Cognitive Impairment Highly Prevalent and Associated With Reduced Physical Function in Older Veteran Clinical Exercise Program.

OBJECTIVE: To evaluate cognition at entry into the Gerofit program and its association with physical function. DESIGN: Retrospective observational cross-sectional design. SETTING: Gerofit outpatient clinical exercise programs at multiple Veterans Affairs Medical Centers from 2021 to 2023. PARTICIPANTS: New enrollees (N=1172) completed measures of lower and upper extremity strength, balance, cardiovascular endurance, and measures of global cognition (telephone Montreal Cognitive Assessment, tMoCA) and cognitive set shifting (Oral Trail Making Test B). Dementia diagnosis in the medical record was exclusionary. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Relationship between physical and cognitive function, self-rated memory change, and demographics were evaluated by linear regression. RESULTS: Mean age was 75 years. 78% of participants were White and 20% Black; 88% were men. Mean tMoCA score was 17.39. tMoCA and Oral Trail Making Test B scores were significantly associated with lower extremity strength (P<.001), and tMoCA score was significantly associated with endurance. tMoCA score was significantly associated with self-rated memory. CONCLUSIONS: Global cognitive functioning was below the cutoff for normal cognition in 61% of participants, suggesting mild cognitive impairment is common in older exercise program enrollees. Lower cognitive scores were related to both reduced strength and endurance.

Duke Scholars

Author Katherine Shepherd Hall Medicine, Geriatrics and Palliative Care