Independent, joint, and temporal associations of social, intellectual, and physical leisure activities with cognitive decline in older Chinese adults: a longitudinal analysis from CHARLS.
7 affiliations
- 1Department of Neurology, The First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China. [email protected].
- 2Henan medical Key Laboratory of Neurology, Henan Joint International Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology and Protein modification, Xinxiang, Henan, China. [email protected].
- 3Department of Neurology, The First Affiliated Hospital of Henan Medical University, No. 88 Jian Kang Road, Weihui, Henan, 453002, China. [email protected].
- 4School of Education, University of Bristol, Bristol, UK.
- 5Department of Gastroenterology, The First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China.
- 6Department of Neurology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
- 7Department of Neurology, The First Affiliated Hospital of Henan Medical University, Xinxiang, Henan, China.
Abstract
Background
It remains unclear whether engaging in different types of leisure activities leads to cognitive decline and whether participation in multidomains offers additional benefits among older Chinese adults.Methods
We analyzed 6,847 participants aged ≥ 60 years from four waves (2011-2018) of the China Health and Retirement Longitudinal Study, with a mean follow-up of 6.1 years. Leisure activities were categorized as social, intellectual, or physical. Linear mixed-effects models examined associations between baseline activity and cognitive change. Random-intercept cross-lagged panel models assessed temporal directionality. Multilevel structural equation models evaluated mediation by depressive symptoms and social support.Results
Higher baseline frequency of each activity domain was independently associated with slower cognitive decline after mutual adjustment, with the strongest association for intellectual activities (β = 0.046 points/year per additional day/week, 95% CI 0.023-0.069), followed by social (β = 0.028, 95% CI 0.011-0.045) and physical activities (β = 0.024, 95% CI 0.009-0.039). Compared with no moderate-level activity, engagement in one, two, and three domains was associated with progressively slower decline (β = 0.043, 0.078, and 0.098 points/year, respectively; all P < 0.001). Within-person increases in leisure activity predicted better subsequent cognitive performance, whereas reverse paths from cognition to later activity were weak and nonsignificant. Depressive symptoms and social support jointly accounted for 37.6%-39.0% of the observed associations in statistical mediation analyses.Conclusions
Greater leisure engagement, particularly across multiple domains, was associated with slower cognitive decline in older Chinese adults. These findings support the potential of low-cost multidomain leisure activities as promising candidate factors worthy of further investigation in future intervention studies aimed at mitigating cognitive decline.
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BibTeX
@article{su2026independent,
title = {{Independent, joint, and temporal associations of social, intellectual, and physical leisure activities with cognitive decline in older Chinese adults: a longitudinal analysis from CHARLS.}},
author = {Zhou Su and Mengran Liu and Jun Kuai and Zejing Xu and Xinran Bao and Bin Xu and Shuangxi Guo and Jiyu Ji},
journal = {BMC geriatrics},
year = {2026},
month = jul,
doi = {10.1186/s12877-026-08033-1},
url = {https://europepmc.org/article/MED/42902204},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Independent, joint, and temporal associations of social, intellectual, and physical leisure activities with cognitive decline in older Chinese adults: a longitudinal analysis from CHARLS.
AU - Zhou Su
AU - Mengran Liu
AU - Jun Kuai
AU - Zejing Xu
AU - Xinran Bao
AU - Bin Xu
AU - Shuangxi Guo
AU - Jiyu Ji
PY - 2026
DA - 2026/07/01
JO - BMC geriatrics
DO - 10.1186/s12877-026-08033-1
UR - https://europepmc.org/article/MED/42902204
AB - Background It remains unclear whether engaging in different types of leisure activities leads to cognitive decline and whether participation in multidomains offers additional benefits among older Chinese adults.Methods We analyzed 6,847 participants aged ≥ 60 years from four waves (2011-2018) of the China Health and Retirement Longitudinal Study, with a mean follow-up of 6.1 years. Leisure activities were categorized as social, intellectual, or physical. Linear mixed-effects models examined associations between baseline activity and cognitive change. Random-intercept cross-lagged panel models assessed temporal directionality. Multilevel structural equation models evaluated mediation by depressive symptoms and social support.Results Higher baseline frequency of each activity domain was independently associated with slower cognitive decline after mutual adjustment, with the strongest association for intellectual activities (β = 0.046 points/year per additional day/week, 95% CI 0.023-0.069), followed by social (β = 0.028, 95% CI 0.011-0.045) and physical activities (β = 0.024, 95% CI 0.009-0.039). Compared with no moderate-level activity, engagement in one, two, and three domains was associated with progressively slower decline (β = 0.043, 0.078, and 0.098 points/year, respectively; all P < 0.001). Within-person increases in leisure activity predicted better subsequent cognitive performance, whereas reverse paths from cognition to later activity were weak and nonsignificant. Depressive symptoms and social support jointly accounted for 37.6%-39.0% of the observed associations in statistical mediation analyses.Conclusions Greater leisure engagement, particularly across multiple domains, was associated with slower cognitive decline in older Chinese adults. These findings support the potential of low-cost multidomain leisure activities as promising candidate factors worthy of further investigation in future intervention studies aimed at mitigating cognitive decline.
SN - 1471-2318
ER -