Profile of non-invasive physical health indicators associated with cognitive performance in Chinese older adults: evidence from the China Health and Retirement Longitudinal Study

Xiyu Wei^#^{1

2}, Chao Li^#^{1

3}, Dongyu Liu^#⁴, Jieyi Chen¹, Yumeng Ju¹, Jin Liu⁵, Bangshan Liu⁶, Yan Zhang⁷

Affiliations

¹ Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
² Department of Social Work, The University of Hong Kong, Hong Kong Special Administrative Region, China.
³ Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
⁴ School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
⁵ Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China. liujin975@csu.edu.cn.
⁶ Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China. bangshan.liu@csu.edu.cn.
⁷ Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China. yan.zhang@csu.edu.cn.

^# Contributed equally.

PMID: 39894807
PMCID: PMC11789399
DOI: 10.1186/s12889-025-21479-z

Profile of non-invasive physical health indicators associated with cognitive performance in Chinese older adults: evidence from the China Health and Retirement Longitudinal Study

Xiyu Wei et al. BMC Public Health. 2025.

. 2025 Feb 2;25(1):420.

doi: 10.1186/s12889-025-21479-z.

Authors

Xiyu Wei^#^{1

2}, Chao Li^#^{1

3}, Dongyu Liu^#⁴, Jieyi Chen¹, Yumeng Ju¹, Jin Liu⁵, Bangshan Liu⁶, Yan Zhang⁷

Affiliations

¹ Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
² Department of Social Work, The University of Hong Kong, Hong Kong Special Administrative Region, China.
³ Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
⁴ School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
⁵ Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China. liujin975@csu.edu.cn.
⁶ Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China. bangshan.liu@csu.edu.cn.
⁷ Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China. yan.zhang@csu.edu.cn.

^# Contributed equally.

PMID: 39894807
PMCID: PMC11789399
DOI: 10.1186/s12889-025-21479-z

Abstract

Background: Existing studies have indicated the potential role of non-invasive physical health indicators as an early detector of mild cognitive impairment (MCI) in older adults. However, evidence is lacking in determining the appropriate physical health indicators for early screening of cognitive decline in each domain. Therefore, the current study aimed to establish a comprehensive physical health indicators profile in association with cognitive performance.

Methods: The present study utilized a three-year longitudinal cohort design, with data from the China Health and Retirement Longitudinal Study (CHARLS). 4,869 participants aged 60-97 years from CHARLS wave 2015 and 2018 who were cognitively and physically healthy were included in analysis. Physical functions (BMI, grip strength, blood pressure, balance tests, course walking time, repeated chair stands, and pulmonary function) were objectively measured by physical tasks. Cognitive performance domains (general cognition, episodic memory, executive function, verbal fluency, orientation, and language-and-praxis) were measured through standardised interviews and cognitive tasks. Multiple linear regression models were conducted to explore the association between physical health indicators and cognitive performance. Subgroup analysis was conducted to identify sex-specific factors.

Results: Pulmonary function was identified as associated with all domains of cognitive performance in older adults (β ranged between 0.05 and 0.08). Right grip strength was also identified as an important factor associated with all cognitive domains except general cognition (β ranged between 0.04 and 0.12). Subgroup analysis revealed that the association between physical health indicators and cognitive performance is more pronounced in males than in females.

Conclusions: A profile of non-invasive physical health indicators associated with cognitive performance was established, which warrants future incorporation of non-invasive physical health indicators in early risk screening systems for MCI, enabling timely intervention and prevention in older adults. Future studies can delve deeper into the mechanisms underlying this full-dimensional relationship between physical and cognitive domains.

Keywords: Cognition; Memory; Mild cognitive impairment; Screening.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The institutional review board at Peking University granted the CHARLS ethical approval. Written informed consent was given by each participate who agreed to take part in the study. Consent for publication: The present study contains no identifiable individual personal data. Competing interests: The authors declare no competing interests.

References

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Profile of non-invasive physical health indicators associated with cognitive performance in Chinese older adults: evidence from the China Health and Retirement Longitudinal Study

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Profile of non-invasive physical health indicators associated with cognitive performance in Chinese older adults: evidence from the China Health and Retirement Longitudinal Study

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Abstract

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