Cross-sectional study of activity habits, socioeconomic status, and cognitive performance in central China’s adult population

Activity habits has been demonstrated to confer cognitive benefits. However, the extent to which these activities can mitigate cognitive disparities in older adults resulting from socioeconomic inequality remains unclear. We assessed cognitive performance and leisure activities in participants aged ≥ 65 years from 31 urban and 48 rural communities in Central China. A life-cycle composite socioeconomic status (SES) index incorporating education, occupational prestige, disposable income, and healthcare facility proximity categorized participants into low-, middle-, and high-SES groups. Logistic and linear regression models were employed to examine the associations between leisure activities and cognition, stratified by sex and age across different SES groups. This cross-sectional survey had a total of 8,597 eligible participants aged ≥ 65 years (mean age: 72.2 years, female: 55.1%). Compared to those of high SES, individuals with middle (OR = 1.86, 95% CI: 1.57-2.19) and low SES (OR = 3.62, 95% CI: 2.83-4.64) exhibited a higher prevalence of cognitive impairment and lower cognitive performance. Physical activity and cognitive leisure activity (PA and CLA) demonstrated a linear association with global and sub-domain cognitive performance, with a combined correlation with global cognition (β = 0.13, 95% CI: 0.10-0.15) being higher than that of CLA (β = 0.09, 95% CI: 0.07-0.11) and PA (β = 0.04, 95% CI: 0.02-0.06); our analysis revealed a stronger association between leisure activities and cognitive performance in low-SES individuals, with a notable effect size (combined: β = 0.35, 95% CI: 0.25-0.45; CLA: β = 0.27, 95% CI: 0.19-0.35 and PA: β = 0.09, 95% CI: 0.00-0.16) and in the > 70 years group, both (combined: β = 0.45, 95% CI: 0.31-0.59; CLA: β = 0.35, 95% CI: 0.24-0.47 and PA: β = 0.12, 95% CI: 0.02-0.22) and higher in men (combined: β = 0.39, 95% CI: 0.24-0.54; CLA: β = 0.30, 95% CI: 0.19-0.40 and PA: β = 0.09, 95% CI: -0.03-0.20). Our findings indicate that leisure activities are significantly associated with cognitive performance among older adults across all SES groups, particularly those in low SES categories. This study supports engagement in cognitively stimulating activities to prevent dementia in older adults of low SES.