Adherence to a healthy lifestyle and its association with cognitive impairment in community-dwelling older adults in Shanghai

Yiqiong Qi; Ziwei Zhang; Xiya Fu; Peipei Han; Weixin Xu; Liou Cao; Qi Guo

doi:10.3389/fpubh.2023.1291458

Adherence to a healthy lifestyle and its association with cognitive impairment in community-dwelling older adults in Shanghai

Front Public Health. 2023 Dec 18:11:1291458. doi: 10.3389/fpubh.2023.1291458. eCollection 2023.

Authors

Yiqiong Qi^#^{1

2

3}, Ziwei Zhang^#⁴, Xiya Fu^#^{1

2

3}, Peipei Han^{1

3}, Weixin Xu⁵, Liou Cao⁶, Qi Guo^{1

7}

Affiliations

¹ Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
² Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
³ Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China.
⁴ Fujian Provincial Hospital, Fujian, China.
⁵ Department of Laboratory Medicine of Central Hospital of Jiading District Shanghai Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
⁶ Department of Nephrology, Molecular Cell Lab for Kidney Disease, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁷ Department of Rehabilitation Medicine, School of Health, Fujian Medical University, Fuzhou, China.

^# Contributed equally.

Abstract

Introduction: There is a growing body of recent literature linking the association of specific or multiple lifestyles with cognitive impairment, but most of these studies have been conducted in Western populations, and it is necessary to study multiple lifestyles and cognitive abilities in different populations, with the primary population of this study being a select group of community-dwelling older adults in Shanghai, China.

Methods: The sample included 2,390 community-dwelling Chinese participants. Their cognitive function was assessed using the Mini-Mental State Examination (MMSE). We defined a healthy lifestyle score on the basis of being non-smoking, performing ≥210 min/wk moderate/vigorous-intensity physical activity, having light to moderate alcohol consumption, eating vegetables and fruits daily, having a body mass index (BMI) of 18.5-23.9 kg/m², and having a waist-to-hip ratio (WHR) <0.90 for men and <0.85 for women, for an overall score ranging from 0 to 6.

Results: Compared with participants with ≤2 healthy lifestyle factors, the adjusted odds ratio (OR) and 95% confidence interval (CI) for participants with 4, 5, and 6 healthy lifestyle factors were 0.53 (95% CI, 0.29-0.98), 0.40 (95% CI, 0.21-0.75), and 0.36 (95% CI, 0.16-0.79), respectively. Only WHR (OR = 0.54, 95% CI = 0.37-0.78) and physical activity (OR = 0.69, 95% CI = 0.51-0.92) were associated with cognitive impairment. A healthy lifestyle correlated with overall cognition (β = 0.066, orientation (β = 0.049), language ability (β = 0.060), delayed recall (β = 0.045) and executive function (β = 0.044) (P all < 0.05).

Conclusion: The study provides evidence on an inverse association between healthy lifestyles and cognitive impairment. We investigated whether healthy lifestyle was related to specific cognitive functions to provide a theoretical basis for accurate clinical prescription.

Keywords: cognitive impairment; community-dwelling older adults; healthy lifestyle; physical activity; waist-to-hip ratio.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
China / epidemiology
Cognition
Cognitive Dysfunction* / epidemiology
Cognitive Dysfunction* / psychology
Female
Healthy Lifestyle
Humans
Independent Living* / psychology
Male

Grants and funding

The author (s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by Capacity Building project of Local Colleges of Shanghai Science and Technology Commission (23010502800).