Sedentary Behaviors and Functional Disability Among Chinese Older Adults (2008–2018): Evidence Including Mahjong

PurposeThis study examined how different types of sedentary behavior relate to changes in functional disability, measured by activities of daily living (ADL) and instrumental activities of daily living (IADL), among Chinese older adults.Major findingsUsing data from 17,939 participants in four waves (2008-2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), sedentary behavior was categorized into four types: none, playing mahjong only, combining these with other sedentary activities, and other activities alone (e.g., reading and watching TV). Cox two-state regression models estimated the hazard of transitioning in ADL and IADL disability. Engaging in sedentary behaviors was generally associated with a lower risk of developing ADL and IADL impairments. Playing mahjong alone was significantly associated with reduced risk of developing ADL (HR) = 0.60) and IADL difficulties (HR = 0.82).ConclusionsCognitively and socially engaging sedentary activities, particularly mahjong, may protect against functional decline in later life.