Background & Aims
Aging populations strain healthcare systems due to increased chronic diseases and functional decline. Age-related brain decline, particularly in the dorsolateral prefrontal cortex (DLPFC, responsible for executive function and pain perception), manifests as impaired cognition and endogenous pain modulation (EPM), potentially leading to dementia and chronic pain1,2. Physical activity (PA) emerges as a potential safeguard. Exercise mitigates DLPFC decline and potentially increases grey matter volume3. While optimal exercise parameters for brain health remain under investigation, a physically active lifestyle slows cognitive decline and promotes healthy aging4. However, a complete understanding of the interplay between PA, executive function and pain modulation in older adults is lacking. This study investigates the role of PA on executive functions and pain modulation, hypothesizing that higher PA levels are associated with better cognitive control and improved EPM across adulthood.
Methods
Fifty-five healthy participants were allocated into three groups: active young (n = 14, mean age 25.8 years), active old (n = 14, mean age 71.4 years), and inactive young (n = 26, mean age 26), after completing the validated EPAQ2 questionnaire based on metabolic equivalent (MET)-hours per week. Participants with neurodegenerative diseases, severe psychiatric disorders, chronic conditions or current pain issues were excluded. Physical health status was assessed through self-reported body weight, height, BMI, waist and hip circumference measurements. Executive control functions were evaluated using the Stop-Signal Task (SST) for inhibitory control and the Trail Making Test (TMT Part A and B) for cognitive flexibility. Pain was assessed using Cuff Pressure Algometry measuring pain detection and tolerance thresholds, temporal summation and conditioned pain modulation. One-way ANOVAs were employed to compare cognitive functions and pain across age and activity groups.
Results
As expected, significant age group differences emerged (young vs. old) for response and delay times in the SST and TMT Part A and B completion time (greater in older adults, p<0.001), and pain detection and tolerance thresholds (lower in older adults, p<0.05). Interestingly, no age group effects were observed for pure cognitive control executive functions as measured by Stop-Signal reaction time (inhibition) and B/A ratio (flexibility). Similarly, pain modulation assessed via absolute changes in pain detection (p=0.827) and tolerance (p=0.462) thresholds between conditioned and unconditioned stimuli did not differ between age groups.
Conclusions
Our findings confirm the relationship between aging and declines in reaction time, visuospatial processing, and pain modulation5,6. However, they also suggest potential strategies to mitigate these declines. Interestingly, no age-related differences emerged in pure executive control or pain inhibition. This unexpected preservation in older adults may be attributable to various factors, including sociocultural background and genetic predisposition7,8. Remarkably, their high measured PA levels likely played a positive role, highlighting the potential of PA to maintain these functions during aging9,10. These promising results warrant further investigation with a larger sample size, incorporating objective PA measures like accelerometers and a more extensive battery of cognitive tasks.
References
1.Krivanek, T. J., Gale, S. A., McFeeley, B. M., Nicastri, C. M., & Daffner, K. R. (2021). Promoting Successful Cognitive Aging: A Ten-Year Update. Journal of Alzheimer’s Disease, 81(3), 871–920. https://doi.org/10.3233/JAD-201462
2.Kwon, M., Altin, M., Duenas, H., & Alev, L. (2014). The Role of Descending Inhibitory Pathways on Chronic Pain Modulation and Clinical Implications. Pain Practice, 14(7), 656–667. https://doi.org/10.1111/papr.12145
3.Northey, J. M., Rattray, B., Pumpa, K. L., Pryor, D. J., Fraser, M. A., Shaw, M. E., Anstey, K. J., & Cherbuin, N. (2020). Objectively measured physical activity is associated with dorsolateral prefrontal cortex volume in older adults. NeuroImage, 221, 117150. https://doi.org/10.1016/j.neuroimage.2020.117150
4.Rolland, Y., Abellan Van Kan, G., & Vellas, B. (2010). Healthy Brain Aging: Role of Exercise and Physical Activity. Clinics in Geriatric Medicine, 26(1), 75–87. https://doi.org/10.1016/j.cger.2009.11.002
5.Libon, D. J., Glosser, G., Malamut, B. L., Kaplan, E., Goldberg, E., Swenson, R., & Prouty Sands, L. (1994). Age, executive functions, and visuospatial functioning in healthy older adults. Neuropsychology, 8(1), 38.
6.Hackett, J., Naugle, K. E., & Naugle, K. M. (2020). The decline of endogenous pain modulation with aging: a meta-analysis of temporal summation and conditioned pain modulation. The Journal of Pain, 21(5-6), 514-528.
7.Brunner, E. J. (2005). Social and biological determinants of cognitive aging. Neurobiology of aging, 26(1), 17-20.
https://doi.org/10.1016/j.neurobiolaging.2005.09.024
8.Mogil, J. S., Sternberg, W. F., Marek, P., Sadowski, B., Belknap, J. K., & Liebeskind, J. C. (1996). The genetics of pain and pain inhibition. Proceedings of the National Academy of Sciences, 93(7), 3048-3055.
https://doi.org/10.1073/pnas.93.7.3048
9.Kamijo, K., & Takeda, Y. (2010). Regular physical activity improves executive function during task switching in young adults. International Journal of Psychophysiology, 75(3), 304-311.
10.Naugle, K. M., Ohlman, T., Naugle, K. E., Riley, Z. A., & Keith, N. R. (2017). Physical activity behavior predicts endogenous pain modulation in older adults. Pain, 158(3), 383-390.
Presenting Author
Michelle Bonvini
Poster Authors
Michelle Bonvini
BSC Student
Aalborg University
Lead Author
Giulia Erica Aliotta
Aalborg University
Lead Author
Kristian Hennings
Lead Author
Silvia Lo Vecchio
Aalborg University
Lead Author
Lars Arendt-Nielsen
PhD
Aalborg University
Lead Author
Alfredo Brancucci
Lead Author
Laura Petrini
Aalborg University
Lead Author
Topics
- Pain in Special Populations: Elderly