The relationship between moderate-to-vigorous physical activity and executive function among individuals with schizophrenia: differences by illness duration

Grassmann, Viviane; Subramaniapillai, Mehala; Duncan, Mark; Arbour-Nicitopoulos, Kelly; Faulkner, Guy E.

doi:10.1590/1516-4446-2016-2106

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Brazilian Journal of Psychiatry

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ORIGINAL ARTICLE • Rev. Bras. Psiquiatr. 39 (4) • Oct-Dec 2017 • https://doi.org/10.1590/1516-4446-2016-2106 copy

The relationship between moderate-to-vigorous physical activity and executive function among individuals with schizophrenia: differences by illness duration

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

Schizophrenia is a chronic mental illness characterized by positive and negative symptoms. Cognitive impairment continues to be a core and consistent deficit. Previous studies have shown that physical activity (PA) is positively associated with cognitive performance. Thus, it may play a supportive role in mitigating cognitive impairments among individuals with schizophrenia. The aim of this study was to analyze the relationship between moderate-to-vigorous physical activity (MVPA) and executive function among adults with schizophrenia.

Methods:

The weekly amount of MVPA (assessed using accelerometers) and executive function (as per Brief Neurocognitive Assessment for Schizophrenia) of 78 adults with schizophrenia (mean [SD] age 42.4 [11.4] years; illness duration 17.0 [11.0] years; 58.2% male) were assessed in this cross-sectional study. Pearson correlations were calculated, followed by a linear regression. Participants were first analyzed together and then dichotomized on the basis of illness duration.

Results:

There was no significant association between MVPA and executive function, independent of the duration of illness. For individuals with < 15 years of illness, there was a significant association between weekly MVPA and working memory performance.

Conclusion:

PA appears to be associated with executive function in some, but not all, individuals with schizophrenia.

Accelerometry; executive function; physical activity; schizophrenia

	All participants (n=78)	≤ 15 years of illness (n=44)	> 15 years of illness (n=34)
Age (years), mean (SD)	42.39 (11.44)	35.27 (8.92)	51.34 (7.17)^* * p < 0.001 and
Gender (male)	46 (58.2)	25 (56.8)	21 (60.0)
Smoking (nonsmoker or past smoker)	43 (54.4)	24 (54.5)	19 (54.3)
BMI (kg/m²), mean (SD)	31.67 (8.04)	32.60 (9.14)	30.51 (6.32)
Illness duration (years), mean (SD)	17.06 (10.99)	9.17 (4.10)	26.73 (8.40)^* * p < 0.001 and
CPZ (mg/day), mean (SD)	559.19 (394.08)	521.73 (312.98)	606.29 (477.80)
Diagnosis^† † p < 0.05 for differences between ≤ 15 years of illness and > 15 years of illness.
Schizophrenia	48 (60.8)	32 (72.7)	16 (45.7)
Schizoaffective disorder	30 (38.0)	12 (27.3)	18 (51.4)
Psychosis NOS	1 (1.3)	0 (0.0)	1 (2.9)
Education
High school diploma	64 (81)	37 (84.1)	27 (77.1)
No high school diploma	14 (17.7)	6 (13.6)	8 (22.9)
Other	1 (1.3)	1 (2.3)	0 (0.0)
Executive function, mean (SD)
Symbol Coding	44.03 (12.33)	49.88 (12.05)	36.83 (8.25)^* * p < 0.001 and
Letters and Numbers Span	13.13 (3.47)	13.66 (3.23)	12.44 (3.70)
Met PA guidelines^† † p < 0.05 for differences between ≤ 15 years of illness and > 15 years of illness.
Yes	48 (60.8)	32 (72.7)	16 (45.7)
No	31 (39.2)	12 (27.3)	19 (54.3)
MVPA, mean (SD)
Total MVPA (minutes/week)	252.77 (206.61)	289.26 (197.71)	206.90 (211.20)
MVPA time per bout (minutes)	15.04 (5.02)	15.85 (5.87)	14.02 (3.49)

	Executive function
	Symbol Coding	Letters and Numbers Span	MVPA	CPZ
All participants
Executive function
Symbol Coding	-
Letters and Numbers Span	0.54^* * < 0.01	-
MVPA	0.17	0.09	-
CPZ	-0.34^* * < 0.01	-0.23^† † p < 0.05.	-0.03	-
≤15 years of illness
Executive function
Symbol Coding	-
Letters and Numbers Span	0.57^* * < 0.01	-
MVPA	0.17	0.34^† † p < 0.05.	-
CPZ	-0.47^* * < 0.01	-0.29	-0.18	-
> 15 years of illness
Executive function
Symbol Coding	-
Letters and Numbers Span	0.48^* * < 0.01	-
MVPA	-0.02	-0.22	-
CPZ	-0.22	-0.16	0.107	-

	All participants
	Symbol Coding				Letters and Numbers Span
Predictors	Adjusted R²	F for R²	β	t	Adjusted R²	F for R²	β	t
	0.32	12.71^* * < 0.001;			0.04	2.06
CPZ			-0.21	-2.15^† † p < 0.05.			-0.21	-1.81
Illness duration			-0.43	-4.25^* * < 0.001;			-0.09	-0.76
Educational level			0.16	1.59			0.08	0.75

	≤ 15 years of illness
	Symbol Coding				Letters and Numbers Span
Step/predictors	Adjusted R²	F for R²	β	t	Adjusted R²	F for R²	β	t
Step 1	0.01	1.24			0.11	6.14^* * p < 0.05;
MVPA			0.17	1.11			0.36	2.48^* * p < 0.05;
Step 2	0.19	4.29^* * p < 0.05;			0.13	3.11^* * p < 0.05;
MVPA			0.05	0.32			0.32	2.09^* * p < 0.05;
CPZ			-0.45	-3.16^† † < 0.01.			-0.26	-1.74
Educational level			0.13	0.39			-0.02	-0.14

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[1] Correspondence: Viviane Grassmann, Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St., Toronto, ON Canada M5S 2W6.E-mail: viviane.grassmann@utoronto.ca