Associations of Leisure Activities and Sleep Duration with Cognitive Function: A Nationwide Prospective Cohort Study of Chinese Old Adults

Yang, Huajun; Gao, Xia; Lu, Yan; Wu, Tingting; Yang, Zongming; Wu, Qianrong

doi:10.3233/jad-230112

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Finally, this study found that, compared to the older adult population who do not participate in any leisure activities, general health can serve as both a mediator and moderator of the impact of two types of leisure activities on survival status. On the one hand, participating in both types of leisure activities can help to comprehensively improve the physiological, psychological, and social adaptation dimensions of the health status of older adults, improve their quality of life, and reduce risk factors for death ( 35 , 36 ). On the other hand, good health can help strengthen the relationship between leisure activities and survival rate.…”

Section: Discussionmentioning

confidence: 99%

Effects of leisure activities and general health on the survival of older people: a cohort study in China

Cai,

Hu,

Zhou

et al. 2023

Front. Public Health

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ObjectiveThis study aimed to examine the influence of physical and cognitive leisure activities on the survival of older adults in China, while also exploring the potential mediating and moderating effects of general health.MethodsThis study utilized the China Longitudinal Healthy Longevity Survey (CLHLS) datasets spanning from 2008 to 2018, and 10,347 eligible participants were included. The primary study outcome was all-cause mortality, and independent variables included physical leisure activities (PLA), cognitive leisure activities (CLA), and self-rated general health. Three sets of covariates were adjusted, including socio-demographic characteristics, health behaviors, and health status.ResultsThe longest survival time was the older people participating in PLA & CLA (mean = 50.31 months), while those participating in neither exhibited the lowest (mean = 29.60 months). Significant differences in survival status were observed in different types of leisure activities participation (Log-rank test, Chi-square = 576.80, p < 0.001). Cox regression indicated that PLA (HR = 0.705, 95% CI: 0.651–0.764), CLA (HR = 0.872, 95% CI: 0.816–0.933), and the both PLA & CLA (HR = 0.700, 95% CI: 0.656–0.747) were protective factors for the survival. Additionally, general health significantly moderated the relationship between PLA and reduced mortality risk (Coefficient = −0.089, p = 0.042). While CLA indirectly influenced the survival through general health (Coefficient = −0.023, p < 0.001). For the older people participating in PLA and CLA, general health played mediating (Coefficient = −0.031, p < 0.001) and moderating (Coefficient = −0.026, p = 0.013) role in the relationship between leisure activities and survival.ConclusionLeisure activities and self-rated general health were important predictors of survival of the older adults, and general health exhibited a mediator and moderator in the relationship between leisure activities and survival status.

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Section: Discussionmentioning

confidence: 99%

Effects of leisure activities and general health on the survival of older people: a cohort study in China

Cai,

Hu,

Zhou

et al. 2023

Front. Public Health

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“…Studies also found that people with a total sleep duration of 7-8 h per day and a nocturnal sleep duration of 6-7 h are at the lowest risk of cognitive disorders (49). A national cohort study found that increased sleep duration among older adult people was independently associated with cognitive decline, and could be affected by gender and level of education (60). Therefore, subjective measurement of long sleep duration in elder people might be an important indicator for the risk of dementia.…”

Section: Comparison With Previous Workmentioning

confidence: 99%

Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China

Liu,

Xu,

Wei

et al. 2024

Front. Public Health

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ObjectiveTo examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations.MethodsThis community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored.ResultsThe age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p < 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7–7.9 h regarded as the reference group) for individuals with a sleep duration of <6, 6–6.9, 8–8.9, and ≥ 9 h were 1.280 (1.053–1.557), 1.425 (1.175–1.728), 1.294 (1.068–1.566), and 1.360 (1.109–1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60–80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108–1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055–1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080–1.534) and those aged 81–97 years (OR: 2.128, 95%CI: 1.152–3.934). For cognitive impairment, the group aged 81–97 years with daytime dysfunction was associated with a higher odds ratio than other age groups.ConclusionThe present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81–97 years exhibiting the strongest association.

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Interaction between plant-based dietary pattern and frailty on cognitive decline: a longitudinal analysis of the Chinese Longitudinal Healthy Longevity Survey cohort

Gao,

Wu,

Long

et al. 2024

Age and Ageing

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Objectives Frailty is a risk factor for faster cognitive decline, while plant-based dietary patterns are associated with decreased risk of cognitive decline. We aimed to explore their interaction with cognitive function among older adults. Methods We used data from the Chinese Longitudinal Healthy Longevity Survey between 2008 and 2018. Frailty was evaluated based on the frailty index (FI), and the plant-based diet index (PDI) was calculated using food frequency questionnaire at baseline. Repeated measures of the Mini-Mental State Examination (MMSE) were utilised to assess cognitive function. We used linear mixed models to estimate regression coefficients (β) and 95% confidence intervals (CI). Results We included 7,166 participants with a median follow-up of 5.8 years. Participants in pre-frail (β = −0.18, 95% CI: −0.24, −0.13) and frail (β = −0.39, 95% CI: −0.48, −0.30) groups experienced an accelerated decline in MMSE score compared with the robust group. The PDI modified the above association, with corresponding associations with frailty being much more pronounced among participants with a lower PDI (frail vs. robust β = −0.44, 95% CI: −0.56, −0.32), compared with those with a higher PDI (frail vs. robust β = −0.27, 95% CI: −0.40, −0.13). In addition, A combination of frailty and a low PDI was strongly associated with a faster decline in MMSE score (β = −0.52, 95% CI: −0.63, −0.41). Conclusion Adherence to plant-based dietary patterns attenuates the association between frailty and cognitive decline. If the observed association is causal, promoting plant-based dietary patterns may be a strategy to reduce the effects of frailty on neurological health.

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Associations of Leisure Activities and Sleep Duration with Cognitive Function: A Nationwide Prospective Cohort Study of Chinese Old Adults

Cited by 3 publications

References 24 publications

Effects of leisure activities and general health on the survival of older people: a cohort study in China

Effects of leisure activities and general health on the survival of older people: a cohort study in China

Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China

Interaction between plant-based dietary pattern and frailty on cognitive decline: a longitudinal analysis of the Chinese Longitudinal Healthy Longevity Survey cohort

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