High-intensity Physical Activity Is Not Associated With Better Cognition in the Elder: Evidence From the China Health and Retirement Longitudinal Study

Abstract Objective To evaluate the association of physical activity (PA) intensity with cognitive performance at baseline and during follow up. Methods A total of 4 039 participants aged 45 years or above from the China Health and Retirement Longitudinal Study were enrolled in visit 1 (2011-2012), and followed for cognitive function in visit 2 (2013-2014), visit 3 (2015-2016) and visit 4 (2017-2018). We analyzed the association of PA intensity with global cognition, episodic memory and mental intactness at baseline using adjusted regression methods, and evaluated the long-term effect of PA intensity using multiple measures of cognition scores by mixed effect model.Results Compared with individuals without PA, those with mild PA had 0.42 (3.7%) higher global cognition, and 0.20 (5.9%) higher episodic memory, while individuals with moderate PA had 0.59 (5.3%) higher global cognition, 0.25 (7.1%) higher episodic memory, and 0.34 (4.4%) higher mental intactness at baseline. The vigorous PA was not associated with better global cognition, episodic memory and mental intactness (all P>0.05). The results remained almost consistent in multiple sensitivity analyses. In addition, mild and moderate PA, rather than vigorous PA, was beneficial to long-term cognitive performance. Conclusions Our study indicates that mild and moderate PA could improve cognitive performance, rather than the vigorous activity. The targeted intensity of PA might be more effective to achieve the greatest cognition improvement considering age, overweight and depressive status.