Association of combined engagement in cognitive and physical activity with domain-specific cognitive function: The Shanghai Aging Study

Objectives: This cross-sectional study aimed to examine the association of the combined engagement in cognitive activity (CA) and physical activity (PA) with domain-specific cognition in community-dwelling older adults.

Methods: We analysed data from 3192 dementia-free participants aged ≥50 years in the Shanghai Aging Study. CA was assessed using Shanghai Cognitive Activities Scale. PA was determined based on questionnaires and further transformed into metabolic equivalent values. We used multivariate linear and logistic regression models to estimate the β and odds ratio of CA, PA, or combined CA and PA and each neuropsychological test.

Results: A high level of CA was associated with a better performance in most of the tests, except for the conflicting instructions task (CIT) and stick test (ST). In contrast, PA displayed no significant associations with any test. Engagement in high CA and high PA was associated with the best performance in Mini-Mental State Examination, recall in ST, categorisation in Modified Common Objects Sorting Test (MCOST), immediate recall, delayed recall, and recognition in Auditory Verbal Learning Test. Participants with "high CA and low PA" had the lowest risk of impairment in Go/No-Go correct tapping in CIT, rotate in ST, item naming, and category naming in MCOST, Trail Making Test (TMT)-A, and TMT-B.

Conclusions: Our study suggests that engagement in both high CA and high PA may be the most efficacious way to maintain various domains of cognition. A higher level of CA may help to preserve cognition among older individuals who have difficulties in performing PA.