Ma Miao, Dong Feng-Wei, Lan Jin-Yan
Department of Physical Education, Yuncheng University, Yuncheng, China.
Martial Arts Academy, Wuhan Sports University, Wuhan, Hubei, China.
Front Public Health. 2025 Jun 2;13:1589606. doi: 10.3389/fpubh.2025.1589606. eCollection 2025.
To systematically analyze the independent and combined effects of abnormal sleep duration and insufficient physical activity on the risk of cognitive impairment in older Chinese adults, to elucidate the regulatory mechanisms of physical activity in the sleep-cognition relationship, and to provide a robust scientific foundation for the development of multidimensional cognitive health intervention strategies.
A total of 5,184 older adults (aged 60 years and above) were selected for analysis from the 2020 China Health and Retirement Longitudinal study (CHARLS) data. The Mini-Mental State Examination (MMSE) and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) were utilized to assess cognitive function and physical activity levels, respectively. Multifactorial logistic regression models were employed to analyze the independent and joint effects of sleep duration and physical activity on cognitive impairment, as well as to investigate the moderating role of physical activity.
Both short sleep duration (less than 6 h per night, OR = 1.274, 95%CI: 1.099 ~ 1.477) and long sleep duration (more than 8 h per night, OR = 1.228, 95%CI: 1.044 ~ 1.445) significantly increased the risk of cognitive impairment. Additionally, low-physical activity levels (less than 600 MET-min/week, OR = 1.436, 95%CI: 1.091 ~ 1.890) were also associated with a heightened risk of cognitive impairment. The interaction between sleep duration and physical activity was significant; specifically, short sleep combined with low-physical activity (OR = 2.196, 95% CI: 1.385 ~ 3.484) and long sleep with low-physical activity (OR = 1.273, 95%CI: 1.078 ~ 1.503) significantly elevated the risk of cognitive impairment. The prevalence of cognitive impairment was significantly different ( < 0.01) between the group with suitable sleep and moderate-high physical activity (24.01%) and the other combination groups.
The results of this study support the hypothesis that sleep duration and physical activity levels may collaboratively enhance cognitive health through various physiological mechanisms. Furthermore, the findings suggest that a combination of sleep and physical activity interventions could be effective in preventing cognitive decline in the older adults population. However, due to the inherent limitations of the cross-sectional design, the findings reflect only statistical associations rather than causal relationships between the variables. Future studies should employ prospective designs and objective measures to investigate the causal relationships and underlying mechanisms in greater depth.
系统分析睡眠时长异常和身体活动不足对中国老年成年人认知障碍风险的独立及联合影响，阐明身体活动在睡眠与认知关系中的调节机制，为制定多维认知健康干预策略提供有力的科学依据。
从2020年中国健康与养老追踪调查（CHARLS）数据中选取5184名60岁及以上的老年人进行分析。分别采用简易精神状态检查表（MMSE）和国际体力活动问卷简表（IPAQ-SF）评估认知功能和身体活动水平。采用多因素逻辑回归模型分析睡眠时长和身体活动对认知障碍的独立及联合影响，以及身体活动的调节作用。
睡眠时长过短（每晚少于6小时，OR = 1.274，95%CI：1.099 ~ 1.477）和过长（每晚多于8小时，OR = 1.228，95%CI：1.044 ~ 1.445）均显著增加认知障碍风险。此外，低身体活动水平（每周少于600代谢当量分钟，OR = 1.436，95%CI：1.091 ~ 1.890）也与认知障碍风险增加相关。睡眠时长与身体活动之间的交互作用显著；具体而言，短睡眠与低身体活动（OR = 2.196，95%CI：1.385 ~ 3.484）以及长睡眠与低身体活动（OR = 1.273，95%CI：1.078 ~ 1.503）均显著提高认知障碍风险。在睡眠适宜且身体活动为中高强度的组（24.01%）与其他组合组之间，认知障碍患病率存在显著差异（<0.01）。
本研究结果支持以下假设，即睡眠时长和身体活动水平可能通过多种生理机制协同促进认知健康。此外，研究结果表明，睡眠和身体活动干预相结合可能有效预防老年人群的认知衰退。然而，由于横断面设计的固有局限性，研究结果仅反映了变量之间的统计关联而非因果关系。未来研究应采用前瞻性设计和客观测量方法，更深入地探究因果关系及潜在机制。
