Table 4. Adjusted Associations of Sport and Exercise Physical Activity With Digit Span Backwards Score Trajectories.
| Model 1a | Model 2b | Model 3c | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DSB level (95% CI) | P value | DSB annual slope (95% CI) | P value | DSB level (95% CI) | P value | DSB annual slope (95% CI) | P value | DSB level (95% CI) | P value | DSB annual slope (95% CI) | P value | |
| DSB value in referent womand | Starting level: 6.91 (6.71 to 7.11) | <.001 | Before age 61 y: 0 (−0.01 to 0.01) | .89 | Starting level: 7.21 (6.85 to 7.58) | <.001 | Before age 61 y: 0 (−0.01 to 0.02) | .78 | Starting level: 7.23 (6.86 to 7.60) | <.001 | Before age 61 y: 0 (−0.01 to 0.02) | .63 |
| After age 61 y: −0.03 (−0.05 to −0.01) | .003 | After age 61 y: −0.03 (−0.09 to 0.04) | .44 | After age 61 y: 0.02 (−0.09 to 0.04) | .502 | |||||||
| Variablee | ||||||||||||
| Sport and exercise PA level | 0.03 (−0.02 to 0.09) | .23 | 0.01 (−0.01 to 0.02) | .21 | −0.03 (−0.09 to 0.02) | .25 | 0 (−0.01 to 0.02) | .73 | −0.03 (−0.09 to 0.02) | .23 | 0 (−0.01 to 0.02) | .57 |
| No. missed visits | −0.11 (−0.20 to 0.01) | .03 | NA | NA | −0.08 (−0.17 to 0.02) | .11 | −0.03 (−0.07 to 0.01) | .12 | −0.07 (−0.17 to 0.02) | .14 | −0.03 (−0.07 to 0.01) | .14 |
| Demographic | ||||||||||||
| Race/ethnicity | ||||||||||||
| Chinese | NA | NA | NA | NA | −0.79 (−1.25 to −0.33) | <.001 | −0.02 (−0.11 to 0.06) | .61 | −0.79 (−1.25 to −0.33) | <.001 | −0.02 (−0.11 to 0.06) | .60 |
| Japanese | NA | NA | NA | NA | −0.48 (−0.92 to −0.05) | .03 | 0.03 (−0.05 to 0.11) | .47 | −0.48 (−0.92 to −0.04) | .03 | 0.03 (−0.05 to 0.12) | .48 |
| Black | NA | NA | NA | NA | −1.31 (−1.57 to −1.06) | <.001 | 0.02 (−0.03 to 0.07) | .42 | −1.26 (−1.52 to −1.00) | <.001 | 0.02 (−0.04 to 0.07) | .55 |
| Education | ||||||||||||
| High school or less | NA | NA | NA | NA | −0.47 (−0.75 to −0.20) | <.001 | −0.01 (−0.06 to 0.05) | .84 | −0.46 (−0.74 to −0.17) | .002 | −0.01 (−0.06 to 0.04) | .73 |
| College or some college | NA | NA | NA | NA | 0.48 (0.23 to 0.74) | <.001 | 0.01 (−0.04 to 0.07) | .58 | 0.48 (0.23 to 0.74) | <.001 | 0.01 (−0.04 to 0.06) | .63 |
| Postbaccalaureate | NA | NA | NA | NA | 0.85 (0.60 to 1.10) | <.001 | −0.02 (−0.07 to 0.03) | .37 | 0.85 (0.60 to 1.10) | <.001 | −0.02 (−0.07 to 0.02) | .34 |
| Test language | ||||||||||||
| Chinese | NA | NA | NA | NA | 1.28 (0.81 to 1.76) | <.001 | 0.05 (−0.06 to 0.16) | .39 | 1.28 (0.81 to 1.76) | <.001 | 0.05 (−0.06 to 0.16) | .35 |
| Japanese | NA | NA | NA | NA | 0.48 (−0.05 to 1.00) | .07 | −0.08 (−0.18 to 0.02) | .11 | 0.47 (−0.06 to 0.99) | .08 | −0.07 (−0.17 to 0.02) | .14 |
| Economic hardship | NA | NA | ||||||||||
| Somewhat hard | NA | NA | NA | NA | −0.08 (−0.20 to 0.04) | .19 | −0.06 (−0.11 to −0.01) | .01 | −0.08 (−0.19 to 0.04) | .21 | −0.07 (−0.12 to −0.02) | .01 |
| Very hard | NA | NA | NA | NA | −0.02 (−0.26 to 0.21) | .84 | −0.03 (−0.16 to 0.09) | .63 | −0.03 (−0.26 to 0.21) | .81 | −0.05 (−0.18 to 0.07) | .42 |
| Menopause-associated variable | ||||||||||||
| Hormone therapy | ||||||||||||
| Past | NA | NA | NA | NA | −0.37 (−0.75 to 0.003) | .05 | NA | NA | −0.36 (−0.73 to 0.02) | .07 | NA | NA |
| Current | NA | NA | NA | NA | 0.17 (−0.003 to 0.35) | .05 | 0.03 (−0.02 to 0.08) | .30 | 0.17 (−0.003 to 0.35) | .054 | 0.03 (−0.02 to 0.08) | .32 |
| Depressive symptoms | ||||||||||||
| Past | NA | NA | NA | NA | −0.28 (−0.69 to 0.12) | .17 | NA | NA | −0.31 (−0.72 to 0.10) | .14 | NA | NA |
| Current | NA | NA | NA | NA | 0.07 (−0.04 to 0.18) | .23 | 0 (−0.05 to 0.05) | .95 | 0.07 (−0.04 to 0.19) | .21 | 0 (−0.05 to 0.05) | .89 |
| Anxiety symptoms | ||||||||||||
| Past | NA | NA | NA | NA | 0.10 (−0.28 to 0.48) | .60 | NA | NA | 0.11 (−0.26 to 0.50) | .55 | NA | NA |
| Current | NA | NA | NA | NA | −0.10 (−0.21 to −0.001) | .048 | −0.03 (−0.07 to 0.02) | .21 | −0.10 (−0.21 to −0.002) | .045 | −0.03 (−0.07 to 0.01) | .20 |
| Sleep problems | ||||||||||||
| Past | NA | NA | NA | NA | 0.21 (−0.14 to 0.56) | .25 | NA | NA | 0.20 (−0.15 to 0.55) | .26 | NA | NA |
| Current | NA | NA | NA | NA | −0.13 (−0.22 to −0.04) | .007 | 0 (−0.04 to 0.04) | .93 | −0.13 (−0.22 to −0.04) | .006 | 0 (−0.05 to 0.04) | .82 |
| Vasomotor symptoms | ||||||||||||
| Past | NA | NA | NA | NA | −0.19 (−0.62 to 0.23) | .38 | NA | NA | −0.16 (−0.59 to 0.27) | .47 | NA | NA |
| Current | NA | NA | NA | NA | 0.07 (−0.04 to 0.17) | .21 | −0.01 (−0.05 to 0.04) | .75 | 0.07 (−0.03 to 0.17) | .18 | −0.01 (−0.05 to 0.04) | .77 |
| Perimenopause | ||||||||||||
| Pre or early | NA | NA | NA | NA | −0.02 (−0.19 to 0.14) | .77 | 0 (−0.06 to 0.07) | .89 | −0.03 (−0.19 to 0.14) | .76 | −0.01 (−0.07 to 0.06) | .88 |
| Late | NA | NA | NA | NA | −0.01 (−0.19 to 0.17) | .92 | −0.03 (−0.10 to 0.03) | .31 | −0.01 (−0.19 to 0.16) | .89 | −0.03 (−0.10 to 0.04) | .45 |
| Cardiometabolic risk factors | ||||||||||||
| Hypertension | ||||||||||||
| Past | NA | NA | NA | NA | NA | NA | NA | 0.03 (−0.31 to 0.26) | .86 | NA | NA | |
| Current | NA | NA | NA | NA | NA | NA | NA | −0.07 (−0.19 to 0.04) | .20 | 0 (−0.03 to 0.04) | .82 | |
| Diabetes | ||||||||||||
| Past | NA | NA | NA | NA | NA | NA | NA | −0.21 (−0.82 to 0.39) | .49 | NA | NA | |
| Current | NA | NA | NA | NA | NA | NA | NA | −0.05 (−0.24 to 0.15) | .63 | 0.07 (−0.01 to 0.16) | .08 | |
Abbreviations: DSB, Digit Span Backwards; NA, not applicable; PA, Physical Activity.
Model 1 covariates: No. of missed visits, practice effect (a fixed increment in score from analysis baseline to all following visits), and random effects for intercept and 2 slopes. The maximum No. of women with DSB values in the analysis sample was 1718. Owing to missing values for 1 or more covariates, the sample size for Model 1 was 1640.
Model 2 covariates: variables in model 1, Study of Women’s Health Across the Nation study site, and each of the demographic characteristics and menopause-associated factors listed in the table. Economic hardship was operationalized as difficulty paying for basic necessities, such as food. The maximum No. of women with DSB values in the analysis sample was 1718. Owing to missing values for 1 or more covariates, the sample size for model 2 was 1582.
Model 3 covariates: variables in model 2 and cardiometabolic risk factors listed in the table. The maximum No. of women with DSB values in the analysis sample was 1718. Owing to missing values for 1 or more covariates, the sample size for model 3 was 1573.
The referent woman participated in all Study of Women’s Health Across the Nation cognition visits and had a sport and exercise PA score of 2.77 (scale, 1-5). For models 2 and 3, the referent woman was age 54 years at analysis baseline; was White; had a high school education; took tests in English; reported no financial hardship; did not use hormone therapy; did not report high levels (ie, top quartile) of depressive symptoms, anxiety symptoms, or vasomotor symptoms; and was postmenopausal at analysis baseline. For model 3, the referent woman did not report hypertension or diabetes at any visit.
For time-varying covariates, past exposure was assessed between Study of Women’s Health Across the Nation cohort baseline and current study analysis baseline (ie, Study of Women’s Health Across the Nation follow-up visit 7). Past exposure was operationalized as the proportion (range, 0 to 1) of visits prior to analysis baseline that the participant reported the exposure. Current values (ie, starting at analysis baseline) of time-varying covariates were modeled to be associated with the outcome of DSB score level at the same visit (ie, contemporaneously), and the value at study baseline was modeled to be associated with the outcome of DSB slope. However, the PA level at each visit was modeled as be associated with the outcome of slope only up to the next visit.