Association of physical activity with motoric cognitive risk syndrome among the middle-aged and older adults in China

Motoric Cognitive Risk Syndrome (MCR) represents a pre-dementia syndrome amenable to intervention, bearing substantial public health significance in China amidst its rapidly aging population. While physical activity (PA) potentially exerts neuroprotective effects, empirical evidence regarding its impact on MCR remains limited. This study endeavors to comprehensively investigate the association between PA and MCR among middle-aged and older adults. Utilizing cross-sectional data from the 2015 China Health and Retirement Longitudinal Study (CHARLS), we employed binary logistic regression models to examine the PA-MCR association. Restricted Cubic Spline (RCS) analysis was conducted to characterize the dose-response relationship and test for potential non-linearity, complemented by extensive subgroup and interaction analyses to evaluate population heterogeneity. To ensure result robustness, we implemented Propensity Score Matching (PSM) and conducted two additional sensitivity analyses. The study revealed an MCR prevalence of 11.96% among middle-aged and older adults. In the fully adjusted model, high PA levels demonstrated a 44.8% reduction in MCR risk compared to low PA levels (OR = 0.552, 95% CI = 0.418–0.729). RCS analysis indicated a significant linear relationship between PA and MCR (P for nonlinearity = 0.060). Subgroup analyses identified sleep duration as a significant effect modifier in the PA-MCR association (P for interaction < 0.05). Consistent findings were observed in PSM-adjusted results and both sensitivity analyses. This study substantiates a significant association between PA and MCR in middle-aged and older adults, providing crucial theoretical foundations for developing PA-based dementia prevention strategies.