Marital Status-Specific Associations Between Multidomain Leisure Activities and Cognitive Reserve in Clinically Unimpaired Older Adults: Based on a National Chinese Cohort
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Participants
2.2. Measurement of Multidomain Leisure Activity
2.3. Assessment of Marital Status
2.4. Assessment of Cognition
2.5. Covariance
2.6. Statistical Analyses
3. Results
3.1. Baseline Characteristics of Study Samples
3.2. Marital Status-Specific Associations of Leisure Activity Diversity with Cognitive Decline
3.3. Marital Status-Specific Association of Leisure Activity Amount and Frequency with Cognitive Decline
3.4. Marital Status-Specific Association of Individual Activity Types with Cognitive Decline
3.5. Sensitivity Analyses
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Overall (n = 5286) | Married (n = 2809) | Unmarried (n = 2477) | F/χ2 | p Value |
---|---|---|---|---|---|
Age (years), Mean ± SD | 79.01 ± 3.77 | 75.03 ± 7.62 | 83.53 ± 9.49 | 127.81 | <0.001 |
Sex, n (%) | 511.92 | <0.001 | |||
Male | 2645 (50.0%) | 1816 (64.6%) | 829 (33.5%) | ||
Female | 2641 (50.0%) | 993 (35.4%) | 1648 (66.5%) | ||
Education (years), Mean ± SD | 2.82 ± 3.77 | 3.73 ± 4.05 | 1.80 ± 3.14 | 257.23 | <0.001 |
Residence, n (%) | 2.451 | 0.294 | |||
Country | 3248 (61.4%) | 1706 (60.7%) | 1542 (62.3%) | ||
Town | 1107 (20.9%) | 587 (20.9%) | 520 (21.0%) | ||
City | 931 (17.6%) | 516 (18.4%) | 415 (16.8%) | ||
Economic status, n (%) | 12.36 | 0.002 | |||
Poor | 753 (14.3%) | 414 (14.8%) | 339 (13.7%) | ||
Average | 3697 (70.0%) | 1996 (71.2%) | 1701 (68.7%) | ||
Rich | 830 (15.7%) | 395 (14.1%) | 435 (17.6%) | ||
Occupation, n (%) | 82.237 | <0.001 | |||
White-collar | 538 (10.4%) | 382 (13.9%) | 156 (6.4%) | ||
Blue-collar | 1097 (21.2%) | 592 (21.6%) | 505 (20.8%) | ||
Farmer | 3534 (68.4%) | 1771 (64.5%) | 1763 (72.7%) | ||
Exercise (Yes), n (%) | 1987 (37.6%) | 1138 (40.5%) | 849 (34.3%) | 21.83 | <0.001 |
Smoking (Yes), n (%) | 2055 (38.9%) | 1348 (48.0%) | 1461 (52.0%) | 208.85 | <0.001 |
Drinking (Yes), n (%) | 1853 (35.1%) | 1155 (41.1%) | 698 (28.2%) | 96.79 | <0.001 |
Dietary habit, Mean ± SD | 3.26 ± 1.54 | 3.40 ± 1.56 | 3.11 ± 1.51 | 11.07 | <0.001 |
Depression, Mean ± SD | 6.53 ± 3.13 | 6.02 ± 2.91 | 7.10 ± 3.26 | 37.17 | <0.001 |
Hypertension (Yes), n (%) | 1145 (22.1%) | 622 (22.5%) | 523 (21.5%) | 0.774 | 0.379 |
Diabetes (Yes), n (%) | 160 (3.1%) | 110 (4.0%) | 50 (2.1%) | 15.87 | <0.001 |
Heart disease (Yes), n (%) | 503 (9.7%) | 293 (10.6%) | 210 (8.6%) | 5.61 | 0.018 |
Stroke (Yes), n (%) | 258 (4.9%) | 159 (5.7%) | 99 (4.1%) | 7.69 | 0.006 |
ADL, Mean ± SD | 15.92 ± 3.53 | 15.12 ± 2.72 | 16.82 ± 4.089 | 428.94 | <0.001 |
BMI (kg/m2), Mean ± SD | 21.17 ± 3.57 | 21.63 ± 3.62 | 20.63 ± 3.43 | 1.179 | <0.001 |
MMSE score, Mean ± SD | 27.2 ± 3.05 | 27.91 ± 2.53 | 26.47 ± 3.38 | 333.65 | <0.001 |
Leisure activity score, Mean ± SD | 9.75 ± 4.74 | 10.79 ± 4.65 | 8.57 ± 4.55 | 47.57 | <0.001 |
Leisure activity frequency, n (%) | 240.84 | <0.001 | |||
T1 | 2409 (45.6%) | 1034 (36.8%) | 1375 (55.5%) | ||
T2 | 1665 (31.5%) | 929 (33.1%) | 736 (29.7%) | ||
T3 | 1212 (22.9%) | 846 (30.1%) | 366 (14.8%) | ||
Leisure activity variety, n (%) | 292.05 | <0.001 | |||
0–1 | 809 (15.3%) | 268 (9.5%) | 514 (21.8%) | ||
2–3 | 2923 (55.3%) | 1472 (52.4%) | 1451 (58.6%) | ||
4–7 | 1554 (29.4%) | 1069 (38.1%) | 485 (19.6%) |
Variables | Model 1 * | Model 2 † | ||
---|---|---|---|---|
β (95% CI) | p Value | β (95% CI) | p Value | |
Overall population: | ||||
(0–1) × time | Reference | Reference | ||
(2–3) × time | 0.365 (0.272–0.459) | <0.001 | 0.347 (0.250–0.444) | <0.001 |
(4–7) × time | 0.511 (0.411–0.610) | <0.001 | 0.500 (0.396–0.603) | <0.001 |
Three-way interaction: | ||||
(0–1 × time) × marital status | Reference | Reference | ||
(2–3 × time) × marital status | 0.426 (0.236–0.617) | <0.001 | 0.437 (0.240–0.633) | <0.001 |
(4–7 × time) × marital status | 0.562 (0.355–0.769) | <0.001 | 0.578 (0.364–0.792) | <0.001 |
Marital status-stratified two-way interactions: | ||||
(0–1) × time married | Reference | Reference | ||
(2–3) × time married | 0.035 (−0.080–0.150) | 0.552 | 0.021 (−0.098–0.140) | 0.733 |
(4–7) × time married | 0.085 (−0.032–0.203) | 0.156 | 0.077 (−0.045–0.198) | 0.216 |
(0–1) × time unmarried | Reference | Reference | ||
(2–3) × time unmarried | 0.487 (0.337–0.638) | <0.001 | 0.489 (0.319–0.659) | <0.001 |
(4–7) × time unmarried | 0.684 (0.505–0.863) | <0.001 | 0.697 (0.495–0.900) | <0.001 |
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Cai, C.; Wang, J.; Liu, D.; Liu, J.; Zhou, J.; Liu, X.; Song, D.; Li, S.; Cui, Y.; Nie, Q.; et al. Marital Status-Specific Associations Between Multidomain Leisure Activities and Cognitive Reserve in Clinically Unimpaired Older Adults: Based on a National Chinese Cohort. Brain Sci. 2025, 15, 371. https://doi.org/10.3390/brainsci15040371
Cai C, Wang J, Liu D, Liu J, Zhou J, Liu X, Song D, Li S, Cui Y, Nie Q, et al. Marital Status-Specific Associations Between Multidomain Leisure Activities and Cognitive Reserve in Clinically Unimpaired Older Adults: Based on a National Chinese Cohort. Brain Sciences. 2025; 15(4):371. https://doi.org/10.3390/brainsci15040371
Chicago/Turabian StyleCai, Cheng, Junyi Wang, Dan Liu, Jing Liu, Juan Zhou, Xiaochang Liu, Dan Song, Shiyue Li, Yuyang Cui, Qianqian Nie, and et al. 2025. "Marital Status-Specific Associations Between Multidomain Leisure Activities and Cognitive Reserve in Clinically Unimpaired Older Adults: Based on a National Chinese Cohort" Brain Sciences 15, no. 4: 371. https://doi.org/10.3390/brainsci15040371
APA StyleCai, C., Wang, J., Liu, D., Liu, J., Zhou, J., Liu, X., Song, D., Li, S., Cui, Y., Nie, Q., Hu, F., Xie, X., Cheng, G., & Zeng, Y. (2025). Marital Status-Specific Associations Between Multidomain Leisure Activities and Cognitive Reserve in Clinically Unimpaired Older Adults: Based on a National Chinese Cohort. Brain Sciences, 15(4), 371. https://doi.org/10.3390/brainsci15040371