The Bidirectional Association Between Physical and Cognitive Function Among Chinese Older Adults: A Mediation Analysis

Abstract

This study investigated the bidirectional association between physical and cognitive function in later life and examined the mechanisms underlying the interrelationship. We employed cross-lagged panel models to analyze a sample of 4232 unique participants aged 65 years and older from three waves of the Chinese Longitudinal Healthy Longevity Survey. Physical activity and social participation were tested as potential mediators between physical and cognitive function. Our findings revealed a reciprocal relationship between physical and cognitive function and a reciprocal relationship between physical and cognitive decline. Moreover, physical activity was confirmed to mediate the bidirectional association between physical and cognitive function, whereas social participation did not seem to be a mediator. A vicious cycle linking physical and cognitive decline may exist in Chinese older adults. However, leading a physically active lifestyle could be an effective intervention to slow physical and cognitive aging, thereby toning down the vicious cycle.

Cognition impairment and risk of subclinical cardiovascular disease in older adults: The atherosclerosis risk in communities study

“…First, CVD risk factors are common in covert stroke and Alzheimer's disease (Fillit et al, 2008;Alonso et al, 2009), thus cognitive impairment may simply be a marker of a high CVD risk population. Second, cognitive impairment may increase CVD risk by leading to multiple unhealthy lifestyles (Zhao et al, 2021), such as an unhealthy diet, sedentary activities, alcoholism, Abbreviations: ARIC, Atherosclerosis Risk in Communities Study; CHD, coronary heart disease; CI, confidence interval; COPD, chronic obstructive pulmonary disorder; CVD, cardiovascular disease; DALYs, disability-adjusted life years; DWRT, delayed word recall test; DSST, digit symbol substitution test; FEV1, forced expiratory volume in one second; hs-cTnT, high-sensitivity cardiac troponin T; NT-proBNP, N-terminal pro-B-type natriuretic peptide; MACE, major adverse cardiac events; OR, odds ratio; WFT, word fluency test.…”

“…First, CVD risk factors are common in covert stroke and Alzheimer’s disease ( Fillit et al, 2008 ; Alonso et al, 2009 ), thus cognitive impairment may simply be a marker of a high CVD risk population. Second, cognitive impairment may increase CVD risk by leading to multiple unhealthy lifestyles ( Zhao et al, 2021 ), such as an unhealthy diet, sedentary activities, alcoholism, etc. Last but not least, stroke and Alzheimer’s disease has an important influence on the renin-angiotensin system ( Nakagawa and Sigmund, 2017 ), autonomic nervous system ( Dorrance and Fink, 2015 ), and mental health ( Kales et al, 2005 ; Monastero et al, 2009 ), all of which were validated risk factors of CVD ( Rosengren et al, 2004 ; Miller and Arnold, 2019 ).…”

Associations of Lifestyle Factors With Cognition in Community-Dwelling Adults Aged 50 and Older: A Longitudinal Cohort Study

“…Evidence from longitudinal studies, cross-lagged panel analyses and intervention trials has accumulated during the past few decades. The cross-lagged panel model excels in taking temporal orders into account and thus sheds light on the temporal sequence and causal direction of the associations between lifestyle factors and cognition ( Farina et al, 2016 ; Ihle et al, 2019 ; Zhao et al, 2020 ). Despite this, most studies focus on only one or two lifestyle factors ( Lövdén et al, 2013 ; Kivipelto et al, 2018 ).…”

Associations between loneliness and frailty among older adults: Evidence from the China Health and Retirement Longitudinal Study

“…2). Based on the existing literature, we constructed early changes in loneliness and frailty as the difference between two measurements of the variable at Wave 2 (T 2 ) and Wave 1 (T 1 ) and late changes in loneliness and frailty as the difference between two measurements of the variable at Wave 3 (T 3 ) and Wave 2 (T 2 ) [40,41]. Within the model system, we focused on: (1) the crosslagged effect of T 1 loneliness or frailty on early change and late change in the other variable (c1, c2; d1, d2); and…”