Bidirectional Association Between Lifestyle and Cognitive Function in Aging Adults.

Lifestyle research on cognitive health has been largely unidirectional and cross-sectional, with limited attention to multidimensional and bidirectional relationships; this study examines longitudinal associations in middle- and older adults. Data from the Korean Longitudinal Study of Aging (2006-2020) included physiological and psychosocial lifestyle factors and cognition assessed by the Korean version of the Mini-Mental State Examination (K-MMSE). Analyses used Mplus 8.9 with cross-lagged panel model (CLPM) and random intercept CLPM (RI-CLPM), adjusting for sex, age, smoking, drinking, and disability. CLPM showed significant lagged effects of lifestyle on cognition across waves (β = .010 to .013, p < .01), with intermittent reverse effects (β = .013 to .015, p < .05). The RI-CLPM confirmed a stable effect of lifestyle on cognition (β = .013 to .017, p < .05), whereas effects from cognition to lifestyle were mixed and nonsignificant (β = -.054 to .034, p > .05). A multidimensional lifestyle was associated with cognitive maintenance, whereas cognitive decline shows variable influences on lifestyle.