Cognitive and physical functions among middle-aged and older people: A special emphasis on executive functions and walking

Abstract

Cognitive and physical functions are key factors for safe walking. Unfortunately, these functions deteriorate with age and therefore older adults may experience difficulties in outdoor mobility. In women, decline in cognitive and physical functions may start as early as middle age due to menopausal-related hormonal changes. However, cognitive and physical decline may be attenuated with cognitive and physical training. This study investigated the associations between cognitive, especially executive, and physical functions in older adults and middle-aged women. Also investigated was the role of participant characteristics in cognitive and physical training-induced change in executive functions in older adults and cognitive performance over the menopausal transition in middle-aged women. This study utilized data from two research projects: the PASSWORD (n=314) and the ERMA (n=342). In the PASSWORD, community-dwelling 70–85-year-old men and women participated in 12-month physical (n=159) or physical and cognitive training (n=155). The measurements for executive and physical functions were organized at baseline and 12 months. In the ERMA, 158 early and 184 late perimenopausal women participated in measurements for cognitive and physical functions at baseline and after reaching post-menopause (n=195). Executive functions were assessed with the Stroop test (inhibition), Trail Making Test B and B-A (set shifting), and Verbal Fluency Test (updating). Physical functions were assessed with 10-m walking speed, 6-min walking distance, dual-task walking and the Short Physical Performance Battery. The results showed domain-dependent, positive cross-sectional associations between executive and physical functions in older adults and middle-aged women. Longitudinal associations between these functions in middle-aged women were not found. Furthermore, cognitive and physical training provide additional benefits for women and participants who trained occasionally, compared to physical training alone, but the additional benefit for executive functions was domain-dependent. Finally, cognitive performance remained stable over menopausal transition. This research suggests that executive and physical functions are associated in older adults and middle-aged women. Furthermore, the results show that executive functions can be promoted with cognitive and physical training.