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Cross-Sectional study on the association between sedentary behavior and cognitive function in community-dwelling older adults
Wanwan LIU, Jianhua MI, Yike NIE, Yunrong LI, Yingxue HUA, Qun XU
Chinese Journal of Alzheimer's Disease and Related Disorders ›› 2026, Vol. 9 ›› Issue (3) : 164-172.
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Abbreviation (ISO4): Chinese Journal of Alzheimer's Disease and Related Disorders
Editor in chief: Jun WANG
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Cross-Sectional study on the association between sedentary behavior and cognitive function in community-dwelling older adults
Objective: To explore the association between sedentary behavior (SB) contexts, characteristics, and cognitive function in older adults. Methods: A face-to-face survey was conducted among 1,485 elderly individuals aged 60-80 years undergoing health check-ups at the Xinchang Community Health Service Center in Pudong New Area, Shanghai. The survey included an SB questionnaire (covering 9 common SB contexts and 2 SB characteristics), MemTrax assessment (measuring the percentage of correct responses [MTx-%C], mean response time [MTx-RT], and a composite index [MTx-Cp, where MTx-Cp = MTx-%C / MTx-RT × 100]), and health examination data. Linear regression analysis was used to examine the association between SB and cognitive function. Stratified analysis was used to explore whether the impact of sedentary behavior (SB) on cognitive function differed by sex. Results: A total of 1,441 participants were included, of whom 630 (43.72%) were male, 454 (31.51%) had primary school education, and 673 (46.70%) had junior high school education. The average daily sedentary time was （6.59 ± 2.78 ）hours. The primary SB context was screen time (2.97 ± 1.55 hours). Participation rates in hobbies (21.10%), reading (5.20%), and listening to the radio (6.94%) were low. Cognitive function was positively correlated with screen time, meals (male), transportation, and hobbies (female) (all P < 0.05), negatively correlated with "thinking/idleness" (male) and socializing (all P < 0.05), but showed no significant association with reading or listening to the radio. The frequency of SB bouts was positively correlated with MTx-%C, but the longest continuous sedentary time had no significant effect. Conclusions: The sedentary time among older adults in Shanghai is higher than the national average, with screen time being the predominant SB context. The effects of different sedentary behavior contexts on cognitive function varied and demonstrated significant sex-specific patterns. Consequently, the future public health strategies should not be limited to advocating for "reducing sedentary time," but should also promote a paradigm shift toward "optimizing sedentary behavior." Furthermore, the influence of sex differences should be fully considered in the design of intervention measures.
Sedentary behavior / Cognitive function / Older adults / Influencing factors
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\n China’s population has rapidly aged over the recent decades of social and economic development as neurodegenerative disorders have proliferated, especially Alzheimer’s disease (AD) and related dementias (ADRD). AD’s incidence rate, morbidity, and mortality have steadily increased to make it presently the fifth leading cause of death among urban and rural residents in China and magnify the resulting financial burdens on individuals, families and society. The ‘Healthy China Action’ plan of\n 2019–2030\n promotes the transition from disease treatment to health maintenance for this expanding population with ADRD. This report describes related epidemiological trends, evaluates the economic burden of the disease, outlines current clinical diagnosis and treatment status and delineates existing available public health resources. More specifically, it examines the public health impact of ADRD, including prevalence, mortality, costs, usage of care, and the overall effect on caregivers and society. In addition, this special report presents technical guidance and supports for the prevention and treatment of AD, provides expertise to guide relevant governmental healthcare policy development and suggests an information platform for international exchange and cooperation.\n
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This study uses National Health and Nutrition Examination Survey data to examine changes in sedentary time among adults in the US from 2013 to 2023.
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The increasing rate of all-cause dementia worldwide and the lack of effective pharmaceutical treatments emphasise the value of lifestyle approaches as prevention strategies. Emerging evidence suggests sedentary behaviour is associated with impaired cognitive function. A better understanding of this association would significantly add to our knowledge of how to best promote healthy cognitive ageing. Thus, we conducted a systematic review ascertaining the contribution of sedentary behaviour towards associated changes in cognitive function over the adult lifespan.
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To examine the acute and chronic effects of reducing prolonged sedentary time (ST) with physical activity (PA) on cognitive and brain health.
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Besides physical activity as a target for dementia prevention, sedentary behaviour is hypothesized to be a potential target in its own right. The rising number of persons with dementia and lack of any effective treatment highlight the urgency to better understand these modifiable risk factors. Therefore, we aimed to investigate whether higher levels of sedentary behaviour are associated with reduced global cognitive functioning and slower cognitive decline in older persons without dementia.We used five population cohorts from Greece, Australia, USA, Japan, and Singapore (HELIAD, PATH, SALSA, SGS, and SLAS2) from the Cohort Studies of Memory in an International Consortium. In a coordinated analysis, we assessed the relationship between sedentary behaviour and global cognitive function with the use of linear mixed growth model analysis (mean follow-up range of 2.0-8.1 years).Baseline datasets combined 10,450 older adults without dementia with a mean age range between cohorts of 66.7-75.1 years. After adjusting for multiple covariates, no cross-sectional association between sedentary behaviour and cognition was found in four studies. One association was detected where more sedentary behaviour was cross-sectionally linked to higher cognition levels (SLAS2, B = 0.118 (0.075; 0.160), P < 0.001). Longitudinally, there were no associations between baseline sedentary behaviour and cognitive decline (P > 0.05).Overall, these results do not suggest an association between total sedentary time and lower global cognition in older persons without dementia at baseline or over time. We hypothesize that specific types of sedentary behaviour may differentially influence cognition which should be investigated further. For now, it is, however, too early to establish undifferentiated sedentary time as a potential effective target for minimizing cognitive decline in older adults without dementia.
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Higher levels of physical activity are known to benefit aspects of brain health across the lifespan. However, the role of sedentary behavior (SB) is less well understood. In this review we summarize and discuss evidence on the role of SB on brain health (including cognitive performance, structural or functional brain measures, and dementia risk) for different age groups, critically compare assessment approaches to capture SB, and offer insights into emerging opportunities to assess SB via digital technologies. Across the lifespan, specific characteristics of SB (particularly whether they are cognitively active or cognitively passive) potentially act as moderators influencing the associations between SB and specific brain health outcomes. We outline challenges and opportunities for future research aiming to provide more robust empirical evidence on these observations.Copyright © 2024 Elsevier Ltd. All rights reserved.
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This study examines the relationship between various domains of sedentary behavior and subsequent cognitive function to evaluate whether different sedentary activities have specific associations with future cognitive performance.
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Previous studies have obtained inconsistent results regarding the association between sedentary behavior and cognitive impairment. The present study aimed to examine the association between cognitive activity in a sitting position (CAS) and cognitive impairment among older adults.Community-dwelling older adults, from Obu or Nagoya in Japan, participated in a survey in 2013. A total of 5300 participants (mean age 75.0 ± 5.1 years; women 52.9%) met the criteria for the present study. We assessed the frequency and variety of CAS composed of six activities, including reading books or newspapers, writing a diary or letters, solving crossword puzzles, playing board games, using a computer and maintaining housekeeping records. The frequency of engagement in CAS was one or more time(s)/week. The variety of CAS was assessed by the number of engagements in CAS. Cognitive impairment was defined by two or more tests at least 1.5 standard deviations below the reference threshold in four neuropsychological tests. Logistic regression analysis was carried out to examine the associations between the frequency and variety of CAS and cognitive impairment, adjusted for covariates.The proportion of participants engaging in each CAS varied from 12.3% (playing board games) to 93.6% (reading books or newspaper). After adjustment, five CAS were significantly associated with cognitive impairment (OR 0.33-0.65, all P < 0.001). The variety of CAS was significantly associated with the reduced OR of cognitive impairment (OR 0.61, 95% confidence interval 0.55-0.68).Almost every CAS and a greater variety of CAS are associated with cognitive impairment among older people. Geriatr Gerontol Int 2019; 19: 98-102.© 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.
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Detrimental associations of sedentary behaviors with depression have been identified, but findings are inconsistent. We propose a novel approach to the classification and analysis of sedentary behaviors, which differentiates between those that are passive (e.g., television viewing) and mentally active (e.g., reading). Available evidence is summarized, and research questions relating to measurement, causal relationships, and mechanisms are considered.
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Background: The prominence of sedentary behavior research in health science has grown rapidly. With this growth there is increasing urgency for clear, common and accepted terminology and definitions. Such standardization is difficult to achieve, especially across multi-disciplinary researchers, practitioners, and industries. The Sedentary Behavior Research Network (SBRN) undertook a Terminology Consensus Project to address this need.Method: First, a literature review was completed to identify key terms in sedentary behavior research. These key terms were then reviewed and modified by a Steering Committee formed by SBRN. Next, SBRN members were invited to contribute to this project and interested participants reviewed and provided feedback on the proposed list of terms and draft definitions through an online survey. Finally, a conceptual model and consensus definitions (including caveats and examples for all age groups and functional abilities) were finalized based on the feedback received from the 87 SBRN member participants who responded to the original invitation and survey.Results: Consensus definitions for the terms physical inactivity, stationary behavior, sedentary behavior, standing, screen time, non-screen-based sedentary time, sitting, reclining, lying, sedentary behavior pattern, as well as how the terms bouts, breaks, and interruptions should be used in this context are provided.Conclusion: It is hoped that the definitions resulting from this comprehensive, transparent, and broad-based participatory process will result in standardized terminology that is widely supported and adopted, thereby advancing future research, interventions, policies, and practices related to sedentary behaviors.
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余珍. 社区老年人久坐行为的影响因素及其干预研究[D]. 郑州: 郑州大学, 2019.
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脑认知健康管理中国专家共识制定委员会, 中华健康管理学杂志编辑委员会. 脑认知健康管理中国专家共识(2023)[J]. 中华健康管理学杂志, 2023, 12(17): 881-892.
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Cognitive impairment is a leading cause of dysfunction in the elderly. When mild cognitive impairment (MCI) occurs in elderly, it is frequently a prodromal condition to dementia. The Montreal Cognitive Assessment (MoCA) is a commonly used tool to screen for MCI. However, this test requires a face-to-face administration and is composed of an assortment of questions whose responses are added together by the rater to provide a score whose precise meaning has been controversial. This study was designed to evaluate the performance of a computerized memory test (MemTrax), which is an adaptation of a continuous recognition task, with respect to the MoCA. Two outcome measures are generated from the MemTrax test: MemTraxspeed and MemTraxcorrect. Subjects were administered the MoCA and the MemTrax test. Based on the results of the MoCA, subjects were divided in two groups of cognitive status: normal cognition (n = 45) and MCI (n = 37). Mean MemTrax scores were significantly lower in the MCI than in the normal cognition group. All MemTrax outcome variables were positively associated with the MoCA. Two methods, computing the average MTX score and linear regression were used to estimate the cutoff values of the MemTrax test to detect MCI. These methods showed that for the outcome MemTraxspeed a score below the range of 0.87 - 91 s-1 is an indication of MCI, and for the outcome MemTraxcorrect a score below the range of 85 - 90% is an indication for MCI.
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A valid, reliable, accessible, engaging, and affordable digital cognitive screen instrument for clinical use is in urgent demand.
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Memory function generally deteriorates with age, and memory impairments are a common symptom of serious illness such as dementia. Although screening tests are widely used throughout Medicine, they are not yet commonly used to detect memory impairments. The objective of this study was to characterize an audience-based memory test suitable for administration to a large number of individuals simultaneously. A continuous recognition test was developed to assess memory function in audiences using a slide-show in which 50 images were presented, of which 25 were repeated. Audience members responded by recording if an image was a repetition. The test was administered to a total of 1018 participants at 25 sites with an average audience size of 41 individuals (range = 9-142). A total of 868 individuals aged 40-97 y completed the test appropriately and provided their age, education level, and gender. Recognition memory as measured by discriminability (d') showed a significant decline with age (40-49 y old, d' = 3.51; 90-99 y old, d' = 1.95, p < 0.001) together with a greater than three-fold increase in variability. Individuals with less than 13 y of education had lower scores than those with more education (d' = 2.13 vs. 2.88, respectively, p < 0.001). These results are consistent with the known effects of age and education on memory. There were no significant effects of gender on test performance. Such memory tests represent a practical and novel approach to screen for the signs of early dementia.
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The prevalence of insufficient physical activity (PA) among Chinese adults has shown an upward trend, reaching 22.3% in 2018. Leisure time PA (LTPA) constitutes a minimal proportion of total physical activity patterns.The adherence rate to Physical activity guidelines (PAGs) was 85.7%. While occupational PA remained the predominant form of physical activity, its proportion has decreased. LTPA has emerged from its historically lowest position among activity types. Screen-based activities now constitute the primary form of sedentary behavior.Strategic interventions are needed to promote LTPA by addressing urban-rural disparities in sports facility access and increasing public venue availability. Additionally, targeted initiatives are required to reduce sedentary time, particularly among young people and urban residents, while maintaining engagement in LTPA.Copyright © 2025 by Chinese Center for Disease Control and Prevention.
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第五次中国城乡老年人生活状况抽样调查基本数据公报.(2024-10-17) [2025-6-9]. http://www.crca.cn/index.php/19-data-resource/life/1117-2024-10-17-08-01-05.html.
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Background: This study aimed to verify the association between Sedentary Behavior (SB) and performance on cognitive function tests in middle-aged and elderly adults. Methods: This cross-sectional study included 6505 participants (55.2% women) of ELSA-Brasil, with a median age of 61 years. The different types of SB considered were sitting time and screen time. The scores obtained in the memory, language, and executive function tests were used to assess cognitive performance (CP). The association between SB and CP was assessed using linear regression. Results: For men, sitting time was associated with better performance in memory, language, and executive function tests. Screen time on the weekend, showed a favorable association with performance in the executive function test. Occupational screen time on weekdays was positively associated with language test performance. For women, sitting time and occupational screen time were positively associated with performance on memory tests. SB was favorably associated with performance in language tests and executive function tests. Conclusions: SB seems to favor CP in this population without evident dementia and with a high level of education. The type of SB (mentally active or passive) and the schooling seem to be of particular interest for cognitive performance.
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Physical activity can improve cognitive function of older adults, but the influence of sedentary behaviour on cognition is less clear. This systematic review investigated associations between sedentary behaviour and cognitive function in older adults without dementia, and possible mechanisms involved.Major databases were searched for studies in English between 01/01/1999 and 31/10/2019. The systematic review followed COSMOS-E guideline and a pre-registered protocol (CRD42019122229). Risk of bias was assessed using NICE Quality appraisal checklist. Findings were narratively synthesized and presented.Eighteen studies comprised of 13 cross-sectional and five longitudinal analyses (n = 40,228). Evidence suggested varied associations between varied sedentary behaviours and cognitive function in older adults. 50% of study analyses did not control for physical activity. 3/18 studies demonstrated associations between higher sedentary levels and lower levels of brain biomarkers, while 1/18 showed auto-regulatory effect in the left hippocampus. Conducting a meta-analysis was not justifiable due to considerable methodological, participant, outcome and exposure heterogeneity.There is a lack of clarity about the overall and independent association between sedentary behaviour and cognition in older age. Underlying mechanisms are similar to physical activity and probably multi-modal. More studies with robust designs and methodology are needed to confirm effect of sedentary behaviour on cognition.
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We investigated the cross-sectional and prospective associations between different sedentary behaviors and cognitive function in a large sample of adults with data stored in the UK Biobank. Baseline data were available for 502,643 participants (2006-2010, United Kingdom). Cognitive tests included prospective memory (baseline only: n = 171,585), visual-spatial memory (round 1: n = 483,832; round 2: n = 482,762), fluid intelligence (n = 165,492), and short-term numeric memory (n = 50,370). After a mean period of 5.3 years, participants (numbering from 12,091 to 114,373, depending on the test) also provided follow-up cognitive data. Sedentary behaviors (television viewing, driving, and nonoccupational computer-use time) were measured at baseline. At baseline, both television viewing and driving time were inversely associated with cognitive function across all outcomes (e.g., for each additional hour spent watching television, the total number of correct answers in the fluid intelligence test was 0.15 (99% confidence interval: 0.14, 0.16) lower. Computer-use time was positively associated with cognitive function across all outcomes. Both television viewing and driving time at baseline were positively associated with the odds of having cognitive decline at follow-up across most outcomes. Conversely, computer-use time at baseline was inversely associated with the odds of having cognitive decline at follow-up across most outcomes. This study supports health policies designed to reduce television viewing and driving in adults.
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| [28] |
靳永爱, 胡文波, 阳冯. 数字时代的互联网使用与中老年人生活——中国老年群体数字鸿沟与数字融入调查主要数据结果分析[J]. 人口研究, 2024, 48(1): 40-55.
中国人口老龄化的加速推进伴随着信息化的快速发展,给人口老龄化应对带来了前所未有的机遇和挑战。从2010年到2022年,50~59岁和60岁及以上人群使用互联网的比例分别从11.1%、4.9%快速提升至73.5%、54.5%。随着互联网在中老年人中快速普及,迫切需要借助新的专项调查数据来探究其中的最新特征和规律。通过分析中国老年群体数字鸿沟与数字融入调查数据,研究发现,中老年上网者互联网使用的深度和广度不断拓展,但数字鸿沟依然存在;中老年上网者互联网使用时长适中,内部异质性强;中老年上网者面临网络安全风险,网络安全教育有所欠缺,网络安全素养有待提升;适度使用互联网对中老年上网者的健康老龄化和主观福祉均有积极影响。建议政府、企业、社区、家庭和老年人个体共同参与,创建老年数字友好型社会。
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| [29] |
Sedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers).
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| [30] |
The recent availability of longitudinal data on the possible association of different lifestyles with dementia and Alzheimer's disease (AD) allow some preliminary conclusions on this topic. This review systematically analyses the published longitudinal studies exploring the effect of social network, physical leisure, and non-physical activity on cognition and dementia and then summarises the current evidence taking into account the limitations of the studies and the biological plausibility. For all three lifestyle components (social, mental, and physical), a beneficial effect on cognition and a protective effect against dementia are suggested. The three components seem to have common pathways, rather than specific mechanisms, which might converge within three major aetiological hypotheses for dementia and AD: the cognitive reserve hypothesis, the vascular hypothesis, and the stress hypothesis. Taking into account the accumulated evidence and the biological plausibility of these hypotheses, we conclude that an active and socially integrated lifestyle in late life protects against dementia and AD. Further research is necessary to better define the mechanisms of these associations and better delineate preventive and therapeutic strategies.
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| [31] |
Although poor social relationships are assumed to contribute to cognitive decline, meta-analytic approaches have not been applied. Individual study results are mixed and difficult to interpret due to heterogeneity in measures of social relationships. We conducted a systematic review and meta-analysis to investigate the relation between poor social relationships and cognitive decline.MEDLINE, Embase and PsycINFO were searched for longitudinal cohort studies examining various aspects of social relationships and cognitive decline in the general population. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random effects meta-analysis. Sources of heterogeneity were explored and likelihood of publication bias was assessed. We stratified analyses according to three aspects of social relationships: structural, functional and a combination of these.We identified 43 articles. Poor social relationships predicted cognitive decline; for structural (19 studies): pooled OR: 1.08 (95% CI: 1.05-1.11); functional (8 studies): pooled OR: 1.15 (95% CI: 1.00-1.32); and combined measures (7 studies): pooled OR: 1.12 (95% CI: 1.01-1.24). Meta-regression and subgroup analyses showed that the heterogeneity could be explained by the type of social relationship measurement and methodological quality of included studies.Despite heterogeneity in study design and measures, our meta-analyses show that multiple aspects of social relationships are associated with cognitive decline. As evidence for publication bias was found, the association might be overestimated and should therefore be interpreted with caution. Future studies are needed to better define the mechanisms underlying these associations. Potential causality of this prognostic association should be examined in future randomized controlled studies.© The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
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| [32] |
In the research reported here, we tested the hypothesis that sustained engagement in learning new skills that activated working memory, episodic memory, and reasoning over a period of 3 months would enhance cognitive function in older adults. In three conditions with high cognitive demands, participants learned to quilt, learned digital photography, or engaged in both activities for an average of 16.51 hr a week for 3 months. Results at posttest indicated that episodic memory was enhanced in these productive-engagement conditions relative to receptive-engagement conditions, in which participants either engaged in nonintellectual activities with a social group or performed low-demand cognitive tasks with no social contact. The findings suggest that sustained engagement in cognitively demanding, novel activities enhances memory function in older adulthood, but, somewhat surprisingly, we found limited cognitive benefits of sustained engagement in social activities.
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| [33] |
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| [34] |
Observational studies show breaking up prolonged sitting has beneficial associations with cardiometabolic risk markers, but intervention studies are required to investigate causality. We examined the acute effects on postprandial glucose and insulin levels of uninterrupted sitting compared with sitting interrupted by brief bouts of light- or moderate-intensity walking.Overweight/obese adults (n = 19), aged 45-65 years, were recruited for a randomized three-period, three-treatment acute crossover trial: 1) uninterrupted sitting; 2) seated with 2-min bouts of light-intensity walking every 20 min; and 3) seated with 2-min bouts of moderate-intensity walking every 20 min. A standardized test drink was provided after an initial 2-h period of uninterrupted sitting. The positive incremental area under curves (iAUC) for glucose and insulin (mean [95% CI]) for the 5 h after the test drink (75 g glucose, 50 g fat) were calculated for the respective treatments.The glucose iAUC (mmol/L) · h after both activity-break conditions was reduced (light: 5.2 [4.1-6.6]; moderate: 4.9 [3.8-6.1]; both P < 0.01) compared with uninterrupted sitting (6.9 [5.5-8.7]). Insulin iAUC (pmol/L) · h was also reduced with both activity-break conditions (light: 633.6 [552.4-727.1]; moderate: 637.6 [555.5-731.9], P < 0.0001) compared with uninterrupted sitting (828.6 [722.0-950.9]).Interrupting sitting time with short bouts of light- or moderate-intensity walking lowers postprandial glucose and insulin levels in overweight/obese adults. This may improve glucose metabolism and potentially be an important public health and clinical intervention strategy for reducing cardiovascular risk.
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利益冲突声明： 论文作者承诺本文不存在任何利益冲突。
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