BACKGROUND:
Proxies for cognitive reserve, including physical and cognitive activity, have been shown to mitigate disease progression in various forms of neurodegeneration. In this study, we examined whether lower levels of physical and/or cognitive activity were associated with greater clinical impairment in familial frontotemporal dementia (FTD), suggesting a potential protective effect of leisure activities against cognitive decline.
METHODS:
A total of 284 presymptomatic C9orf72, GRN, or MAPT mutation carriers and 193 non-carrier family relatives from the Genetic Frontotemporal Dementia Initiative (GENFI) completed the Physical Activity Scale for the Elderly (PASE) and Cognitive Activity Scale (CAS). The Clinical Dementia Rating scale plus NACC FTLD neuropsychiatric and motor domains (CDR plus NACC FTLD-NM) was used as a marker of clinical progression. Based on PASE and CAS scores,presymptomatic carriers were stratified into age-adjusted high, medium, and low activity groups. Group comparisons were conducted using Wilcoxon rank-sum tests.
RESULTS:
For physical activity, the high and low PASE groups had mean (SD) scores of 300 (76) and 104 (30), respectively. For cognitive activity, the high and low CAS groups had mean (SD) scores of 27 (5) and 12 (3). Participants in the low PASE group had significantly higher CDR+NACC FTLD-NM scores (mean ± SD: 0.59 ± 1.04) compared to the high group (0.29 ± 0.67; Wilcoxon rank-sum test: p=0.005). Similarly, the low CAS group had significantly higher CDR+NACC FTLD-NM scores (0.60 ± 0.88) than the high group (0.38 ± 0.90; p=0.018).
CONCLUSION:
These findings suggest that lower levels of physical and cognitive activity are associated with greater clinical impairment in presymptomatic familial FTD. Ongoing analyses will explore associations with neuropsychological features, potential synergistic interactions between activities in moderating clinical progression, and longitudinal trajectories to determine causal effects.