The impact of healthy lifestyles on cognitive function in community-dwelling older adults: A cross-sectional study in Shanghai, China

Recent literature has demonstrated the link between lifestyle behavior factors and cognitive function, yet most evidence comes from Western populations. This study examined the associations between multiple healthy lifestyle factors and cognitive function among community-dwelling older adults in Shanghai, China. This cross-sectional study included 942 residents aged ≥ 60 years in Pudong District, Shanghai, China, who participated in China's national free physical examination program from July to September 2024. Cognitive function and cognitive impairment status were assessed by Mini-Mental State Examination (MMSE). Five healthy lifestyle factors were considered: never smoking, healthy body mass index, regular physical activity, light-to-moderate alcohol drinking and optimal night sleep duration. A composite healthy lifestyle score (0-5) was calculated. Results showed that regular physical activity and optimal night sleep duration were positively correlated with a MMSE score [<i>β</i> = 0.21 (95% confidence interval (CI): 0.09-0.34), <i>p</i> = 0.001; <i>β</i> = 0.15 (95% CI: 0.03-0.27), <i>p</i> = 0.016, respectively], and were significantly associated with lower odds of cognitive impairment [odds ratio (OR) = 0.69 (95% CI: 0.47-0.98); OR = 0.66 (95% CI: 0.45-0.95), respectively]. Compared with participants with ≤ 1 healthy lifestyle factor, the <i>β</i> (95% CI) of MMSE score for participants with 3, and 4-5 healthy lifestyle factors were 0.26 (0.08-0.44) and 0.25 (0.04-0.47), respectively; and the OR and 95% CI for participants with 3 healthy lifestyle factors were 0.59 (0.34-0.98). Adherence to multiple healthy lifestyle behaviors, particularly regular physical activity and adequate night sleep, was associated with better cognitive function among elders in Shanghai.