Health and Quality of Life Perception in Older Adults: The Joint Role of Cognitive Efficiency and Functional Mobility

Cognitive and mobility functions are involved in health-related quality of life (HRQoL). The present cross-sectional study aimed at investigating what facets of efficient cognition and functional mobility interactively contribute to mental and physical HRQoL. Fifty-six healthy older individuals (aged 65–75 years) were evaluated for mental and physical HRQoL, core cognitive executive functions (inhibition, working memory, and cognitive flexibility), and functional mobility (walking) under single and dual task conditions. Multiple regression analyses were run to verify which core executive functions predicted mental and physical HRQoL and whether the ability to perform complex (dual) walking tasks moderated such association. Inhibitory efficiency and the ability to perform physical-mental dual tasks interactively predicted mental HRQoL, whereas cognitive flexibility and the ability to perform physical dual tasks interactively predicted physical HRQoL. Different core executive functions seem relevant for mental and physical HRQoL. Executive function efficiency seems to translate into HRQoL perception when coupled with tangible experience of the ability to walk under dual task conditions that mirror everyday life demands. Implications of these results for supporting the perception of mental and physical quality of life at advanced age are discussed, suggesting the usefulness of multicomponent interventions and environments conducive to walking that jointly aid successful cognitive aging and functional mobility.

[1]  D. Miller,et al.  Health-related quality of life , 2002, Multiple sclerosis.

[2]  C. Marra,et al.  The independent contribution of executive functions to health related quality of life in older women , 2010, BMC geriatrics.

[3]  Jeffrey M. Hausdorff,et al.  The role of executive function and attention in gait , 2008, Movement disorders : official journal of the Movement Disorder Society.

[4]  W. Hippel,et al.  Aging, Executive Functioning, and Social Control , 2007 .

[5]  C. Voelcker-Rehage,et al.  Training effects on motor–cognitive dual-task performance in older adults , 2014, European Review of Aging and Physical Activity.

[6]  A. Dhar,et al.  National Institute for Health and Clinical Excellence , 2005 .

[7]  Cecilia Fagerström,et al.  Mobility, functional ability and health-related quality of life among people of 60 years or older , 2010, Aging clinical and experimental research.

[8]  J. Varni,et al.  Health-Related Quality of Life , 2007 .

[9]  Larry E. Toothaker,et al.  Multiple Regression: Testing and Interpreting Interactions , 1991 .

[10]  Richard W. Bohannon Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. , 1997, Age and ageing.

[11]  H. Ekström,et al.  Associations between functional ability and life satisfaction in the oldest old: results from the longitudinal population study Good Aging in Skåne , 2012, Clinical interventions in aging.

[12]  S. Bryan,et al.  Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments , 2012, BMC Geriatrics.

[13]  Suzanne G. Leveille,et al.  Are Changes in Leg Power Responsible for Clinically Meaningful Improvements in Mobility in Older Adults? , 2010, Journal of the American Geriatrics Society.

[14]  Xiaonan Xue,et al.  Cognitive processes related to gait velocity: results from the Einstein Aging Study. , 2006, Neuropsychology.

[15]  J. Cummings,et al.  Executive control function: a review of its promise and challenges for clinical research. A report from the Committee on Research of the American Neuropsychiatric Association. , 2002, The Journal of neuropsychiatry and clinical neurosciences.

[16]  Phillip D Tomporowski,et al.  Acute aerobic exercise and information processing: modulation of executive control in a Random Number Generation task. , 2009, Acta psychologica.

[17]  C. Pesce,et al.  Executive function moderates the role of muscular fitness in determining functional mobility in older adults , 2013, Aging Clinical and Experimental Research.

[18]  B. Saelens,et al.  Built environment correlates of walking: a review. , 2008, Medicine and science in sports and exercise.

[19]  A. Stewart,et al.  Environmental demands associated with community mobility in older adults with and without mobility disabilities. , 2002, Physical therapy.

[20]  M. J. Emerson,et al.  The Unity and Diversity of Executive Functions and Their Contributions to Complex “Frontal Lobe” Tasks: A Latent Variable Analysis , 2000, Cognitive Psychology.

[21]  C. O'boyle,et al.  Measuring health-related quality of life in older patient populations , 2012, PharmacoEconomics.

[22]  R. Doughty,et al.  Measuring health-related quality of life. , 1999, The New Zealand medical journal.

[23]  S. Iwarsson,et al.  A 10-year follow-up study on subjective well-being and relationships to person-environment (P-E) fit and activity of daily living (ADL) dependence of older Swedish adults. , 2009, Archives of gerontology and geriatrics.

[24]  E. Schouten,et al.  Physical exercise or micronutrient supplementation for the wellbeing of the frail elderly? A randomised controlled trial , 2002, British journal of sports medicine.

[25]  Y. Gustafson,et al.  Is a change in functional capacity or dependency in activities of daily living associated with a change in mental health among older people living in residential care facilities? , 2013, Clinical interventions in aging.

[26]  D. Skelton,et al.  Exercise studies with elderly volunteers. , 1994, Age and ageing.

[27]  C. O'boyle,et al.  Measuring health-related quality of life in older patient populations , 2012, PharmacoEconomics.

[28]  J. Ware SF-36 health survey: Manual and interpretation guide , 2003 .

[29]  Daniel N. Allen,et al.  Trail-Making Test , 2010 .

[30]  Simone V Gill,et al.  Obesity, functional mobility and quality of life. , 2013, Best practice & research. Clinical endocrinology & metabolism.

[31]  J. Manson,et al.  Physical activity, including walking, and cognitive function in older women. , 2004, JAMA.

[32]  D. Roth,et al.  Functional status, life-space mobility, and quality of life: a longitudinal mediation analysis , 2013, Quality of Life Research.

[33]  Roy P C Kessels,et al.  Executive functions are associated with gait and balance in community-living elderly people. , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[34]  R. Layte,et al.  Quality of Life in Older Age: Evidence from an Irish Cohort Study , 2013, Journal of the American Geriatrics Society.

[35]  C. Goodman Quality of life from the perspectives of older people , 2004 .

[36]  P. Boyer,et al.  Evaluation of the supervisory system in elderly subjects with and without disinhibition , 2000, European Psychiatry.

[37]  C. Blake,et al.  The Short Form 36 (SF-36) Health Survey: normative data for the Irish population , 2000, Irish journal of medical science.

[38]  John N. Towse,et al.  Analyzing human random generation behavior: A review of methods used and a computer program for describing performance , 1998 .

[39]  Caterina Pesce,et al.  Enhancing cognitive functioning in the elderly: multicomponent vs resistance training , 2013, Clinical interventions in aging.

[40]  L. Bherer,et al.  The multiple dimensions of frailty: physical capacity, cognition, and quality of life , 2012, International Psychogeriatrics.

[41]  Terrence E Murphy,et al.  Disability in activities of daily living, depression, and quality of life among older medical ICU survivors: a prospective cohort study , 2011, Health and quality of life outcomes.

[42]  Knut Engedal,et al.  Physical Performance and Quality of Life of Nursing-Home Residents with Mild and Moderate Dementia , 2013, International journal of environmental research and public health.

[43]  B. Franklin,et al.  American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. , 2011, Medicine and science in sports and exercise.

[44]  M. Murphy,et al.  Stay active: the physical activity, ageing and health study , 2014 .

[45]  F S Cromwell,et al.  Inaugural editorial. , 1984, Occupational therapy in health care.

[46]  I. Hallberg,et al.  Life satisfaction in 6 European countries: the relationship to health, self-esteem, and social and financial resources among people (Aged 65-89) with reduced functional capacity. , 2008, Geriatric nursing.

[47]  P. Scarborough,et al.  Physical Activity Statistics 2015 , 2012 .

[48]  John N. Towse,et al.  Random number generation and working memory , 2007 .

[49]  L. Vaughan,et al.  Executive function in daily life: Age-related influences of executive processes on instrumental activities of daily living. , 2010, Psychology and aging.

[50]  Lars Nyberg,et al.  Plasticity of executive functioning in young and older adults: immediate training gains, transfer, and long-term maintenance. , 2008, Psychology and aging.

[51]  D. Warburton,et al.  Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines , 2010, The international journal of behavioral nutrition and physical activity.

[52]  S. Bandinelli,et al.  Age‐Associated Declines in Complex Walking Task Performance: The Walking InCHIANTI Toolkit , 2007, Journal of the American Geriatrics Society.

[53]  J. Cummings,et al.  Executive Control Function , 2002 .

[54]  J. Jolles,et al.  The SF-36 as a precursory measure of adaptive functioning in normal aging: the Maastricht Aging Study , 2010, Aging clinical and experimental research.

[55]  Eling D de Bruin,et al.  Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up , 2015, Clinical interventions in aging.

[56]  S. Heymsfield,et al.  Epidemiology of sarcopenia among the elderly in New Mexico. , 1998, American journal of epidemiology.

[57]  E. Király,et al.  The effect of functional movement ability on the quality of life after total hip replacement. , 2014, Journal of Clinical Nursing.

[58]  H. Levin A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary , 1993 .

[59]  L. Calvó-Perxas,et al.  The Trail Making Test , 2017, Assessment (Odessa, Fla.).

[60]  Eduardo Lattari,et al.  Neuroscience of Exercise: From Neurobiology Mechanisms to Mental Health , 2013, Neuropsychobiology.