Time spent in physical activities, TV watching and sleep and its association with executive functioning in middle age and older adults: An isotemporal substitution analysis

Time spent in physical activities, sedentary behavior and sleep during the day are interrelated and are differentially associated with executive functioning (EF). Most studies have not analyzed these three activities simultaneously when examining this association. We examined the association between these activities and EF, and estimated the influence of time reallocation of sedentary behavior (TV watching) for other activities on EF. Baseline data (≥40y) from Lifelines Cohort study (n = 58,582) was used to assess the association between self-reported time spent in TV-watching, sleep, and physical activities (active commuting, leisure, sports, household, and work) with EF (Ruff Figural Fluency Test) using multivariable linear regression. Isotemporal substitution analyses were applied to estimate the impact of time replacement of TV-watching by other activities on CP. Analyses were stratified by age (middle age (<60y) and older adults) and sleep duration (short, normal (7–8 h/day), and long). In participants with normal sleep (75%), TV-watching time was inversely associated with EF in middle aged (β −0.30, 95%CI -0.41, −0.19) and older (β −0.33, 95%CI -0.51, −0.14) participants. Replacing 30 min of TV-watching with leisure (β 0.22, 95%CI 0.11, 0.34), sports (β 0.51, 95%CI 0.48, 0.97), household (β 0.21, 95%CI 0.09, 0.33), or work (β 0.39, 95%CI 0.28, 0.50) showed a stronger and positive association with EF. Associations were less pronounced in short sleepers, and absent among long sleepers aged ≥60y. Substituting 30 min of TV-watching by with physical activities may be a potential strategy to improve or preserve EF. Future research should explore this theoretical implication. • TV time is associated with poorer executive functioning in those sleeping 7–8 h/day. • Replacing TV time with sports or work activities may benefit executive functioning. • Replacing TV time with sleep may benefit executive functioning in short sleepers.