The Five-Times-Sit-to-stand test, a marker of global cognitive functioning among community-dwelling older women

ObjectiveTo determine whether there was an association between the Five-Times-Sit-to-Stand test (FTSS) and the global cognitive function assessed with Short-Portable-Mental-State-Questionnaire (SPMSQ) among the EPIDOS cohort.DesignCross-sectional study corresponding to the baseline assessment of the EPIDOS study.SettingFive French cities including Amiens, Lyon, Montpellier, Paris and Toulouse.Participants7421 community-dwelling older women (mean age 80.41±0.04 years).MeasurementsTime to achieve FTSS, and SPMSQ score. Age, body mass index, high number of comorbidities, cardiovascular risk factors, depression, regular physical activity, joint pain, quadriceps strength, visual acuity, use of psychoactive drugs, serum albumin, vitamin D deficiency (i.e., serum concentration <10ng/mL), and the influence of seasons and study centers were used as covariables. Subjects were divided into 2 groups according to SPMSQ score (either impaired < 8/10 or normal ≥ 8/10).ResultsCompared to their counterparts, the women with cognitive impairment (n=1190, mean 81.51±0.45years) took more time in performing FTSS (17.8±0.9seconds versus 16.1±0.3seconds, P < 0.001). There was a significant negative association of SPMSQ score with FTSS (Unadjusted β=−0.02(95%CI −0.03;−0.01), P<0.001; Fully Adjusted β=−0.03(95%CI −0.05;−0.01), P=0.003; Stepwise Backward Adjusted β=−0.02(95%CI −0.04;−0.01), P=0.005), as well as with advance in age (β=−0.04, P=0.006) and vitamin D deficiency (β=−0.34, P=0.011). The FTSS limit value in predicting moderate cognitive impairment was set at 15 seconds by a sensitivity analysis (negative predictive value=86%).ConclusionWe found a negative association of FTSS with global cognitive performance. Achieving FTSS in less than 15 seconds made unlikely the existence of a moderate cognitive impairment. FTSS could be used as a tool in primary care medicine to exclude moderate cognitive decline.

[1]  Glen A. Satten,et al.  Cross-Sectional Study † , 2005 .

[2]  E. Scherder,et al.  Exercise, cognition and Alzheimer's disease: More is not necessarily better , 2006, Neuroscience & Biobehavioral Reviews.

[3]  Frederick A. Schmitt,et al.  Should older adults be screened for dementia? It is important to screen for evidence of dementia! , 2007, Alzheimer's & Dementia.

[4]  Wilson Jm,et al.  Principles and practice of mass screening for disease , 1968 .

[5]  R. Sulkava,et al.  Short Portable Mental Status Questionnaire as a Screening Test for Dementia and Delirium Among the Elderly , 1987, Journal of the American Geriatrics Society.

[6]  L. Ferrucci,et al.  A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. , 1994, Journal of gerontology.

[7]  C. Annweiler,et al.  Vitamin D and cognitive performance in adults: a systematic review , 2009, European journal of neurology.

[8]  C. Annweiler,et al.  Cross‐sectional association between serum vitamin D concentration and walking speed measured at usual and fast pace among older women: The EPIDOS study , 2010, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[9]  Li Wang,et al.  Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older , 2006, Annals of Internal Medicine.

[10]  T. Seeman,et al.  The relationship between cognitive and physical performance: MacArthur Studies of Successful Aging. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[11]  S L Zeger,et al.  Association between executive attention and physical functional performance in community-dwelling older women. , 1999, The journals of gerontology. Series B, Psychological sciences and social sciences.

[12]  D. Mccarty,et al.  Simple method for measurement of lower extremity muscle strength. , 1985, The American journal of medicine.

[13]  M. Lusardi,et al.  Functional Performance in Community Living Older Adults , 2003 .

[14]  Richard Camicioli,et al.  Independent predictors of cognitive decline in healthy elderly persons. , 2002, Archives of neurology.

[15]  S. Rubin,et al.  Cognitive function, gait speed decline, and comorbidities: the health, aging and body composition study. , 2007, The journals of gerontology. Series A, Biological sciences and medical sciences.

[16]  Anne B. Newman,et al.  Association between Physical and Cognitive Function in Healthy Elderly: The Health, Aging and Body Composition Study , 2004, Neuroepidemiology.

[17]  L. Fried,et al.  Correlates of performance-based measures of muscle function in the elderly: the Cardiovascular Health Study. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[18]  Athanase Benetos,et al.  FIVE TIMES SIT TO STAND TEST IS A PREDICTOR OF RECURRENT FALLS IN HEALTHY COMMUNITY‐LIVING SUBJECTS AGED 65 AND OLDER , 2008, Journal of the American Geriatrics Society.

[19]  S. Lord,et al.  Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[20]  Luigi Ferrucci,et al.  Association of executive function and performance of dual-task physical tests among older adults: analyses from the InChianti study. , 2006, Age and ageing.

[21]  Paige E. Scalf,et al.  Aerobic exercise training increases brain volume in aging humans. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[22]  Kathleen N Lohr,et al.  Screening for Dementia in Primary Care: A Summary of the Evidence for the U.S. Preventive Services Task Force , 2003, Annals of Internal Medicine.

[23]  F. Wolinsky,et al.  Cognitive Ability and Physical Performance in Middle‐Aged African Americans , 2005, Journal of the American Geriatrics Society.

[24]  Dolores Catelan,et al.  Multiple testing in disease mapping and descriptive epidemiology. , 2010, Geospatial health.

[25]  E. Pfeiffer.  A Short Portable Mental Status Questionnaire for the Assessment of Organic Brain Deficit in Elderly Patients † , 1975, Journal of the American Geriatrics Society.

[26]  S. Iliffe,et al.  Primary care and dementia: 2. long‐term care at home: psychosocial interventions, information provision, carer support and case management , 2001, International journal of geriatric psychiatry.

[27]  W. Beam,et al.  A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. , 1999, Research quarterly for exercise and sport.

[28]  Jersey Liang,et al.  Low cognitive performance, comorbid disease, and task-specific disability: findings from a nationally representative survey. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[29]  J. Nordenström,et al.  Nutritional Status Using Mini Nutritional Assessment and Subjective Global Assessment Predict Mortality in Geriatric Patients , 2002, Journal of the American Geriatrics Society.

[30]  L. Ferrucci,et al.  Nonlinear multisystem physiological dysregulation associated with frailty in older women: implications for etiology and treatment. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[31]  D. Jolley,et al.  Cost benefits of a medically supervised day treatment program for patients with Alzheimer's disease and other forms of dementia , 1989 .

[32]  L G Branch,et al.  Physical performance measures in aging research. , 1989, Journal of gerontology.

[33]  S. Iliffe,et al.  Primary care and dementia: 1. diagnosis, screening and disclosure , 2009, International journal of geriatric psychiatry.

[34]  G. Breart,et al.  Fall-related factors and risk of hip fracture: the EPIDOS prospective study , 1996, The Lancet.

[35]  Richard W. Bohannon,et al.  Reference Values for the Five-Repetition Sit-to-Stand Test: A Descriptive Meta-Analysis of Data from Elders , 2006, Perceptual and motor skills.

[36]  N. Cohen,et al.  Aerobic fitness reduces brain tissue loss in aging humans. , 2003, The journals of gerontology. Series A, Biological sciences and medical sciences.

[37]  K. Toyoshima,et al.  Physical Fitness and Cognitive Function in an 85-Year-Old Community-Dwelling Population , 2008, Gerontology.

[38]  Luigi Ferrucci,et al.  Executive Function Correlates with Walking Speed in Older Persons: The InCHIANTI Study , 2005, Journal of the American Geriatrics Society.

[39]  James S Goodwin,et al.  The interaction of cognitive and emotional status on subsequent physical functioning in older mexican americans: findings from the Hispanic established population for the epidemiologic study of the elderly. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[40]  D. Le Gall,et al.  Vitamin D and Ageing: Neurological Issues , 2010, Neuropsychobiology.

[41]  F. Craik.  Memory Changes in Normal and Pathological Aging , 2008, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[42]  C. Annweiler,et al.  Association of vitamin D deficiency with cognitive impairment in older women , 2010, Neurology.

[43]  Mark S Redfern,et al.  Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-Times-Sit-to-Stand Test. , 2005, Physical therapy.

[44]  Xiaonan Xue,et al.  Quantitative gait dysfunction and risk of cognitive decline and dementia , 2007, Journal of Neurology, Neurosurgery & Psychiatry.

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

[46]  Richard W. Bohannon,et al.  Deficits in lower extremity muscle and gait performance among renal transplant candidates. , 1995, Archives of physical medicine and rehabilitation.

[47]  J. Williamson,et al.  The relationship between cognitive function and physical performance in older women: results from the women's health initiative memory study. , 2010, The journals of gerontology. Series A, Biological sciences and medical sciences.

[48]  J W Rowe,et al.  Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur studies of successful aging. , 1994, Journal of gerontology.

[49]  Li Wang,et al.  Predictors of Functional Change: A Longitudinal Study of Nondemented People Aged 65 and Older , 2002, Journal of the American Geriatrics Society.

[50]  C. Annweiler,et al.  Is there an association between serum 25-hydroxyvitamin D concentration and muscle strength among older women? Results from baseline assessment of the EPIDOS study , 2009, The journal of nutrition, health & aging.