Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
Structured exercise, cognitive-social engagement, and cognitive impairment-free life expectancy across four longitudinal aging cohorts.
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Li Xiangwei, Liu Ying, Sun Junyu, Zhang Hui, Xu Yaqian, Ding Chongyu, Zhang Yanting, Tong Tianlang, Wang Zhaojun, Lyu Wei, Cui Xian
Аннотация
INTRODUCTION: Whether cognitive-social engagement can compensate for insufficient structured exercise in cognitive aging remains unclear.
METHODS: We harmonized repeated data from four aging cohorts across Asia, North America, and Europe. Structured exercise and cognitive-social engagement were cross-classified at each wave into low-low (LL), high exercise-low engagement (HL), low exercise-high engagement (LH), and high-high (HH). Cohort-specific Cox models and multistate life tables estimated incident cognitive impairment and cognitive impairment-free life expectancy.
RESULTS: Cognitive impairment-free life expectancy from age 50 was 17.5, 23.2, 20.1, and 24.7 years for the low exercise + low cognitive-social engagement (LL), high exercise + low cognitive-social engagement (HL), low exercise + high cognitive-social engagement (LH), and high exercise + high cognitive-social engagement (HH) groups, respectively.
DISCUSSION: Structured exercise and cognitive-social engagement showed combined, non-interchangeable benefits for cognitive aging. These findings support integrated lifestyle strategies for dementia prevention across diverse aging populations, health systems, and prevention settings worldwide.
METHODS: We harmonized repeated data from four aging cohorts across Asia, North America, and Europe. Structured exercise and cognitive-social engagement were cross-classified at each wave into low-low (LL), high exercise-low engagement (HL), low exercise-high engagement (LH), and high-high (HH). Cohort-specific Cox models and multistate life tables estimated incident cognitive impairment and cognitive impairment-free life expectancy.
RESULTS: Cognitive impairment-free life expectancy from age 50 was 17.5, 23.2, 20.1, and 24.7 years for the low exercise + low cognitive-social engagement (LL), high exercise + low cognitive-social engagement (HL), low exercise + high cognitive-social engagement (LH), and high exercise + high cognitive-social engagement (HH) groups, respectively.
DISCUSSION: Structured exercise and cognitive-social engagement showed combined, non-interchangeable benefits for cognitive aging. These findings support integrated lifestyle strategies for dementia prevention across diverse aging populations, health systems, and prevention settings worldwide.