Dataset Information

High-intensity physical activity is not associated with better cognition in the elder: evidence from the China Health and Retirement Longitudinal Study

ABSTRACT:

Background

To evaluate the association of physical activity (PA) intensity with cognitive performance at baseline and during follow-up.

Methods

A total of 4039 participants aged 45 years or above from the China Health and Retirement Longitudinal Study were enrolled in visit 1 (2011–2012) and followed for cognitive function in visit 2 (2013–2014), visit 3 (2015–2016), and visit 4 (2017–2018). We analyzed the association of PA intensity with global cognition, episodic memory, and mental intactness at baseline using adjusted regression methods and evaluated the long-term effect of PA intensity using multiple measures of cognition scores by mixed effect model.

Results

In cross-sectional analysis, mild and moderate PA, rather than vigorous PA, was associated with better cognitive performance. The results remained consistent in multiple sensitivity analyses. During the follow-up, participant with mild PA had a 0.56 (95% CI 0.12–0.99) higher global cognition, 0.23 (95% CI 0.01–0.46) higher episodic memory, and 0.33 (95% CI 0.01–0.64) higher mental intactness, while those with moderate PA had a 0.74 (95% CI 0.32–1.17) higher global score, 0.32 (95% CI 0.09–0.54) higher episodic memory, and 0.43 (95% CI 0.12–0.74) higher mental intactness, compared with individuals without PA. Vigorous PA was not beneficial to the long-term cognitive performance.

Conclusions

Our study indicates that mild and moderate PA could improve cognitive performance, rather than the vigorous activity. The targeted intensity of PA might be more effective to achieve the greatest cognition improvement considering age and depressive status.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13195-021-00923-3.

SUBMITTER: Wu Z

PROVIDER: S-EPMC8567563 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundThe relationship between sarcopenia and frailty among middle-aged and elder adults remains unclear. This study conducted a cross-sectional and longitudinal analysis to investigate the association of sarcopenia and frailty in the middle-aged and elder Chinese population.MethodsOur data were drawn from the China Health and Retirement Longitudinal Study. Sarcopenia status was assessed according to the Asian Working Group for Sarcopenia 2019 criteria and categorised into: no sarcopenia, possible sarcopenia, sarcopenia, and severe sarcopenia. A 38-item deficit-accumulation frailty index was constructed to assess frailty trajectories at each visit. Generalised linear regression models were performed to analyse the cross-sectional associations between sarcopenia and frailty index. The Group-based trajectory modelling was adopted to identify potential frailty trajectories, and we then examined the associations of sarcopenia and frailty trajectories using logistic regression analysis.ResultsA total of 13 218 participants were enrolled in the cross-sectional analysis and 4200 individuals were included in the longitudinal study. The cross-sectional study found that possible sarcopenia (regression coefficient (β) = 0.76; 95% confidence interval (CI) = 0.64-0.87, P < 0.001), sarcopenia (β = 0.56; 95% CI = 0.37-0.75, P < 0.001) and severe sarcopenia (β = 1.35; 95% CI = 0.97-1.73, P < 0.001) were significantly associated with higher frailty index. The longitudinal study indicated that participants with possible sarcopenia (odds ratio (OR) = 2.46; 95% CI = 1.77-3.42, P < 0.001), sarcopenia (OR = 1.87; 95% CI = 1.27-2.74, P < 0.001) and severe sarcopenia (OR = 6.57; 95% CI = 3.14-13.77, P < 0.001) had a higher risk of accelerated progression of frailty compared to those with no sarcopenia.ConclusionsPossible sarcopenia, sarcopenia, and severe sarcopenia were associated with higher levels of frailty and accelerated progression of frailty. Therefore, clinical medical professionals should pay more attention to frailty status in individuals who have possible sarcopenia and sarcopenia.

Project description:ObjectivesTo examine the cross-sectional associations between self-reported postlunch napping and structured cognitive assessments in Chinese older adults.DesignCross-sectional cohort study.SettingChina.ParticipantsIndividuals aged 65 and older from the baseline national wave of the China Health and Retirement Longitudinal Study (CHARLS) (N = 2,974).MeasurementsInterview-based cognitive assessments of orientation and attention, episodic memory, visuospatial abilities, and a combined global cognition score incorporating these assessments. Other self-reported or interview-based assessments included postlunch napping duration, nighttime sleep duration, demographic characteristics, health habits, comorbidities, functional status and social activities. According to reported napping duration, older adults were categorized as non-nappers (0 minutes), short nappers (<30 minutes), moderate nappers (30-90 minutes), and extended nappers (>90 minutes).ResultsPostlunch napping was reporting in 57.7% of participants for a mean of 63 minutes. Cognitive function was significantly associated with napping (P < .001). Between-group comparisons showed that moderate nappers had better overall cognition than nonnappers (P < .001) or extended nappers (P = .01). Nonnappers also had significantly poorer cognition than short nappers (P = .03). In multiple regression analysis, moderate napping was significantly associated with better cognition than non- (P = .004), short (P = .04), and extended napping (P = .002), after controlling for demographic characteristics, body mass index, depression, instrumental activities of daily living, social activities, and nighttime sleep duration.ConclusionA cross-sectional association was found between moderate postlunch napping and better cognition in Chinese older adults. The cross-sectional design and self-reported measures of sleep limited the findings. Longitudinal studies with objective napping measures are needed to further test this hypothesis.

Project description:BackgroundCancer, the leading cause of mortality in China, is a significant burden on patients, their families, the medical system, and society at large. However, there is minimal data on health service utilization and catastrophic health expenditure (CHE) among cancer patients in China. The objective of this study was to identify factors associated with health care utilization and CHE in Chinese cancer patients.MethodsThe 2018 wave of a nationally representative dataset, the China Health and Retirement Longitudinal Study, was used in our study. Of 18,968 respondents recruited for the analysis, 388 were clinically diagnosed with cancer. CHE was defined as household health expenditure that exceeded 40% of non-food household expenses. A binary logistic regression model was used to identify the risks of cancer exposure among all participants, along with the likelihood of CHE in households with cancer patients at the 40% threshold. A negative binomial regression model was used to identify determinants of health service utilization among cancer patients.ResultsContracting a family physician (incidence rate ratio IRR: 2.38, 1.18-4.77), Urban Employee Basic Medical Insurance (IRR: 4.02, 1.91-8.46, compared to the uninsured), Urban and Rural Resident Basic Medical Insurance (IRR: 3.08, 1.46-6.49, compared to the uninsured), and higher per-capita household consumption were positively associated with inpatient service utilization. Patients with a college education and above reported a greater number of outpatient visits (IRR: 5.78, 2.56-13.02) but fewer inpatient hospital days (IRR: 0.37, 0.20-0.67). Being diagnosed with a non-cancer chronic non-communicable disease was associated with an increased number of outpatient visits (IRR: 1.20, 1.10-1.31). Of the 388 participants, 50.1% of households had CHE, which was negatively correlated with a larger household size (odds ratio OR: 0.52, 0.32-0.86) and lower socioeconomic status [for quintile 5 (lowest group) OR: 0.32, 0.14-0.72].ConclusionsThe socioeconomic characteristics of cancer patients had a considerable impact on their healthcare utilization. Individualized and targeted strategies for cancer management should be implemented to identify high-risk populations and trace the utilization of care among Chinese cancer patients. Strategic purchasing models in cancer care and social health insurance with expanded benefits packages for cancer patients are crucial to tackling the cancer burden in China.

Project description:Background: China is the biggest consumer of tobacco in the world, with a high prevalence of smoking especially among men. Along with the rapid demographic change in China, the burden of diseases attributable to health behaviors, particularly smoking is steadily increasing. So, smoking has become a major risk factor for mortality in China. Smoking behaviors may be related to migration processes, as a result of both who migrates and post-migration experiences related to socioeconomic position, stress and acculturation. Existing studies that have examined smoking and migration in China have, however, only focused on temporary rural-to-urban migrants and focused on relatively younger migrants. This paper examines the association between smoking behaviors and a comprehensive assessment of migration status in later-life in China. Methods: Using the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative dataset, this paper studies smoking behaviors of rural-to-urban migrants, urban-to-urban migrants, rural return migrants, and urban return migrants. We compare them with corresponding non-migrant groups in both rural and urban locations in China. Using a model that controls for demographic factors, early-life circumstances, socioeconomic factors, and factors related to migration, we examine both the decision to start smoking and the decision to quit smoking. In addition, we also address pre-migration selection in our analyses. Results: The results show rural-to-urban migrants are no more likely to start smoking compared with rural non-migrants, but they are more likely to quit smoking. While urban-to-urban migrants are more likely to start smoking compared with urban non-migrants, this effect is explained by the factors we include in the full model. Urban-to-urban migrants are, however, less likely to quit smoking. Moreover, both rural return migrants and urban return migrants seem to be more likely to start smoking and less likely to quit smoking compared with non-migrant groups. Conclusion: There are strong associations between migration status and later-life smoking behaviors in China; these associations vary greatly according to different migration status and point to populations and factors that public health activities should focus on.