The influence of healthy lifestyle behaviors on cognitive function among older Chinese adults across age and gender: Evidence from panel data

Experiences of older adults participating in dance exergames: A systematic review and meta-synthesis

BACKGROUND

Interventions to encourage adequate physical activity amongst older adults have had limited long-term success. Dancing and exergames, two beneficial and enjoyable physical activities for older adults, may make regular exercise more interesting and effective. Dance exergames are physical exercises that integrate sensory, cognitive, psychological, and physical functions by requiring users to interact with game scenarios through deliberate body motions and receive real-time feedback. They provide an inherently enjoyable gaming and workout experience, which may boost exercise adherence. However, little is known about older adults' experiences with dance exergames.

OBJECTIVE

To synthesise the qualitative experiences of older adults participating in dance exergames.

DESIGN

Systematic review and meta-synthesis.

METHODS

Dance exergame studies (peer-reviewed and grey literature) involving older adults in any setting published in English from inception to 17 August 2023 were included. Qualitative or mixed-method studies must use immersive or non-immersive virtual-reality platforms. PubMed, Scopus, CINAHL, The Cochrane Library, ProQuest Dissertations & Theses Global, Google Scholar, and reference lists of relevant studies and reviews were searched for eligible studies. The search strategy for Scopus was: (TITLE-ABS-KEY (danc*) AND TITLE-ABS-KEY (exergames OR exergame OR video AND games OR virtual AND reality) AND TITLE-ABS-KEY (older AND adults OR elderly OR seniors OR geriatrics)). Thematic synthesis by Thomas and Harden was used for meta-synthesis.

RESULTS

Eleven studies (n = 200 older adults) were included. Three themes and 14 subthemes were synthesised: 1) Dance exergames as dual-task training for physical, cognitive, and psychological well-being, 2) Concerns on usability issues, and 3) Possible enhancements of dance exergames. Older adults recognised that dance exergames could improve their physical, cognitive, and psychological well-being. Existing dance exergame systems had several usability issues. For example, some older adults were unfamiliar with using new technology and had trouble in navigating the game systems. The older adults also provided various suggestions for adaptation to their age group, such as ensuring a variety of dances, difficulty levels suited for older adults' cultural backgrounds, and physical and cognitive capabilities.

CONCLUSIONS

Dance exergames may be an attractive way to encourage older adults to exercise, but appropriate modifications are needed. When designing/selecting dance exergames for older persons, researchers, healthcare professionals, and senior care centres should consider using exergames that have simple designs, varied dances that are locally adapted, and appeal to a large proportion of older adults.

REGISTRATION

PROSPERO CRD42023395709.

The relationship between healthy lifestyles and cognitive function in Chinese older adults: the mediating effect of depressive symptoms

BACKGROUND

Previous studies have proven the positive relationship between healthy lifestyles and cognitive function in older adults. However, the specific impacts and mechanisms require further investigation. Therefore, this study aimed to investigate whether healthy lifestyles and cognitive function were associated with Chinese older adults and whether depressive symptoms mediated their association.

METHODS

8272 valid samples were included using the latest data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Pearson's test was applied to investigate the relationship between the key variables. Regression models were employed to examine the mediating effects of healthy lifestyles, using Sobel's test and the bootstrap method to confirm path effects.

RESULTS

There was a significant correlation between healthy lifestyles, depressive symptoms, and cognitive function (p < 0.01). Healthy lifestyles directly impact cognitive function (β = 0.162, p < 0.01). Healthy lifestyles had a significant effect on depressive symptoms (β=-0.301, p < 0.01), while depressive symptoms have a significant impact on cognitive function (β=-0.108, p < 0.01). Depressive symptoms partially mediated the effect of healthy lifestyles on cognitive function (β = 0.032, p < 0.01). The Sobel and bootstrap tests confirmed the robustness of the regression analysis results.

CONCLUSION

Depressive symptoms mediate the relationship between healthy lifestyles and cognitive function. Our findings suggest that prevention strategies for cognitive impairment in older adults should focus on healthy lifestyles and mental health.

The Effects of a Healthy Lifestyle on Depressive Symptoms in Older Chinese Adults: The Mediating Role of Psychological Resilience

Objectives This study aimed to validate the interrelationships and potential pathways of influence between healthy lifestyles, psychological resilience, and depressive symptoms in the Chinese elderly population. Methods We utilized data from the Chinese Elderly Health Influential Factors Tracking Survey 2018 and included 9448 samples for the study after screening according to the qualifying conditions. The interrelationships among healthy lifestyles, psychological resilience and depressive symptoms were analyzed using stepwise regression, and the robustness of mediation effects was assessed using Sobel and Bootstrap test. Results Among Chinese older adults, healthy lifestyles were negatively associated with depressive symptoms (β = -0.310, 95% CI: -0.405, -0.215), positively associated with psychological resilience (β = 0.137, 95% CI:0.071, 0.023), and psychological resilience was negatively associated with depressive symptoms (β = -1.014, 95% CI: -1.037, -0.990). Conclusions Psychological resilience partially mediated the association between healthy lifestyles and depressive symptoms, with the mediating effect accounting for 44.8% of the total effect. Our study contributes to the understanding of the relationship between healthy lifestyles and depressive symptoms in the elderly population and emphasizes the important role of psychological resilience. It is recommended that the government and policymakers improve depressive symptoms among older adults through comprehensive measures such as promoting healthy lifestyles and education, providing psychological support services, and creating a favorable environment.

Investigating the individual and joint effects of socioeconomic status and lifestyle factors on mild cognitive impairment in older Italians living independently in the community: results from the NutBrain study

OBJECTIVES

Despite extensive research, a clear understanding of the role of the interaction between lifestyle and socioeconomic status (SES) on cognitive health is still lacking. We investigated the joint association of socioeconomic factors in early to midlife and lifestyle in later life and Mild Cognitive Impairment (MCI).

DESIGN

Observational cross-sectional study.

SETTING

NutBrain study in northern Italy.

PARTICIPANTS

773 community-dwelling adults aged 65 years and older (73.2 ± 6.0 SD, 58.6% females) participating in the NutBrain study (2019-2023).

MEASUREMENTS

Three SES indicators (home ownership, educational level, occupation) and five lifestyle factors (adherence to Mediterranean diet, physical activity, smoking habits, social network, leisure activities) were selected. Each factor was scored and summed to calculate SES and healthy lifestyle scores; their joint effect was also examined. The association with MCI was assessed by logistic regression controlling for potential confounders. Sex-stratified analysis was performed.

RESULTS

In total, 24% of the subjects had MCI. The multivariable logistic model showed that a high SES and a high lifestyle score were associated with 81.8% (OR0.182; 95%CI 0.095-0.351), and 44.1% (OR0.559; 95%CI 0.323-0.968) lower odds of having MCI, respectively. When examining the joint effect of SES and lifestyle factors, the cognitive benefits of a healthy lifestyle were most pronounced in participants with low SES. A healthier lifestyle score was found to be significantly associated with lower odds of MCI, only in females.

CONCLUSIONS

According to our findings, SES was positively associated with preserved cognitive function, highlighting the importance of active lifestyles in reducing socioeconomic health inequalities, particularly among those with a relatively low SES.

TRIAL REGISTRATION

Trial registration number NCT04461951, date of registration July 7, 2020 (retrospectively registered, ClinicalTrials.gov).

Impact of Optimism on Cognitive Performance of People Living in Rural Area: Findings From a 20-Year Study in US Adults

Objectives: Mid- or early-late-life cognitive function is an indicator for developing late-life dementia. However, it is still unclear whether rural/urban living contexts provide cognitive benefits across adulthood. Further, higher optimism serves as a general protective factor for many health outcomes. The present study examines associations between rurality/urbanicity, optimism, and change in mid/late-life cognitive functions over time. Methods: Data were from waves 1 to 3 (1995-2015) of the Midlife in the United States (MIDUS) study (N = 2,507). Structural equation models examine whether long-term rural living across both waves (1-2) or intermittent rural living at one wave is associated with better cognitive function over 20 years, compared to no rural living, while controlling for prior cognitive function and covariates (baseline socio-demographics, health, and functional status). Additionally, we assessed if optimism mediates the above associations. Results: After controlling for covariates, long-term rural living (waves 1-2) was indirectly (through less optimism) associated with significantly lower levels of cognitive executive function and episodic memory in wave 3. Conclusions: While long-term rural living and cognitive outcomes have no direct association for MIDUS middle-aged and older adults, mediating roles of optimism in these associations were evident. Future investigations could examine mechanisms that underlie these risk/protective factors on late-life cognition.

Exploring the Reciprocal Relationship between Depressive Symptoms and Cognitive Function among Chinese Older Adults

(1) Objectives: This study aims to investigate the bidirectional relationship between depressive symptoms and cognitive function among older adults in China, addressing a research gap in the context of developing nations. (2) Methods: A total of 3813 adults aged 60 and older participating in 2013, 2015, and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS) were included. A fixed-effects model and cross-lagged panel model (CLPM) was utilized. (3) Results: First, the results indicated that a significant negative correlation existed between depressive symptoms and cognitive function in older adults during the study period (β = -0.084, p < 0.001). Second, after controlling for unobserved confounding factors, the deterioration and improvement of depressive symptoms still significantly affected cognitive function (β = -0.055, p < 0.001). Third, using the cross-lagged panel model, we observed a reciprocal relationship between depressive symptoms (Dep) and cognitive function (Cog) among Chinese older adults (Dep2013 → Cog2015, β = -0.025, p < 0.01; Dep2015 → Cog2018, β = -0.028, p < 0.001; Cog2013 → Dep2015, β = -0.079, p < 0.01; Cog2015 → Dep2018, β = -0.085, p < 0.01). (4) Discussion: The reciprocal relationship between depressive symptoms and cognitive functioning in older adults emphasizes the need for integrated public health policies and clinical interventions, to develop comprehensive intervention strategies that simultaneously address depressive symptoms and cognitive decline.