Interventions and public health nutrition

Association of healthy lifestyle with cognitive function among Chinese older adults

Abstract

Background/Objectives

Dietary patterns and daily life habits have been reported to be associated with cognitive function in European populations. We aimed to examine the associations of dietary patterns and daily life habits with cognitive function among Chinese old people.

Subjects/Methods

We used 2011–2014 longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) comprising 5716 participants with an average age of 82 years. Cognitive function was measured in 2014 based on the results of Mini-Mental Status Examination. Data on participants’ dietary patterns and daily life habits were collected during baseline survey. Logistic regression models and general linear models were adopted to estimate the associations of dietary pattern and daily life habit with cognitive function.

Results

Compared with participants in the lowest quartile of lifestyle score, those in the highest quartile had a lower risk of cognitive impairment after controlling for all covariates (OR = 0.52, 95% confidence interval (CI), 0.41–0.65, P < 0.001). Higher lifestyle score was associated with better cognitive function (β = 0.74, 95% CI, 0.55–0.93, P < 0.001). Participants with top quartile of dietary pattern had a lower risk of cognitive impairment (OR = 0.65, 95% CI, 0.51–0.81, P < 0.001). Similar trends were observed in daily life habit, showing that more exercises, moderate alcohol consumption, and non-smoking were associated with improved cognition status (OR = 0.64, 95% CI, 0.53–0.77, P < 0.001).

Conclusions

Our findings suggest that maintaining a healthy dietary pattern and carrying out outdoor exercises is associated with a lower risk of cognitive impairment among Chinese old people.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Fig. 1: Flowchart of participants selection.

References

  1. 1.

    Chan KY, Campbell H, Wei W, Rudan I, Jing JW, Li L et al. Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990−2010:a systematic review and analysis. Lancet. 2013;381:2016–23.

  2. 2.

    Hendriea HC, Butters MA, Gao S, Knopman DS, Launer LJ, Yaffe K, et al. The NIH cognitive and emotional health project: report of the Critical Evaluation Study Committee. Alzheimers Dement. 2006;2:12–32.

    Article  Google Scholar 

  3. 3.

    Bookheimer SY, Strojwas MH, Cohen MS, Saunders AM, Pericak-Vance MA, Mazziotta JC, et al. Patterns of brain activation in people at risk for Alzheimer’s disease. N. Engl J Med. 2000;343:450–6.

    CAS  Article  Google Scholar 

  4. 4.

    Scheltens P, Blennow K, Breteler MM, de Strooper B, Frisoni GB, Salloway S, et al. Alzheimer’s disease. Lancet. 2016;388:505–17.

    CAS  Article  Google Scholar 

  5. 5.

    Schrijvers EM, Verhaaren BF, Koudstaal PJ, Hofman A, Ikram MA, Breteler MM. Is dementia incidence declining?: Trends in dementia incidence since 1990 in the Rotterdam Study. Neurology. 2012;78:1456–63.

    CAS  Article  Google Scholar 

  6. 6.

    Wu YT, Fratiglioni L, Matthews FE, Lobo A, Breteler MM, Skoog I. et al. Dementia in western Europe: epidemiological evidence and implications for policy making. Lancet Neurol. 2016;15:116–24.

    CAS  Article  Google Scholar 

  7. 7.

    Hillman CH, Erickson KI, Kramer AF. Be smart, exercise your heart: exercise effects on brain and cognition. Nat Rev Neurosci. 2008;9:58.

    CAS  Article  Google Scholar 

  8. 8.

    Young J, Angevaren M, Rusted J, Tabet N. Aerobic exercise to improve cognitive function in older people without known cognitive impairment. Cochrane DB Syst Rev. 2015;4:3–21.

    Google Scholar 

  9. 9.

    Alles B, Samieri C, Feart C, Jutand M, Laurin D, Barberger-Gateau P. Dietary patterns: a novel approach to examine the link between nutrition and cognitive function in older individuals. Nutr Res Rev. 2012;25:207–22.

    CAS  Article  Google Scholar 

  10. 10.

    Corley J, Starr JM, McNeill G, Deary IJ. Do dietary patterns influence cognitive function in old age?. Int Psychogeriatr. 2013;25:1393–407.

    Article  Google Scholar 

  11. 11.

    Van de Rest O, Berendsen AA, Haveman-Nies A, de Groot LC. Dietary patterns, cognitive decline, and dementia: a systematic review. Adv Nutr. 2015;6:154–68.

    Article  Google Scholar 

  12. 12.

    Valls-Pedret C, Sala-Vila A, Serra-Mir M, Corella D, De la Torre R, Martínez-González MÁ, et al. Mediterranean diet and age-related cognitive decline: a randomized clinical trial. JAMA Intern Med. 2015;175:1094–103.

    Article  Google Scholar 

  13. 13.

    Tangney CC, Kwasny MJ, Li H, Wilson RS, Evans DA, Morris MC. Adherence to a Mediterranean-type dietary pattern and cognitive decline in a community population–. Am J Clin Nutr. 2011;93:601–7.

    CAS  Article  Google Scholar 

  14. 14.

    Gu Y, Luchsinger JA, Stern Y, Scarmeas N. Mediterranean diet, inflammatory and metabolic biomarkers, and risk of Alzheimer’s disease. J Alzheimer’s Dis. 2010;22:483–92.

    CAS  Article  Google Scholar 

  15. 15.

    De Yébenes García MJ, Sánchez FS, Frades BP, Rodríguez AL, Bartolomé MM, Otero AP. Cognitive assessment in the elderly. Normative data of a Spanish population sample older than 70 years. Med Clin-Barcelona. 2004;122:727–40.

    Article  Google Scholar 

  16. 16.

    Cherbuin N, Anstey KJ. The Mediterranean diet is not related to cognitive change in a large prospective investigation: the PATH Through Life study. Am J Geriatr Psychiatry. 2012;20:635–9.

    Article  Google Scholar 

  17. 17.

    Samieri C, Grodstein F, Rosner BA, Kang JH, Cook NR, Manson JE, et al. Mediterranean diet and cognitive function in older age: results from the Women’s Health Study. Epidemiology. 2013;24:490.

    Article  Google Scholar 

  18. 18.

    Chan R, Chan D, Woo J. A cross sectional study to examine the association between dietary patterns and cognitive impairment in older Chinese people in Hong Kong. J Nutr Health Aging. 2013;17:757–65.

    CAS  Article  Google Scholar 

  19. 19.

    Ozawa M, Ninomiya T, Ohara T, Doi Y, Uchida K, Shirota T, et al. Dietary patterns and risk of dementia in an elderly Japanese population: the Hisayama Study. Am Clin Nutr. 2013;97:1076–82.

    CAS  Article  Google Scholar 

  20. 20.

    Kim J, Yu A, Choi BY, Nam JH, Kim MK, Oh DH, et al. Dietary patterns and cognitive function in Korean older adults. Eur J Nutr. 2015;54:309–18.

    Article  Google Scholar 

  21. 21.

    Okubo H, Inagaki H, Gondo Y, Kamide K, Ikebe K, Masui Y, et al. Association between dietary patterns and cognitive function among 70-year-old Japanese elderly: a cross-sectional analysis of the SONIC study. Nutr J. 2017;16:56.

    Article  CAS  Google Scholar 

  22. 22.

    Cheung BH, Ho IC, Chan RS, Sea MM, Woo J. Current evidence on dietary pattern and cognitive function. Adv Food Nutr Res. 2014;71:137–63.

    CAS  Article  Google Scholar 

  23. 23.

    Northey JM, Cherbuin N, Pumpa KL, Smee DJ, Rattray B. Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. Br J Sports Med. 2018;52:154–60.

    Article  Google Scholar 

  24. 24.

    Sabia S, Elbaz A, Britton A, Bell S, Dugravot A, Shipley M, et al. Alcohol consumption and cognitive decline in early old age. Neurology. 2014;82:332–9.

    Article  Google Scholar 

  25. 25.

    Zhou S, Zhou R, Zhong T, Li R, Tan J, Zhou H. Association of smoking and alcohol drinking with dementia risk among elderly men in China. Curr Alzheimer Res. 2014;11:899–907.

    CAS  Google Scholar 

  26. 26.

    Wang J, Xiao LD, He GP, De, Bellis A. Family caregiver challenges in dementia care in a country with undeveloped dementia services. J Adv Nurs. 2014;70:1369–80.

    Article  Google Scholar 

  27. 27.

    Organization WH. World report on ageing and health. Indian J Med Res. 2017;145:150–1.

    Article  Google Scholar 

  28. 28.

    Gu D. General data quality assessment for the 2005 CLHLS wave. The CLHLS technical report; 2007.

  29. 29.

    Zeng Y. Introduction to the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Netherlands: Springer; 2008.

    Google Scholar 

  30. 30.

    Huang C, Elo IT. Mortality of the oldest old Chinese: the role of early-life nutritional status, socio-economic conditions, and sibling sex-composition. Popul Stud. 2009;63:7–20.

    Article  Google Scholar 

  31. 31.

    Zeng Y, Feng Q, Gu D, Vaupel JW. Demographics, phenotypic health characteristics and genetic analysis of centenarians in China. Mech Ageing Dev. 2017;165:86–97.

    Article  Google Scholar 

  32. 32.

    Shi Z, Zhang T, Byles J, Martin S, Avery J, Taylor A. Food habits, lifestyle factors and mortality among oldest old Chinese: the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Nutrients. 2015;7:7562–79.

    CAS  Article  Google Scholar 

  33. 33.

    Dangour AD, Allen E, Elbourne D, Fletcher A, Richards M, Uauy R. Fish consumption and cognitive function among older people in the UK: Baseline data from the OPAL study. J Nutr, Health Aging. 2009;13:198–202.

    CAS  Article  Google Scholar 

  34. 34.

    Shi Z, Zhang T, Byles J, Martin S, Avery JC, Taylor AW. Food habits, lifestyle factors and mortality among oldest old Chinese: the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Nutrients. 2015;7:7562–79.

    CAS  Article  Google Scholar 

  35. 35.

    Yin Z, Brasher MS, Kraus VB, Lv Y, Shi X, Zeng Y. Dietary diversity was positively associated with psychological resilience among elders: a population-based study. Nutrients. 2019;11:650.

    Article  Google Scholar 

  36. 36.

    Chan R, Leung J, Woo J. Dietary patterns and risk of frailty in Chinese community-dwelling older people in Hong Kong: a prospective cohort study. Nutrients. 2015;7:7070–84.

    CAS  Article  Google Scholar 

  37. 37.

    Huadong Z, Juan D, Jingcheng L, Yanjiang W, Meng Z, Hongbo H. Study of the relationship between cigarette smoking, alcohol drinking and cognitive impairment among elderly people in China. Age Ageing. 2003;32:205–10. https://doi.org/10.1093/ageing/32.2.205.

    Article  Google Scholar 

  38. 38.

    Steis MR, Schrauf RW. A review of translations and adaptations of the Mini-Mental State Examination in languages other than English and Spanish. Res Gerontol Nurs. 2009;2:214–24.

    Article  Google Scholar 

  39. 39.

    Zhang Z, Gu D, Hayward MD. Childhood nutritional deprivation and cognitive impairment among older Chinese people. Soc Sci Med. 2010;71:941–9.

    Article  Google Scholar 

  40. 40.

    Folstein MF, Folstein SE, McHugh PR. Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.

    CAS  Article  Google Scholar 

  41. 41.

    Zeng Y. Chinese longitudinal healthy longevity survey (1998-2012) and related policy research review. Sci Res Aging. 2013;1:2.

    Google Scholar 

  42. 42.

    Larson EB, Wang L, Bowen JD, McCormick WC, Teri L, Crane P, et al. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Ann Intern Med. 2006;144:73–81.

    Article  Google Scholar 

  43. 43.

    Yin ZX, Shi XM, Jian-Wei XU. Association between the hypersensitive C-reactive protein and diabetes in the senile elders. Chin J Diabetes. 2012;5:332–5.

    Google Scholar 

  44. 44.

    WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157.

    Article  Google Scholar 

  45. 45.

    Theodora P, Sergentanis TN, Panagiotakos DB, Sergentanis IN, Rena K, Nikolaos S. Mediterranean diet, stroke, cognitive impairment, and depression: a meta-analysis. Ann Neurol. 2013;74:580–91.

    Article  Google Scholar 

  46. 46.

    Ilianna L, Maya S, Joanna TC, Nitin P, Lang IA, Ukoumunne OC, et al. Mediterranean diet, cognitive function, and dementia: a systematic review. Epidemiology. 2013;24:479–89.

    Article  Google Scholar 

  47. 47.

    Singh B, Parsaik AK, Mielke MM, Erwin PJ, Knopman DS, Petersen RC, et al. Association of mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis Jad. 2014;39:271–82.

    Article  Google Scholar 

  48. 48.

    Luchsinger JA, Mayeux R. Dietary factors and Alzheimer’s disease. Lancet Neurol. 2004;3:579–87.

    Article  Google Scholar 

  49. 49.

    Lautenschlager NT, Cox KL, Flicker L, Foster JK, van Bockxmeer FM, Xiao J, et al. Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA. 2008;300:1027–37.

    CAS  Article  Google Scholar 

  50. 50.

    Mukamal KJ, Kuller LH, Fitzpatrick AL, Longstreth WT Jr, Mittleman MA, Siscovick DS. Prospective study of alcohol consumption and risk of dementia in older adults. JAMA. 2003;289:1405–13.

    CAS  Article  Google Scholar 

  51. 51.

    Ruitenberg A, van Swieten JC, Witteman JC, Mehta KM, van Duijn CM, Hofman A, et al. Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet. 2002;359:281–6.

    Article  Google Scholar 

  52. 52.

    Anstey KJ, von Sanden C, Salim A, O’Kearney R. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. Am J Epidemiol. 2007;166:367–78.

    Article  Google Scholar 

Download references

Acknowledgements

The study was supported by grants from the National Key Research and Development Project (2019YFC2003400), the Peking University Start-up Grant (BMU2018YJ002) and Beijing Technology and Business University Grant, China-Canada Joint Lab of Food Nutrition and Health (Beijing): 88442Y0033. The funding organizations had no role in the preparation of the manuscript.

Author information

Affiliations

Authors

Corresponding authors

Correspondence to Zheng Xie or Tao Huang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wang, Z., Pang, Y., Liu, J. et al. Association of healthy lifestyle with cognitive function among Chinese older adults. Eur J Clin Nutr (2020). https://doi.org/10.1038/s41430-020-00785-2

Download citation

Further reading

Search

Quick links