Background: Studies have reported declines with age in cognitive or physical functioning, but rarely identify whether these are parallel or linked events in the same study. Furthermore, most research in this area has focused on persons in late life rather than midlife. Objective: The objective of the study was to determine (1) if cognitive functioning was related to physical functioning and whether this relationship persisted after adjustment for age, menopause status, metabolic status, depression and socioeconomic resources, and (2) if changes in physical functioning were associated with changes in cognitive functioning over a 4-year follow-up period. Methods: Data were from the Study of Women’s Health Across the Nation (SWAN), a multi-site, longitudinal study of women aged 46–56 years at follow-up examination 4. Three follow-up examinations (study years 04, 06 and 08) included measures of physical functioning perception (MOS SF-36) and cognitive functioning [Symbol Digit Modality Test (SDMT), Digit Span Backward Test (DSBT), and East Boston Memory Test (EBMT)] (n = 2,405). Results: Women with lower cognitive functioning scores also had lower perceived physical functioning scores. While adjustment for covariates attenuated the association between perceived physical functioning and both the SDMT and EBMT cognitive measures, these associations remained statistically significant. Additionally, the 4-year change in perceived physical functioning was significantly associated with the 4-year change in the EBMT. Conclusions: At midlife, there were associated declines in cognitive and perceived physical functioning scores, commencing at midlife in women.
© 2009 S. Karger AG, Basel
- Physical functioning
- Cognitive functioning
- Metabolic syndrome
- MOS SF-36
- Binder EF, Storandt M, Birge SJ: The relation between psychometric test performance and physical performance in older adults. J Gerontol A Biol Sci Med Sci 1999;54:M428–M432.
- Fried LP, Herdman SJ, Kuhn KE, Rubin G, Turano K: Preclinical disability: hypotheses about the bottom of the iceberg. J Aging Health 1991;3:285–300.
- Royall RR, Palmer R, Chiodo LK, Polk MJ: Declining executive control in normal aging predicts change in functional status: the Freedom House Study. J Am Geriatr Soc 2004;52:346–352.
- Atkinson HH, Rosano C, Simonsick EM, Williamson JD, Davis C, Ambrosius WT, Rapp SR, Cesari M, Newman AB, Harris TB, Rubin SM, Yaffe K, Satterfield S, Kritchevsky SB: Cognitive function, gate speed decline, and comorbidities: the Health, Aging and Body Composition Study. J Gerontol 2007;62A:844–850.
- Jagger C, Clark M, Cook AJ: Mental and physical health of elderly people: five year follow-up of a total population. Age Aging 1989;18:77–82.
- Royall RR, Palmer R, Chiodo LK, Polk MJ: Executive control mediates memory’s association with change in instrumental activities of everyday living. J Am Geriatr Soc 2005;53:11–17.
- Singh-Manoux A, Ferrie JE, Lynch JW, Marmot M: The role of cognitive ability (intelligence) in explaining the association between socioeconomic position and health: evidence from the Whitehall II prospective cohort study. Am J Epidemiol 2005;161:831–839.
- Skerr PA, Albert MS, Fukenstein HH, et al: Correlates of cognitive function in an elderly community population. Am J Epidemiol 1998;128:1084–1101.
- Tabbarah M, Crimmins EM, Seeman TE: The relationship between cognitive and physical performance: MacArthur studies of successful aging. J Gerontol 2002;57:M228–M235.
- Royall DR, Lauterbach EC, Kaufer D, Mallot P, Coburn KL, Black KJ: The cognitive correlates of functional status: a review from the Committee on Research of the Am Neuropsychiatric Association. J Neuropsychiatry Clin Neurosci 2007;19:249–265.
- Chung TF, Sipe JD, McKee A, Fine RE, Schreiber BM, Liang JS, Johnson RJ: Serum amyloid A in Alzheimer’s disease brain is predominantly localized to myelin sheaths and axonal membrane. Amyloid Int J Exp Clin Invest 2000;7:105–110.
- McDermott MM, Guralnik JM, Greenland P, Green D, Liu K, Ridker PM, Chan C, Criqui MH, Ferrucci L, Taylor LM, Pearce WK, Schneider JR, Oskin SK: Inflammatory and thrombotic blood markers and walking-related disability in men and women with and without peripheral arterial disease. J Am Geriatr Soc 2004;52:1888–1894.
- Rogers RL, Meyer JS, Mortel KF: After reaching retirement age physical activity sustains cerebral perfusion and cognition. J Am Geriatr Soc 1990;38:123–128.
- Stern Y, Gurland B, Tatemichi TK, Tang MX, Wilder D, Mayeux R: Influence of education and occupation on the incidence of Alzheimer’s disease. JAMA 1994;271:1004–1010.
- Hemingway H, Nicholson A, Stafford M, Roberts R, Marmot M: The impact of socioeconomic status on health functioning as assessed by the SF-36 questionnaire: the Whitehall II Study. Am J Publ Health 1997;87:1484–1490.
- Pennix BW, Guralnik JM, Ferruci L, Simonsick EM, Deeg DG, Wallace RB: Depressive symptoms and physical decline in community dwelling older persons. JAMA 1998;279:1720–1726.
- Gallo JJ, Rebok GW, Tennsted S, Wadley WD, Horgas A: Linking depressive symptoms and functional disability in late life. Aging Ment Health 2003;7:469–480.
- Wilson RS, Mendes de Leon CF, Bennett DA, Benias JL, Evans DA: Depressive symptoms and cognitive decline in a community population of older persons. J Neurol Neurosurg Psychiatry 2004;75:126–129.
- Sheline YI, Barch DM, Garcia K, Gersing K, Pieper C, Welsh-Bohmer K, Steffens DC, Doraiswamy PM: Cognitive function in late life depression: relationships to depression severity, cerebrovascular risk factors and processing speed. Biol Psychiatry 2006;60:58–65.
- Sowers MF, Crawford S, Sternfeld B, et al: SWAN: a multicenter, multiethnic, community-based cohort study of women and the menopausal transition; in Lobo RA, Kelsey J, Marcus R (eds): Menopause: Biology and Pathobiology. San Diego, Academic Press, 2000, pp 175–188.
- Smith A: Symbol Digit Modalities Test, revised manual. Los Angeles, Western Psychological Services, 1982.
- Weschler D: Weschler Memory Scale, revised manual. New York, The Psychological Corporation, 1987.
- Albert M, Smith LA, Scherr PA, Taylor JO, Evans DA, Funkenstein HH: Use of brief cognitive tests to identify individuals in the community with clinically diagnosed Alzheimer’s disease. Int J Neurosci 1991;57:167–178.
- McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD: The MOS 36-item Short-Form Health Survey (SF-36). III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994;32:40–66.
- Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486–2497.
- Steering Committee of the Western Pacific Region of the World Health Organization, the International Association for the Study of Obesity, and the International Obesity Task Force: The Asia-Pacific Perspective: Redefining Obesity and Its Treatment [monograph on the Internet]. Melbourne, Australia: Health Communications Australia Pty Limited; 2000 [cited 2005 Oct 25]. Available from: http://www.diabetes.com.au/pdf/obesity_report.pdf.
- Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measurement 1997;1:385–401.
- Elias PK, Elias MF, D’Agostino RB, Upples LA, Wilson PW, Silbershatz HJ, Wolfe PA: NIDDM and blood pressure as risk factors for poor cognitive performance: the Framingham Study. Diabetes Care 1997;20:1388–1395.
- Rapp SR, Espeland MA, Schumaker SA, Henderson VW, Brunner RL, Manson JE, Gass MLS, Stefanick ML, Lane DS, Hays J, Johnson KC, Coker LH, Dailey M, Bowen D: Effect of estrogen plus progestin on global cognitive functioning in postmenopausal women. The Women’s Health Initiative Memory Study: a randomized controlled trial. JAMA 2003;289:2663–2672.
- Vanhanen M, Koivisto K, Kuusisto J, et al: Cognitive function in an elderly population with persistent impaired glucose tolerance. Diabetes Care 1998;21:398–402.
- Greenwood CE, Winocur G: Glucose treatment reduces memory deficits in young adult rats fed high-fat diets. Neurobiol Learn Mem 2001;75:179–189.
- Marmot MG: Socio-economic factors in cardiovascular disease. J Hypertens Suppl 1996;14:S201–S205.
- House JS, Williams DR: Understanding and reducing socioeconomic and racial/ethnic disparities in health; in Smedley BD, Syme SL (eds): Promoting Health: Intervention Strategies from Social and Behavioral Research. Washington, National Academy Press, 2000, pp 81–204.
- Koster A, Penninx BW, Bosma H, Kempen GI, Harris TB, Newman AB, Rooks RN, Rubin SM, Simonsick EM, van Eijk JT, Kritchevsky SB: Is there a biomedical explanation for socioeconomic differences in incident mobility limitation? J Gerontol A Biol Sci Med Sci 2005;60:1022–1027.
- Sowers MF, Pope S, Welch G, Sternfeld B, Albrecht G: The association of menopause and physical functioning in women at midlife. J Am Geriatr Soc 2001;49:1485–1492.
- Schmidt R, Fazekas F, Reinhart B, Kapeller P, Fazekas G, Offenbacker H, Eber B, Schumacher M, Freidl W: Estrogen replacement therapy in older women: a neuropsychological and brain MRI study. J Am Geriatr Soc 1996;44:1307–1313.
- Okura T, Teshima Y, Isse K, Matsuda H, Inoue T, Sakai Y, Iwasaki W, Yaoi Y: Estrogen increases cerebral and cerebellar blood flows in postmenopausal women. Menopause 1995;2:13–18.
- Rasgon NL, Silverman D, Siddarth P, Miller K, Ercoli LM, Elman S, Lavretsky H, Huang SC, Phelps ME, Small GW: Estrogen use and brain metabolic change in postmenopausal women. Neurobiol Aging 2005;26:229–235.
- Smith YR, Zubieta JK: Neuroimaging of aging and estrogen effects on central nervous system physiology. Fertil Steril 2001;76:651–659.
- Resnick SM, Maki PM, Golski S, Kraut MA, Zonderman AB: Effects of estrogen replacement therapy on PET cerebral blood flow and neuropsychological performance. Horm Behav 1998;34:171–182.
Department of Epidemiology
University of Michigan
Ann Arbor, MI 48104 (USA)
Tel. +1 734 994 7391, Fax +1 734 998 6837, E-Mail firstname.lastname@example.org
Received: November 18, 2008
Accepted: April 20, 2009
Published online: October 10, 2009
Number of Print Pages : 9
Number of Figures : 1, Number of Tables : 4, Number of References : 40
Gerontology (International Journal of Experimental, Clinical, Behavioural and Technological Gerontology)
Vol. 56, No. 3, Year 2010 (Cover Date: April 2010)
Journal Editor: Wick G. (Innsbruck)
ISSN: 0304-324X (Print), eISSN: 1423-0003 (Online)
For additional information: http://www.karger.com/GER
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.