Longitudinal association between the weekend warrior physical activity pattern and cognitive function trajectories among middle-aged and older Chinese adults

BACKGROUND: Cognitive decline is a major public health concern in aging societies, and physical activity (PA) is a key modifiable factor. Some individuals concentrate their PA into one or two days per week-the "weekend warrior" pattern-but its long-term relationship with cognitive changes remains unclear. This study aimed to examined the association between the weekend warrior pattern and cognitive trajectories among middle-aged and older adults in China. METHODS: Data were derived from the China Health and Retirement Longitudinal Study (CHARLS, 2013-2018). A total of 1,530 adults aged ≥ 45 years who completed three survey waves were included. Group-based trajectory modeling (GBTM) was used to identify distinct cognitive trajectories, and multinomial logistic regression with hierarchical adjustment assessed associations between the weekend warrior pattern and these trajectories. RESULTS: Six distinct cognitive trajectories were identified. Compared with the Cognitive Impairment-Persistent Low group, participants adopting the weekend warrior pattern were significantly more likely to belong to the Cognitive Normal-Stable group (Model5: OR = 2.685, 95% CI: 2.68-2.69, P < 0.001). Sensitivity and subgroup analyses yielded consistent results, supporting the robustness of the association. CONCLUSION: The weekend warrior PA pattern was significantly associated with more favorable cognitive trajectories among middle-aged and older adults. Concentrating PA within one or two days per week may offer long-term cognitive benefits and represents a practical strategy for promoting brain health in aging populations.