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UM Researchers Link Cognitive, Mobility Limitations and Mortality

Emily Frith, Ph.D. Student in Exercise Science (left) and Dr. Paul Loprinzi, Associate Professor of Health, Exercise Science and Recreation Management, recently published “Individual and Combined Associations of Cognitive and Mobility Limitations on Mortality Risk in Older Adults” in the Mayo Clinic Proceedings. Submitted photo
With its first interprofessional degree program in applied gerontology rolling out in fall 2018, the University of Mississippi’s School of Applied Sciences is ramping up its exploration of areas that directly affect the elderly population, like decline in cognitive function and mobility.
New data from the Centers for Disease Control and Prevention indicate the rate of people dying from Alzheimer’s disease in the United States rose by 55 percent over a 15-year period. Even mild cognitive impairment has been shown to substantially raise the risk of death.
Research has shown that some types of physical exercise, however, may reduce the decline in cognitive performance and protect against dementia, in addition to improving physical wellness and prolonging optimal health.
Researchers in the Department of Health, Exercise Science and Recreation Management and the University of Mississippi Medical Center confirmed in their latest study published in the Mayo Clinic Proceedings that older adults who demonstrate cognitive or mobility limitations have increased all-cause mortality risk. The highest mortality risk, however, occurred in those with both limitations.
“Our findings highlight the importance for clinicians to assess mobility and cognitive function among their older adult patients, whenever feasible,” said Paul Loprinzi, associate professor of health, exercise science and recreation management, indicating that early detection is key to prolonging life and improving overall quality of life.
Walking and other exercise behaviors have been suggested to correlate specifically with executive function, the set of mental skills that help you get things done, such as managing time, paying attention, planning and organizing, remembering details and multitasking.
Individuals who are able to engage in regular physical movement have shown marked improvements in executive functioning parameters.
Since limitations in cognitive and physical capacity complicate efforts to maintain physical fitness, the Ole Miss researchers wanted to explore if the combination of cognitive and physical mobility limitations, in concert, would result in an increase in all-cause mortality.
“In alignment with other work, we hypothesized that both cognitive and mobility limitations would increase the risk of mortality, but few studies have examined whether older adults with both of these limitations have the highest mortality risk, which was the motivation for this study,” Loprinzi said.
This study looked at the combined effects of mobility limitations and cognitive functioning among a large sample of adults accessed from the National Health and Nutrition Examination Survey, using data from 1,852 participants ages 60-85 years old from NHANES cycles 1999-2002. Participants were followed until 2011.
Specifically, researchers assessed mobility limitations via self-report, asking participants if they were able to walk a quarter-mile without assistance; if they were able to walk without assistive equipment; if they were able to rise from a chair or seated position without using any type of external support such as the arms of chair; if they were able to walk from room to room on the same level without any assistance; or if they had to stop, squat or kneel at any point.
They assessed cognitive mobility using the Digit Symbol Substitution Test, a visuospatial and motor speed of processing test known to be an objective measure of central executive functioning.
“We separated the groups into four segments: individuals with no evidence of cognitive dysfunction and no mobility limitations, individuals with evidence of either cognitive dysfunction or mobility limitations, and individuals with evidence of both cognitive dysfunction and mobility limitations,” said Emily Frith, lead author and a UM doctoral student.
Notably, the team found that individuals with evidence of both cognitive and mobility limitations had the lowest rate of survival and the highest point estimate of increased risk of all-cause mortality.
“Our results have important clinical implications, showing that adults with both mobility and cognitive impairment may have an abbreviated lifespan,” Frith said.
“They may also be at risk for lower functional independence across the lifespan, as well as reduced ability to engage safely and comfortably in activities of daily living. Mobility and cognitive limitations, in isolation, may also contribute to detrimental health outcomes in late life.”
This multiple-authored paper demonstrates interdisciplinary collaborations across UM departments and centers and brings new perspectives on cognition, physical activity and health, said Minsoo Kang, UM chair and professor of health, exercise science and recreation management.
“I am grateful for the excellent work by our HESRM grad students and faculty in support of our mission,” Kang said. “Emily Frith, Ovuokerie Addoh and their adviser, Dr. Paul Loprinzi, published an excellent article in this prestigious journal.”
The doctoral program in health and kinesiology has two emphasis areas: one in health behavior and promotion, and the other in exercise science. Admission is competitive, limited in number and dependent upon availability of faculty mentors.
The emphasis in health behavior and promotion prepares students for university teaching and research, and positions in public, private and international health.
The emphasis in exercise science prepares students for university teaching and research positions. Also, the degree prepares students for research careers in industry and medicine that include the study of exercise.
For more information about the Department of Health, Exercise Science and Recreation Management, email HESRM@olemiss.edu.

By Sarah Sapp
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