Gender Differences in Physical Activity Patterns and Cognitive Function Among Middle-Aged and Older Adults: Evidence From the CHARLS
Keywords:
Cognitive Impairment, Middle-Aged, Older Adults, Physical ActivityAbstract
While the mental health benefits of physical activity (PA) are well documented, evidence regarding the association between specific PA patterns and the risk of cognitive impairment among middle-aged and older adults in China remains limited, particularly with respect to gender differences. This study aimed to examine the relationships between different dimensions of PA—including intensity, frequency, duration, and total volume and cognitive function among Chinese adults aged 45 years and above. Data were drawn from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS), comprising a nationally representative sample of 4,160 participants. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), and binary logistic regression models were employed to estimate the associations between PA patterns and the likelihood of cognitive impairment, stratified by gender. The findings indicated notable gender-specific associations. Among men, engaging in light physical activity (LPA) for 3–5 days per week (OR = 0.42, 95% CI: 0.19–0.92), with daily durations of at least 240 minutes (OR = 0.71, 95% CI: 0.40–1.29) and total weekly activity exceeding 1,260 minutes (OR = 0.69, 95% CI: 0.38–1.25), was associated with a lower risk of cognitive impairment. Among women, LPA performed 6–7 days per week (OR = 0.76, 95% CI: 0.57–1.00), with daily durations of at least 240 minutes (OR = 0.71, 95% CI: 0.50–1.02) and either low (<525 minutes) or high (>1,260 minutes) weekly PA volume (OR = 0.72, 95% CI: 0.51–1.03), was linked to reduced impairment risk. In contrast, excessive vigorous physical activity (VPA), defined as more than 240 minutes per day, was associated with an increased risk of cognitive impairment among women (OR = 1.34, 95% CI: 1.00–1.79). Overall, the study highlights the importance of moderate, light-intensity physical activity for cognitive health in later life and underscores the need to consider gender-specific PA recommendations.
References
Aaronson, J. A., van Bennekom, C. A., Hofman, W. F., van Bezeij, T., van den Aardweg, J. G., Groet, E., Kylstra, W. A., & Schmand, B. (2015). Obstructive Sleep Apnea is Related to Impaired Cognitive and Functional Status after Stroke [Journal Article]. Sleep, 38(9), 1431-1437. http://doi.org/10.5665/sleep.4984
Beinhoff, U., Tumani, H., Brettschneider, J., Bittner, D., & Riepe, M. W. (2008). Gender-specificities in Alzheimer's disease and mild cognitive impairment [Journal Article]. Journal of Neurology, 255(1), 117-122. http://doi.org/10.1007/s00415-008-0726-9
Brown, D. R., & Blanton, C. J. (2002). Physical activity, sports participation, and suicidal behavior among college students [Journal Article]. Medicine & Science in Sports & Exercise, 34(7), 1087-1096. http://doi.org/10.1097/00005768-200207000-00006
Buchman, A. S., Yu, L., Wilson, R. S., Lim, A., Dawe, R. J., Gaiteri, C., Leurgans, S. E., Schneider, J. A., & Bennett, D. A. (2019). Physical activity, common brain pathologies, and cognition in community-dwelling older adults [Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't]. Neurology, 92(8), e811-e822. http://doi.org/10.1212/WNL.0000000000006954
Busse, A. L., Gil, G., Santarem, J. M., & Jacob, F. W. (2009). Physical activity and cognition in the elderly: A review [Journal Article; Review]. Dement Neuropsychol, 3(3), 204-208. http://doi.org/10.1590/S1980-57642009DN30300005
Cannon, J. A., Moffitt, P., Perez-Moreno, A. C., Walters, M. R., Broomfield, N. M., McMurray, J., & Quinn, T. J. (2017). Cognitive Impairment and Heart Failure: Systematic Review and Meta-Analysis [Journal Article; Meta-Analysis; Review; Systematic Review]. Journal of Cardiac Failure, 23(6), 464-475. http://doi.org/10.1016/j.cardfail.2017.04.007
Clay, E., Zhou, J., Yi, Z. M., Zhai, S., & Toumi, M. (2019). Economic burden for Alzheimer's disease in China from 2010 to 2050: a modelling study [Journal Article]. J Mark Access Health Policy, 7(1), 1667195. http://doi.org/10.1080/20016689.2019.1667195
Dao, E., Barha, C. K., Best, J. R., Hsiung, G. Y., Tam, R., & Liu-Ambrose, T. (2019). The Effect of Aerobic Exercise on White Matter Hyperintensity Progression May Vary by Sex [Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't]. Canadian Journal On Aging-Revue Canadienne Du Vieillissement, 38(2), 236-244. http://doi.org/10.1017/S0714980818000582
Dauwan, M., Begemann, M., Slot, M., Lee, E., Scheltens, P., & Sommer, I. (2021). Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials [Journal Article; Meta-Analysis; Review; Systematic Review]. Journal of Neurology, 268(4), 1222-1246. http://doi.org/10.1007/s00415-019-09493-9
Deng, Y., Zhao, S., Cheng, G., Yang, J., Li, B., Xu, K., Xiao, P., Li, W., & Rong, S. (2021). The Prevalence of Mild Cognitive Impairment among Chinese People: A Meta-Analysis [Meta-Analysis; Research Support, Non-U.S. Gov't; Systematic Review]. Neuroepidemiology, 55(2), 79-91. http://doi.org/10.1159/000512597
Ding, M., Jia, N., Zhou, Y., & Li, B. (2021). The Dose-Response Relationships of Different Dimensions of Physical Activity with Daily Physical Function and Cognitive Function in Chinese Adults with Hypertension: A Cross-Sectional Study [Journal Article; Research Support, Non-U.S. Gov't]. International Journal of Environmental Research and Public Health, 18(23) http://doi.org/10.3390/ijerph182312698
Fang, E. F., Xie, C., Schenkel, J. A., Wu, C., Long, Q., Cui, H., Aman, Y., Frank, J., Liao, J., Zou, H., Wang, N. Y., Wu, J., Liu, X., Li, T., Fang, Y., Niu, Z., Yang, G., Hong, J., Wang, Q., Chen, G., Li, J., Chen, H. Z., Kang, L., Su, H., Gilmour, B. C., Zhu, X., Jiang, H., He, N., Tao, J., Leng, S. X., Tong, T., & Woo, J. (2020). A research agenda for ageing in China in the 21st century (2nd edition): Focusing on basic and translational research, long-term care, policy and social networks [Journal Article; Research Support, Non-U.S. Gov't; Review]. Ageing Research Reviews, 64, 101174. http://doi.org/10.1016/j.arr.2020.101174
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician [Journal Article]. Journal of Psychiatric Research, 12(3), 189-198. http://doi.org/10.1016/0022-3956(75)90026-6
Heesch, K. C., Burton, N. W., & Brown, W. J. (2011). Concurrent and prospective associations between physical activity, walking and mental health in older women [Journal Article; Research Support, Non-U.S. Gov't]. Journal of Epidemiology and Community Health, 65(9), 807-813. http://doi.org/10.1136/jech.2009.103077
Hotting, K., & Roder, B. (2013). Beneficial effects of physical exercise on neuroplasticity and cognition [Journal Article; Research Support, Non-U.S. Gov't; Review]. Neuroscience and Biobehavioral Reviews, 37(9 Pt B), 2243-2257. http://doi.org/10.1016/j.neubiorev.2013.04.005
Hu, Y., Peng, W., Ren, R., Wang, Y., & Wang, G. (2022). Sarcopenia and mild cognitive impairment among elderly adults: The first longitudinal evidence from CHARLS [Journal Article; Research Support, Non-U.S. Gov't]. Journal of Cachexia Sarcopenia and Muscle, 13(6), 2944-2952. http://doi.org/10.1002/jcsm.13081
Hyde, J. S. (2016). Sex and cognition: gender and cognitive functions [Journal Article; Review]. Current Opinion in Neurobiology, 38, 53-56. http://doi.org/10.1016/j.conb.2016.02.007
Jedrziewski, M. K., Ewbank, D. C., Wang, H., & Trojanowski, J. Q. (2014). The Impact of Exercise, Cognitive Activities, and Socialization on Cognitive Function: Results From the National Long-Term Care Survey [Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't]. American Journal of Alzheimers Disease and Other Dementias, 29(4), 372-378. http://doi.org/10.1177/1533317513518646
Kumar, M., Srivastava, S., & Muhammad, T. (2022). Relationship between physical activity and cognitive functioning among older Indian adults [Journal Article]. Scientific Reports, 12(1), 2725. http://doi.org/10.1038/s41598-022-06725-3
Litwin, H., & Shaul, A. (2019). The effect of social network on the physical activity-cognitive function nexus in late life [Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't]. International Psychogeriatrics, 31(5), 713-722. http://doi.org/10.1017/S1041610218001059
Liu, W., Wu, Q., Wang, M., Wang, P., & Shen, N. (2022). Prospective association between sleep duration and cognitive impairment: Findings from the China Health and Retirement Longitudinal Study (CHARLS) [Journal Article]. Frontiers in Medicine, 9, 971510. http://doi.org/10.3389/fmed.2022.971510
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimaki, M., Larson, E. B., Ogunniyi, A., Orgeta, V., Ritchie, K., Rockwood, K., Sampson, E. L., Samus, Q., Schneider, L. S., Selbaek, G., Teri, L., & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission [Journal Article; Review]. Lancet, 396(10248), 413-446. http://doi.org/10.1016/S0140-6736(20)30367-6
Lopez-Fontana, I., Castanier, C., Le Scanff, C., & Perrot, A. (2018). Protective Role of Recent and Past Long-Term Physical Activity on Age-Related Cognitive Decline: The Moderating Effect of Sex [Journal Article]. Journal of Aging and Physical Activity, 26(3), 353-362. http://doi.org/10.1123/japa.2016-0362
Luo, L., Wang, G., Zhou, H., Zhang, L., Ma, C. X., Little, J. P., Yu, Z., Teng, H., Yin, J. Y., & Wan, Z. (2022). Sex-specific longitudinal association between baseline physical activity level and cognitive decline in Chinese over 45 years old: Evidence from the China health and retirement longitudinal study [Journal Article; Research Support, Non-U.S. Gov't]. Aging & Mental Health, 26(9), 1721-1729. http://doi.org/10.1080/13607863.2021.1935456
Morley, J. E. (2018). An Overview of Cognitive Impairment [Journal Article; Review]. Clinics in Geriatric Medicine, 34(4), 505-513. http://doi.org/10.1016/j.cger.2018.06.003
Nuzum, H., Stickel, A., Corona, M., Zeller, M., Melrose, R. J., & Wilkins, S. S. (2020). Potential Benefits of Physical Activity in MCI and Dementia [Journal Article; Review]. Behavioural Neurology, 2020, 7807856. http://doi.org/10.1155/2020/7807856
Okura, M., Ogita, M., & Arai, H. (2019). Self-Reported Cognitive Frailty Predicts Adverse Health Outcomes for Community-Dwelling Older Adults Based on an Analysis of Sex and Age [Journal Article; Research Support, Non-U.S. Gov't]. Journal of Nutrition Health & Aging, 23(7), 654-664. http://doi.org/10.1007/s12603-019-1217-7
Prakash, R. S., Voss, M. W., Erickson, K. I., & Kramer, A. F. (2015). Physical activity and cognitive vitality [Journal Article; Review]. Annual Review of Psychology, 66, 769-797. http://doi.org/10.1146/annurev-psych-010814-015249
Rosenberg, A., Ngandu, T., Rusanen, M., Antikainen, R., Backman, L., Havulinna, S., Hanninen, T., Laatikainen, T., Lehtisalo, J., Levalahti, E., Lindstrom, J., Paajanen, T., Peltonen, M., Soininen, H., Stigsdotter-Neely, A., Strandberg, T., Tuomilehto, J., Solomon, A., & Kivipelto, M. (2018). Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline and dementia regardless of baseline characteristics: The FINGER trial [Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't]. Alzheimers & Dementia, 14(3), 263-270. http://doi.org/10.1016/j.jalz.2017.09.006
Shi, X. M. (2017). [Focusing on and strengthening the health research on the elderly, especially the oldest old in China] [Journal Article]. Zhonghua Yu Fang Yi Xue Za Zhi, 51(11), 963-965. http://doi.org/10.3760/cma.j.issn.0253-9624.2017.11.002
Tian, Y., & Shi, Z. (2022). Effects of Physical Activity on Daily Physical Function in Chinese Middle-Aged and Older Adults: A Longitudinal Study from CHARLS [Journal Article]. Journal of Clinical Medicine, 11(21) http://doi.org/10.3390/jcm11216514
Wang, R., Bishwajit, G., Zhou, Y., Wu, X., Feng, D., Tang, S., Chen, Z., Shaw, I., Wu, T., Song, H., Fu, Q., & Feng, Z. (2019). Intensity, frequency, duration, and volume of physical activity and its association with risk of depression in middle- and older-aged Chinese: Evidence from the China Health and Retirement Longitudinal Study, 2015 [Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't]. Plos One, 14(8), e221430. http://doi.org/10.1371/journal.pone.0221430
Xu, J., Zhang, J., Liu, M., Bai, Y., Guo, X., Dong, J., Xu, A., & Wu, J. (2020). Estimating 24-Hour Sodium Excretion from Spot Urine Samples in Chinese Adults: Can Spot Urine Substitute 24-Hour Urine Samples? [Journal Article]. Nutrients, 12(3) http://doi.org/10.3390/nu12030798
Xu, L., Yang, Y., & Cui, D. (2022). Association between blood pressure control status, visit-to-visit blood pressure variability, and cognitive function in elderly Chinese: A nationwide study [Journal Article]. Frontiers in Public Health, 10, 877192. http://doi.org/10.3389/fpubh.2022.877192
Xu, W., Wang, H. F., Wan, Y., Tan, C. C., Yu, J. T., & Tan, L. (2017). Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies [Journal Article; Meta-Analysis; Review]. Bmj Open, 7(10), e14706. http://doi.org/10.1136/bmjopen-2016-014706
Yan, Y., Du Y, Li, X., Ping, W., & Chang, Y. (2023). Physical function, ADL, and depressive symptoms in Chinese elderly: Evidence from the CHARLS [Journal Article; Research Support, Non-U.S. Gov't]. Frontiers in Public Health, 11, 1017689. http://doi.org/10.3389/fpubh.2023.1017689
Yang, J., Zheng, X., Wang, Y., Wang, H., & Song, G. (2024). The Relationship between Leisure Time Physical Activity and Cognitive Function in Older Americans [Journal Article]. Journal of Frailty & Aging, 13(4), 461-469. http://doi.org/10.14283/jfa.2024.70
Yao, Y., Wang, K., & Xiang, H. (2022). Association between cognitive function and ambient particulate matters in middle-aged and elderly Chinese adults: Evidence from the China Health and Retirement Longitudinal Study (CHARLS) [Journal Article]. Science of the Total Environment, 828, 154297. http://doi.org/10.1016/j.scitotenv.2022.154297
Zhang, S., Qiu, Q., Qian, S., Lin, X., Yan, F., Sun, L., Xiao, S., Wang, J., Fang, Y., & Li, X. (2021). Determining Appropriate Screening Tools and Cutoffs for Cognitive Impairment in the Chinese Elderly [Journal Article]. Frontiers in Psychiatry, 12, 773281. http://doi.org/10.3389/fpsyt.2021.773281
Zhao, Y., Hu, Y., Smith, J. P., Strauss, J., & Yang, G. (2014). Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS) [Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't]. International Journal of Epidemiology, 43(1), 61-68. http://doi.org/10.1093/ije/dys203
Zhou, S., Chen, S., Liu, X., Zhang, Y., Zhao, M., & Li, W. (2022). Physical Activity Improves Cognition and Activities of Daily Living in Adults with Alzheimer's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials [Journal Article; Meta-Analysis; Review; Systematic Review]. International Journal of Environmental Research and Public Health, 19(3) http://doi.org/10.3390/ijerph19031216
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