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Higher 24-h Total Movement Activity Percentile Is Associated with Better Cognitive Performance in U.S. Older Adults

ABSTRACT Purpose This study aimed to assess the association of a wrist-worn, device-based metric of 24-h movement with cognitive function and subjective cognitive complaints among older adults, 60 yr and older. Methods This is a cross-sectional analysis of the 2011–2012 and 2013–2014 National Health and Nutrition Examination Survey (NHANES) cycles. A wrist-worn ActiGraph GT3X+ accelerometer captured total 24-h movement activity, analyzed as Monitor-Independent Movement Summary units (MIMS-units), and quantified into placement based on an age- and sex-standardized percentile. Cognitive tests in the domains of memory, language/verbal fluency, and executive performance were administered. Test-specific cognitive z-scores were generated. Subjective cognitive complaints included perceived difficulty remembering and confusion/memory loss. Results The analytical sample included 2708 U.S. older adults (69.5 ± 0.2 yr, 55% female, 20.9% non-White). Multivariable linear regressions revealed those in quartiles 3 (50th–74th percentile) and 4 (≥75th percentile) for their age and sex had higher cognitive function z-scores across all domains compared with those in quartile 1. Logistic regressions demonstrated those in quartiles 3 and 4 also had lower odds of reporting difficulty remembering (adjusted odds ratio [AOR] = 0.52, 95% confidence interval [CI] = 0.31–0.89; AOR = 0.57, 95% CI = 0.37–0.88) and confusion/memory loss (AOR = 0.49, 95% CI = 0.27–0.91; AOR = 0.49, 95% CI = 0.27–0.98), respectively, compared with those in quartile 1. Conclusions In a representative sample of U.S. older adults, higher cognitive functioning occurs among those that perform total 24-h movement activity at or above the 50th percentile for their age and sex. Future studies should consider movement behaviors across a 24-h period on cognitive health outcomes in older adults. More research exploring prospective associations of MIMS-units and time-use behaviors across midlife and older adulthood that may affect cognitive functioning across diverse populations is needed.