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NIH Toolbox Cognition Battery in Young and Older Adults: Reliability and Relationship to Adiposity and Physical Activity
Journal article   Peer reviewed

NIH Toolbox Cognition Battery in Young and Older Adults: Reliability and Relationship to Adiposity and Physical Activity

Keith R. Cole, Chu-Ling Yen, Shauna Dudley-Javoroski and Richard K. Shields
Journal of geriatric physical therapy (2001), Vol.44(1), pp.51-59
01/01/2021
DOI: 10.1519/JPT.0000000000000244
PMCID: PMC7093212
PMID: 31567883

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Abstract

Background and Purpose: Executive function in normal aging may be modulated by body habitus and adiposity, both factors modified by physical therapist prescriptions. This study measured between-day reliability of executive function metrics in young and older individuals and examined associations between cognition, adiposity, and physical activity. Methods: Forty-three young and 24 older participants underwent executive function assessment via the National Institutes of Health Toolbox Cognition Battery (Dimensional Change Card Sort, Flanker Inhibitory Control and Attention [Flanker], and List Sorting Working Memory [List Sorting]) at 7-day intervals. Between-day reliability was assessed via intraclass correlation (ICC). Responsiveness was assessed via between-day effect size and Cohen's d. Forward stepwise linear regression examined associations between cognition and age, body mass index, percent body fat, and a self-report measure of physical activity (International Physical Activity Questionnaire Short Form). Results and Discussion: Executive function scores were higher for young participants than for older participants (all P < .002), consistent with typical age-related cognitive decline. Reliability of cognitive metrics was higher for older participants (ICC = 0.483-0.917) than for young participants (ICC = 0.386-0.730). Between-day effect sizes were approximately 50% smaller for older participants. Percent body fat significantly correlated with the Flanker Unadjusted Scale (P = .004, R-2 = 0.0772). Neither vigorous nor total physical activity correlated with any cognitive metric. Conclusions: Older participants demonstrated greater between-day reliability for executive function measures, while young participants showed greater capacity to improve performance upon repeat exposure to a cognitive test (especially Flanker). Percent body fat correlated significantly with Flanker scores, while body mass index (an indirect measure of body fat) did not. Self-reported physical activity did not correlate with executive function. Cognitive response to physical therapist-prescribed exercise is a fertile ground for future research.
Geriatrics & Gerontology Life Sciences & Biomedicine Rehabilitation Science & Technology

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