Association between sedentary behavior and risk of cognitive decline or mild cognitive impairment among the elderly: a systematic review and meta-analysis

Xiao-Ye Cai; Guo-Ping Qian; Feng Wang; Ming-Yang Zhang; Ying-Juan Da; Jing-Hong Liang

doi:10.3389/fnins.2023.1221990

Association between sedentary behavior and risk of cognitive decline or mild cognitive impairment among the elderly: a systematic review and meta-analysis

Front Neurosci. 2023 Aug 4:17:1221990. doi: 10.3389/fnins.2023.1221990. eCollection 2023.

Authors

Xiao-Ye Cai¹, Guo-Ping Qian², Feng Wang³, Ming-Yang Zhang^{2

4}, Ying-Juan Da¹, Jing-Hong Liang⁵

Affiliations

¹ Department of Physical Education, Shanghai Normal University Tianhua College, Shanghai, China.
² Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdańsk, Poland.
³ Department of Physical Education, Shanghai Ocean University, Shanghai, China.
⁴ Department of Physical Education, Chengdu Sport University, Chengdu, China.
⁵ Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.

Abstract

Background: Existing evidence on the association between sedentary behavior (SB) and cognitive function remains inconclusive. Therefore, this study investigated the association between SB and the risk of cognitive decline (CD) or mild cognitive impairment (MCI) in the elderly.

Methods: A comprehensive search was independently conducted by two researchers (XC and GQ) in seven electronic databases, including Medline (via PubMed), China Biology Medicine, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang database, and VIP database for Chinese technical periodicals, covering studies published from the inception of database to June 2023. Studies that investigated the relationship between SB and the risk of CD or MCI in the elderly were included. The quality of the literature was assessed using the Newcastle-Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) assessment tools. The combined effect size analysis, subgroup analysis, and publication bias assessment were performed using STATA 14.0.

Results: A total of 13 cross-sectional and 6 cohort studies involving 81,791 individuals were included, comprising 17 high-quality studies and 2 medium-quality studies. We found that SB was significantly associated with an increased risk of CD [odds ratio (OR) = 1.69, 95% confidence intervals (CI): 1.47-1.94] or MCI (OR = 1.34, 95% CI: 1.14-1.56) among the elderly. Subgroup analysis stratified according to comorbidity, lifestyle, family structure, publication year, and region showed statistical differences between groups, and the consistency of the results revealed the sources of the heterogeneity.

Conclusion: This meta-analysis showed that SB is positively associated with the risk of CD or MCI in the elderly, providing a higher level of evidence for the promotion of healthy behaviors by clinicians and health policymakers. Due to the number and quality of the included articles, more high-quality longitudinal studies are needed to further confirm our findings.

Keywords: cognitive decline; elderly; meta-analysis; mild cognitive impairment; sedentary behavior.

Publication types

Review

Grants and funding

This research was supported by the Shanghai Education Science Research of China (No. C2021250) and the Shanghai Normal University Tianhua College.