Validity of the Shuttle Walk Test to Assess Cardiorespiratory Fitness in Persons at Varying Stages in the Alzheimer's Continuum
Bibliographic record
Abstract
Abstract Background Cardiorespiratory fitness (CRF) has been positively associated with brain volumes and health in older adults and negatively associated with dementia onset or risk and mortality. Cardiopulmonary exercise testing (CPET) is a gold standard test for evaluating CRF for exercise prescription, but requires specialized equipment and is time‐ and resource‐intensive, highlighting the need for more feasible and valid options for evaluating CRF. Therefore, the purpose of this study was to evaluate the validity and relationship of the shuttle walk test (SWT) distance with peak oxygen consumption (VO 2Peak ) from cycle ergometer‐based CPET in persons with amnestic mild cognitive impairment (aMCI) or mild‐to‐moderate AD dementia. Method This study used baseline data from two Phase II, single‐blinded clinical trials (The ACT Trial and The FIT‐AD Trial). The sample included 80 participants with aMCI and 90 with mild‐to‐moderate AD. Across the two studies, CRF was measured with VO 2Peak obtained from the symptom‐limited peak cycle‐ergometer test and the SWT. Data were analyzed with simple and multiple linear regression. Adjusted models included age, sex, cognition (Montreal Cognitive Assessment [MoCA] or Mini Mental State Examination [MMSE], and body mass index (BMI) that were significantly associated with VO 2peak . Result The participants included 80 from the ACT Trial (55% male, 74.1 [5.7] years, and MoCA 23.2 [2.0]) and 90 from the FIT‐AD Trial (56% males, age 77.1 [6.6] years, and MMSE 21.8 [3.4]). In persons with aMCI, SWT was positively correlated with VO 2Peak ( r = .57 p < 0.01). When controlling for age, sex, MoCA, and BMI, SWT distance remained significantly and positively associated with VO 2Peak and collectively represented 54% of the variance in VO 2Peak (F (5,69) =18.37, p <0.001). In persons with AD dementia, SWT was positively correlated with VO 2Peak ( r = .44 p <0.01). When controlling for age, sex, MMSE, and BMI, SWT distance remained significantly and positively associated with VO 2Peak and collectively represented 43% of the variance in VO 2Peak (F (5,77) =11.46, p <0.001). Conclusion SWT distance is a significant predictor of VO 2Peak in persons with cognitive impairment and remains a significant predictor in the presence of related, clinically measured covariates including age, sex, cognition, and BMI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.020 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".