d | Schrack, Jennifer A.^{a; b}

Affiliations: [a] Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA | [b] Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA | [c] Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA | [d] Intramural Research Program, National Institute on Aging, Baltimore, MD, USA | [e] Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA | [f] Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA | [g] Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA

Correspondence: [*] Correspondence to: Amal A. Wanigatunga, PhD, MPH, 614 N. Wolfe Street, E6040, Baltimore, MD 21205, USA. Tel.: +1 443 287 2706; E-mail: [email protected].

Abstract: Background:Gradual disengagement from daily physical activity (PA) could signal present or emerging mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Objective:This study examined whether accelerometry-derived patterns of everyday movement differ by cognitive diagnosis in participants of the Baltimore Longitudinal Study of Aging (BLSA). Methods:Activity patterns, overall and by time-of-day, were cross-sectionally compared between participants with adjudicated normal cognition (n = 549) and MCI/AD diagnoses (n = 36; 5 participants [14%] living with AD) using covariate-adjusted regression models. Results:Compared to those with normal cognition, those with MCI/AD had 2.1% higher activity fragmentation (SE = 1.0%, p = 0.036) but similar mean total activity counts/day (p = 0.075) and minutes/day spent active (p = 0.174). Time-of-day analyses show MCI/AD participants had lower activity counts and minutes spent active during waking hours (6:00 am–5:59 pm; p < 0.01 for all). Also, they had lower activity fragmentation from 12:00–5:59 am (p < 0.001), but higher fragmentation from 12:00–5:59 pm (p = 0.026). Conclusion:Differences in the timing and patterns of physical activity throughout the day linked to MCI/AD diagnoses warrant further investigation into potential clinical utility.

Keywords: Accelerometry, Alzheimer’s disease, diurnal patterns, mild cognitive impairment

DOI: 10.3233/JAD-215544

Journal: Journal of Alzheimer's Disease, vol. 88, no. 2, pp. 459-469, 2022