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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
Falck RS, Best JR, Li LC, Chan PCY, Feehan LM, Liu-Ambrose T
BMC Musculoskeletal Disorders 2018 Dec 21;19(447):Epub
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 versus delayed intervention) in cognitive performance were evaluated following the primary intervention (ie, baseline to 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 versus delayed intervention (estimated mean difference 1.27; 95% CI 9.27 to 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: NCT02315664.

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