Physical activities attenuate the negative cognitive impact from white matter hyperintensities in stroke and TIA patients with low education

• Published in: International journal of geriatric psychiatry Vol. 34; no. 12; pp. 1792 - 1798
• Main Authors: Wong, Adrian, Yiu, Stanley, Lam, Bonnie Yin Ka, Leung, Kam Tat, Shi, Lin, Lo, Eugene, Abrigo, Jill, Au, Lisa Wc, Lau, Alexander, Mok, Vincent
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2019
• Subjects: Aged; Cognition - physiology; Cognitive ability; Cognitive Dysfunction - pathology; Cognitive Dysfunction - psychology; cognitive impairment; Education; Educational Status; Exercise; Exercise - psychology; Female; Geriatric psychiatry; Humans; Ischemia; Ischemic Attack, Transient - pathology; Ischemic Attack, Transient - psychology; Leisure Activities - psychology; leisure activity; Linear Models; Magnetic Resonance Imaging; Male; Mental Status and Dementia Tests; Middle Aged; Physical activity; prevention; Stroke; Stroke - pathology; Stroke - psychology; Substantia alba; Transient ischemic attack; White Matter - pathology; cognitive impairment; transient ischemic attack; leisure activity; stroke; prevention
• ISSN: 0885-6230; 1099-1166; 1099-1166
• DOI: 10.1002/gps.5194

Background The objective of this study is to examine the effects of recent regular participation leisure activities upon cognitive functions between 3 and 6 months after stroke or transient ischemic attack (TIA). We also explored whether the cognitive effects interacted with the severity of white matter hyperintensities (WMH), a marker of cerebral white matter disease, in patients with low or high education. Methods Two‐hundred and ninety‐two subjects with mean age of 66.1 (11.0) years were recruited at median 161(131‐180) days post index event. WMH volume was evaluated using a semi‐automated method on MRI brain. Cognitive functions were measured using the Montreal Cognitive Assessment (MoCA). Multivariable linear regression analysis was conducted to explore the associations between leisure activity participation with WMH and the moderating effects of leisure activities upon relationship between WMH and MoCA. Analyses were further stratified by low (<6 years) or high education (≥6 years). All models were adjusted with age, sex, and years of education. Results Physical activity (PA), but not intellectual activity (IA), was negatively related to WMH volume (P < .05). IA exerted a main effect on MoCA performance (b = 3.21, P < .001). PA, but not IA, significantly interacted with WMH volume (b = −0.18, P < .01) on MoCA performance, but the interaction was only significant in the lower education group (b = 0.28, P < .01) but not in the higher education group. Conclusions In patients with stroke/TIA, IA confers general cognitive benefits. Regular participation in PA negatively correlated with WMH volume. In patients with low education, PA increases resilience against vascular cognitive impairment.