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Randomized Controlled Trial
. 2018 Dec 21;19(1):447.
doi: 10.1186/s12891-018-2369-z.

Can we improve cognitive function among adults with osteoarthritis by increasing moderate-to-vigorous physical activity and reducing sedentary behaviour? Secondary analysis of the MONITOR-OA study

Ryan S Falck  1 , John R Best  1 , Linda C Li  2 , Patrick C Y Chan  1 , Lynne M Feehan  2 , Teresa Liu-Ambrose  3
Affiliations
Randomized Controlled Trial

Can we improve cognitive function among adults with osteoarthritis by increasing moderate-to-vigorous physical activity and reducing sedentary behaviour? Secondary analysis of the MONITOR-OA study

Ryan S Falck et al. BMC Musculoskelet Disord. .

Abstract

Background: Preliminary evidence suggests osteoarthritis is a risk factor for cognitive decline. One potential reason is 87% of adults with osteoarthritis are inactive, and low moderate-to-vigorous physical activity and high sedentary behaviour are each risk factors for cognitive decline. Thus, we investigated whether a community-based intervention to increase moderate-to-vigorous physical activity and reduce sedentary behaviour could improve cognitive function among adults with osteoarthritis.

Methods: This was a secondary analysis of a six month, proof-of-concept randomized controlled trial of a community-based, technology-enabled counselling program to increase moderate-to-vigorous physical activity and reduce sedentary behaviour among adults with knee osteoarthritis. The Immediate Intervention (n = 30) received a Fitbit® Flex™ and four bi-weekly activity counselling sessions; the Delayed Intervention (n = 31) received the same intervention two months later. We assessed episodic memory and working memory using the National Institutes of Health Toolbox Cognition Battery. Between-group differences (Immediate Intervention vs. Delayed Intervention) in cognitive performance were evaluated following the primary intervention (i.e., Baseline - 2 Months) using intention-to-treat.

Results: The intervention did not significantly improve cognitive function; however, we estimated small average improvements in episodic memory for the Immediate Intervention vs. Delayed Intervention (estimated mean difference: 1.27; 95% CI [- 9.27, 11.81]; d = 0.10).

Conclusion: This small study did not show that a short activity promotion intervention improved cognitive health among adults with osteoarthritis. However, the effects of increased moderate-to-vigorous physical activity and reduced sedentary behaviour are likely to be small and thus we recommend subsequent studies use larger sample sizes and measure changes in cognitive function over longer intervals.

Trial registration number: ClinicalTrials.gov Protocol Registration System: NCT02315664 ; registered 12 December, 2014; https://clinicaltrials.gov/ct2/show/NCT02315664?cond=NCT02315664&rank=1.

Keywords: Cognitive function; Osteoarthritis; Physical activity; Sedentary behaviour.

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Conflict of interest statement

Ethics approval and consent to participate

This study was was approved by Vancouver Coastal Health Research Institute and the University of British Columbia’s Clinical Research Ethics Board (H14–01762). All participants provided written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
CONSORT Flow Chart
Fig. 2
Fig. 2
Changes in cognitive performance by treatment group (Baseline – 2 Months). a Change in NIH Toolbox List Sorting Task (i.e., Working Memory) score by treatment group adjusting for baseline cognitive score. b Change in NIH Toolbox Picture Sequence Memory Task (i.e., Episodic Memory) score by treatment group adjusting for baseline cognitive score
Fig. 3
Fig. 3
Relationship between intervention associated changes (i.e., Immediate Intervention = Baseline – 2 Months; Delayed Intervention = Baseline – 4 Months) in moderate-to-vigorous physical activity (minutes/day) and changes in cognitive function. Each model includes 1) baseline score for the cognitive performance variable of interest; 2) baseline moderate-to-vigorous physical activity; and 3) treatment group as covariates of no interest
Fig. 4
Fig. 4
Relationship between intervention associated changes (i.e., Immediate Intervention = Baseline – 2 Months; Delayed Intervention = Baseline – 4 Months) in sedentary behaviour (minutes/day) and changes in cognitive function. Each model includes 1) baseline score for the cognitive performance variable of interest; 2) baseline sedentary behaviour; and 3) treatment group as covariates of no interest
See this image and copyright information in PMC

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