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Association between actigraphy-derived physical activity and cognitive performance in patients with schizophrenia

Published online by Cambridge University Press:  10 June 2016

L.-J. Chen ,
A. Steptoe ,
M.-S. Chung  and
P.-W. Ku
L.-J. Chen
Affiliation:
Department of Exercise Health Science, National Taiwan University of Sport, 271 Lixing Road, Taichung 404, Taiwan Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK
A. Steptoe
Affiliation:
Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK
M.-S. Chung
Affiliation:
Jianan Psychiatric Center, Ministry of Health and Welfare, 80, Lane 870, Zhongshan Road, Tainan 717, Taiwan
P.-W. Ku*
Affiliation:
Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK Graduate Institute of Sports and Health, National Changhua University of Education, 1 Jin-De Road, Changhua 500, Taiwan
*
*Address for correspondence: P.-W. Ku, National Changhua University of Education, 1 Jin-De Road, Changhua City 500, Taiwan. (Email: powen.ku@gmail.com)
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Abstract

Background

An association between low levels of physical activity and impaired cognitive performance in schizophrenia has been proposed, but most studies have relied on self-report measures of activity. This study examined the association between actigraphy-derived physical activity and cognitive performance adjusting for multiple covariates in patients with schizophrenia.

Method

Patients with schizophrenia (n = 199) were recruited from chronic psychiatric wards, and 60 age-, sex- and body mass index-matched comparison participants were recruited from the staff of two hospitals and universities. Physical activity was assessed objectively for 7 days using an ActiGraph. Cognitive performance was assessed with the Cognitrone test from the Vienna Test System and the Grooved Pegboard Test. Demographic variables, metabolic parameters, positive and negative symptoms, duration of illness and hospitalization, and medication use were included as covariates. Pearson correlations and multivariable linear regressions were conducted to examine the associations between physical activity levels and cognitive performance.

Results

Patients with schizophrenia were less physically active and had poorer performance on attention/concentration and speed of processing than the comparison group. Patients with schizophrenia who spent more time in light physical activity showed better performance on attention/concentration (β = 0.198, p = 0.020) and speed of processing (β= −0.169, p = 0.048) tasks than those who were less active. Cognitive performance was also associated with moderate-vigorous physical activity, but the effect was no longer significant once light physical activity had been taken into account.

Conclusions

This study provides evidence for a positive association between objectively measured light physical activity and cognitive performance in people with schizophrenia, after adjustment for multiple confounders.

Keywords

Accelerometryactigraphycognitioninactivitypsychiatric disorders
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 11 , August 2016 , pp. 2375 - 2384
Copyright
Copyright © Cambridge University Press 2016 

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Angevaren, M, Aufdemkampe, G, Verhaar, HJ, Aleman, A, Vanhees, L (2008). Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database of Systematic Reviews 16, CD005381.Google Scholar
Belsky, DW, Caspi, A, Israel, S, Blumenthal, JA, Poulton, R, Moffitt, TE (2015). Cardiorespiratory fitness and cognitive function in midlife: neuroprotection or neuroselection? Annals of Neurology 77, 607–617.CrossRefGoogle ScholarPubMed
Bezdicek, O, Nikolai, T, Hoskovcová, M, Štochl, J, Brožová, H, Dušek, P, Zárubová, K, Jech, R, Růžička, E (2014). Grooved pegboard predicates more of cognitive than motor involvement in Parkinson's disease. Assessment 21, 723–730.Google Scholar
Cain, KL, Conway, TL, Adams, MA, Husak, LE, Sallis, JF (2013). Comparison of older and newer generations of ActiGraph accelerometers with the normal filter and the low frequency extension. International Journal of Behavioral Nutrition and Physical Activity 10, 51.Google Scholar
De Leon, J, Diaz, FJ (2005). A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophrenia Research 76, 135–157.Google Scholar
De Moura, BP, Marins, JC, Franceschini Sdo, C, Reis, JS, Amorim, PR (2015). Aerobic exercise did not have compensatory effects on physical activity levels in type 2 diabetes patients. Journal of Sports Sciences 33, 545–551.Google Scholar
Deijen, J, Orlebeke, J, Rijsdijk, F (1993). Effect of depression on psychomotor skills, eye movements and recognition-memory. Journal of Affective Disorders 29, 33–40.Google Scholar
Falkai, P, Malchow, B, Wobrock, T, Gruber, O, Schmitt, A, Honer, WG, Pajonk, F-G, Sun, F, Cannon, TD (2013). The effect of aerobic exercise on cortical architecture in patients with chronic schizophrenia: a randomized controlled MRI study. European Archives of Psychiatry and Clinical Neuroscience 263, 469–473.Google Scholar
Freedson, PS, Melanson, E, Sirard, J (1998). Calibration of the Computer Science and Applications, Inc. accelerometer. Medicine and Science in Sports and Exercise 30, 777–781.Google Scholar
García-Ortiz, L, Recio-Rodríguez, JI, Martín-Cantera, C, Cabrejas-Sánchez, A, Gómez-Arranz, A, González-Viejo, N, Nicolás, EI, Patino-Alonso, MC, Gómez-Marcos, MA (2010). Physical exercise, fitness and dietary pattern and their relationship with circadian blood pressure pattern, augmentation index and endothelial dysfunction biological markers: EVIDENT study protocol. BMC Public Health 10, 233.Google Scholar
Gardner, DM, Murphy, AL, O'Donnell, H, Centorrino, F, Baldessarini, RJ (2010). International consensus study of antipsychotic dosing. American Journal of Psychiatry 167, 686–693.CrossRefGoogle ScholarPubMed
Glisky, EL (2007). Changes in cognitive function in human aging. In Brain Aging: Models, Methods, and Mechanisms, chapter 1 (ed. D. R. Riddle, ). CRC Press/Taylor & Francis: Boca Raton, FL (http://www.ncbi.nlm.nih.gov/books/NBK3885/).Google Scholar
Green, MF (1996). What are the functional consequences of neurocognitive deficits in schizophrenia? American Journal of Psychiatry 153, 321–330.Google Scholar
Guiney, H, Machado, L (2013). Benefits of regular aerobic exercise for executive functioning in healthy populations. Psychonomic Bulletin and Review 20, 73–86.Google Scholar
Hägg, S, Lindblom, Y, Mjörndal, T, Adolfsson, R (2006). High prevalence of the metabolic syndrome among a Swedish cohort of patients with schizophrenia. International Clinical Psychopharmacology 21, 93–98.Google Scholar
Hansen, BH, Kolle, E, Dyrstad, SM, Holme, I, Anderssen, SA (2012). Accelerometer-determined physical activity in adults and older people. Medicine and Science in Sports and Exercise 44, 266–272.CrossRefGoogle ScholarPubMed
Hausswolff-Juhlin, V, Bjartveit, M, Lindström, E, Jones, P (2009). Schizophrenia and physical health problems. Acta Psychiatrica Scandinavica 119, 15–21.Google Scholar
Holley, J, Crone, D, Tyson, P, Lovell, G (2011). The effects of physical activity on psychological well-being for those with schizophrenia: a systematic review. British Journal of Clinical Psychology 50, 84–105.Google Scholar
Kay, SR, Flszbein, A, Opfer, LA (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.Google Scholar
Kimhy, D, Vakhrusheva, J, Bartels, MN, Armstrong, HF, Ballon, JS, Khan, S, Chang, RW, Hansen, MC, Ayanruoh, L, Lister, A (2015). The impact of aerobic exercise on brain-derived neurotrophic factor and neurocognition in individuals with schizophrenia: a single-blind, randomized clinical trial. Schizophrenia Bulletin 41, 859–868.Google Scholar
Kimhy, D, Vakhrusheva, J, Bartels, MN, Armstrong, HF, Ballon, JS, Khan, S, Chang, RW, Hansen, MC, Ayanruoh, L, Smith, EE (2014). Aerobic fitness and body mass index in individuals with schizophrenia: implications for neurocognition and daily functioning. Psychiatry Research 220, 784–791.Google Scholar
Klasik, A, Krysta, K, Krzystanek, M, Skałacka, K (2011). Impact of olanzapine on cognitive functions in patients with schizophrenia during an observation period of six months. Psychiatria Danubina 23, S83–S86.Google ScholarPubMed
Lee, HJ, Kim, L, Suh, KY (2003). Cognitive deterioration and changes of P300 during total sleep deprivation. Psychiatry and Clinical Neurosciences 57, 490–496.CrossRefGoogle ScholarPubMed
Leutwyler, H, Hubbard, EM, Jeste, DV, Miller, B, Vinogradov, S (2014). Associations of schizophrenia symptoms and neurocognition with physical activity in older adults with schizophrenia. Biological Research for Nursing 16, 23–30.Google Scholar
Lindamer, LA, McKibbin, C, Norman, GJ, Jordan, L, Harrison, K, Abeyesinhe, S, Patrick, K (2008). Assessment of physical activity in middle-aged and older adults with schizophrenia. Schizophrenia Research 104, 294–301.Google Scholar
Malchow, B, Reich-Erkelenz, D, Oertel-Knöchel, V, Keller, K, Hasan, A, Schmitt, A, Scheewe, TW, Cahn, W, Kahn, RS, Falkai, P (2013). The effects of physical exercise in schizophrenia and affective disorders. European Archives of Psychiatry and Clinical Neuroscience 263, 451–467.Google Scholar
Marder, SR, Essock, SM, Miller, AL, Buchanan, RW, Casey, DE, Davis, JM, Kane, JM, Lieberman, JA, Schooler, NR, Covell, N (2014). Physical health monitoring of patients with schizophrenia. American Journal of Psychiatry 161, 1334–1349.CrossRefGoogle Scholar
Matza, LS, Buchanan, R, Purdon, S, Brewster-Jordan, J, Zhao, Y, Revicki, DA (2006). Measuring changes in functional status among patients with schizophrenia: the link with cognitive impairment. Schizophrenia Bulletin 32, 666–678.CrossRefGoogle ScholarPubMed
McGrath, J, Saha, S, Chant, D, Welham, J (2008). Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiologic Reviews 30, 67–76.Google Scholar
McMorris, T, Hale, BJ (2012). Differential effects of differing intensities of acute exercise on speed and accuracy of cognition: a meta-analytical investigation. Brain and Cognition 80, 338–351.CrossRefGoogle ScholarPubMed
National Institute of Mental Health (2009). Schizophrenia. US Department of Health and Human Services, National Institute of Mental Health: Bethesda, MD.Google Scholar
Nuechterlein, KH, Barch, DM, Gold, JM, Goldberg, TE, Green, MF, Heaton, RK (2004). Identification of separable cognitive factors in schizophrenia. Schizophrenia Research 72, 29–39.Google Scholar
Oertel-Knöchel, V, Mehler, P, Thiel, C, Steinbrecher, K, Malchow, B, Tesky, V, Ademmer, K, Prvulovic, D, Banzer, W, Zopf, Y, Schmitt, A, Hänsel, F (2014). Effects of aerobic exercise on cognitive performance and individual psychopathology in depressive and schizophrenia patients. European Archives of Psychiatry and Clinical Neuroscience 264, 589–604.Google Scholar
Pajonk, F-G, Wobrock, T, Gruber, O, Scherk, H, Berner, D, Kaizl, I, Kierer, A, Müller, S, Oest, M, Meyer, T (2010). Hippocampal plasticity in response to exercise in schizophrenia. Archives of General Psychiatry 67, 133–143.CrossRefGoogle ScholarPubMed
Ramsay, CE, Stewart, T, Compton, MT (2012). Unemployment among patients with newly diagnosed first-episode psychosis: prevalence and clinical correlates in a US sample. Social Psychiatry and Psychiatric Epidemiology 47, 797–803.Google Scholar
Ratliff, JC, Palmese, LB, Reutenauer, EL, Liskov, E, Grilo, CM, Tek, C (2012). The effect of dietary and physical activity pattern on metabolic profile in individuals with schizophrenia: a cross-sectional study. Comprehensive Psychiatry 53, 1028–1033.Google Scholar
Rege, S (2008). Antipsychotic induced weight gain in schizophrenia: mechanisms and management. Australian and New Zealand Journal of Psychiatry 42, 369–381.Google Scholar
Richardson, CR, Faulkner, G, McDevitt, J, Skrinar, GS, Hutchinson, DS, Piette, JD (2005). Integrating physical activity into mental health services for persons with serious mental illness. Psychiatric Services 56, 324–331.CrossRefGoogle ScholarPubMed
Scheewe, TW, Van Haren, NE, Sarkisyan, G, Schnack, HG, Brouwer, RM, De Glint, M, Pol, HEH, Backx, FJ, Kahn, RS, Cahn, W (2013). Exercise therapy, cardiorespiratory fitness and their effect on brain volumes: a randomised controlled trial in patients with schizophrenia and healthy controls. European Neuropsychopharmacology 23, 675–685.Google Scholar
Schuhfried (2013). Vienna Test System Psychological Assessment. Schuhfried GmbH: Moedling, Austria.Google Scholar
Sharma, T, Antonova, L (2003). Cognitive function in schizophrenia: deficits, functional consequences, and future treatment. Psychiatric Clinics of North America 26, 25–40.Google Scholar
Steinberg, SI, Sammel, MD, Harel, BT, Schembri, A, Policastro, C, Bogner, HR, Negash, S, Arnold, SE (2015). Exercise, sedentary pastimes, and cognitive performance in healthy older adults. American Journal of Alzheimer's Disease and Other Dementias 30, 290–298.Google Scholar
Vancampfort, D, De Hert, M, Sweers, K, De Herdt, A, Detraux, J, Probst, M (2013). Diabetes, physical activity participation and exercise capacity in patients with schizophrenia. Psychiatry and Clinical Neurosciences 67, 451–456.Google Scholar
Vancampfort, D, Sweers, K, Probst, M, Maurissen, K, Knapen, J, Minguet, P, De Hert, M (2011). Association of the metabolic syndrome with physical activity performance in patients with schizophrenia. Diabetes and Metabolism 37, 318–323.Google Scholar
Verburgh, L, Königs, M, Scherder, EJ, Oosterlaan, J (2014). Physical exercise and executive functions in preadolescent children, adolescents and young adults. British Journal of Sports Medicine 48, 973–979.Google Scholar
Wang, YC, Magasi, SR, Bohannon, RW, Reuben, DB, Mccreath, HE, Bubela, DJ, Gershon, RC, Rymer, WZ (2011). Assessing dexterity function: a comparison of two alternatives for the NIH Toolbox. Journal of Hand Therapy 24, 313–321.Google Scholar
Wichniak, A, Skowerska, A, Chojnacka-Wojtowicz, J, Taflinski, T, Wierzbicka, A, Jernajczyk, W, Jarema, M (2011). Actigraphic monitoring of activity and rest in schizophrenic patients treated with olanzapine or risperidone. Journal of Psychiatric Research 45, 1381–1386.Google Scholar
Wu, EQ, Birnbaum, HG, Shi, L, Ball, DE, Kessler, RC, Moulis, M, Aggarwal, J (2005). The economic burden of schizophrenia in the United States in 2002. Journal of Clinical Psychiatry 66, 1122–1129.Google Scholar
Yamamoto, H, Yamamoto, K, Miyaji, S, Yukawa-Inui, M, Hori, T, Tatematsu, S, Yutani, M, Tanaka, K, Miyaoka, H (2011). Daily physical activity in patients with schizophrenia. Kitasato Medical Journal 41, 145–153.Google Scholar
Zschucke, E, Gaudlitz, K, Ströhle, A (2013). Exercise and physical activity in mental disorders: clinical and experimental evidence. Journal of Preventive Medicine and Public Health 46, S12–S21.Google Scholar