Relationship Between Physical Exercise and Cognitive Function Among Older Adults in China: Cross-Sectional Population-Based Study.

BACKGROUND: The existing literature reveals several significant knowledge gaps that hinder health care providers in formulating exercise prescriptions for cognitive health. OBJECTIVE: This study endeavors to elucidate the relationship between the level of physical activity and cognitive function in older adults in China. Moreover, it seeks to explore the associations between distinct exercise behaviors-such as exercise types, the purpose motivating engagement in exercise, the accessibility of exercise fields, and the inclination toward exercise-and cognitive function. METHODS: Using data from the China Longitudinal Aging Social Survey (CLASS conducted in 2016, cognitive function was meticulously assessed through the modified Chinese version of the Mini-Mental State Examination, encompassing measures of orientation, memory, and calculation. Using self-report structured questionnaires, a myriad of information about physical activity during leisure time, exercise engagement, exercise intensity, primary exercise types, reasons for exercise participation, availability of sports facilities, and exercise willingness was diligently gathered. Robust ordinary least squares regression models were then used to compute coefficients along with 95% CIs. RESULTS: A discernible inverted U-shaped trend in cognitive scores emerged as the level of physical activity surpassed the threshold of 500 metabolic equivalents of task (MET) minutes per week. Notably, individuals with a physical activity level between 500 and 999 MET minutes per week exhibited a coefficient of 0.31 (95% CI 0.09 to 0.54), those with a physical activity level between 1000 and 1499 MET minutes per week displayed a coefficient of 0.75 (95% CI 0.52 to 0.97), and those with a physical activity level above 1500 MET minutes per week demonstrated a coefficient of 0.45 (95% CI 0.23 to 0.68). Older individuals engaging in exercise at specific MET levels showcased superior cognitive function compared to their inactive counterparts. Furthermore, individuals driven by exercise motivations aimed at enhancing physical fitness and health, as well as those using sports facilities or public spaces for exercise, exhibited notably higher cognitive function scores. CONCLUSIONS: The findings underscore the potential of exercise as a targeted intervention for the prevention and treatment of dementia or cognitive decline associated with aging in older individuals. Leveraging these insights to formulate informed exercise recommendations holds promise in addressing a significant public health challenge linked to aging populations.

Association between relative handgrip strength and hypertension in Chinese adults: An analysis of four successive national surveys with 712,442 individuals (2000-2014).

OBJECTIVES: This study aimed to identify the 15-year trends of handgrip strength-to-weight (relative HS) and assess the association between relative HS and hypertension among Chinese adults aged 20-69. METHODS: Using a complex, stratified, multistage probability cluster sampling, we analyzed data collected from 712,442 adults aged 20-69 years in four successive national surveys (2000-2014). We used a handheld dynamometer to measure strength and divided by body weight to calculate the relative HS. Blood pressure was recorded with a sphygmomanometer and hypertension was defined as resting systolic blood pressure at least 140 mmHg or diastolic at least 90 mmHg. The Mann-Kendall trend test examined trends in relative HS over time. We also computed odd ratios (OR) and 95% confidence intervals (95% CI) by tertile of relative HS and examined the association between relative HS and hypertension. RESULTS: The relative HS level decreased with the increase of age in both male and females (p trend <0.001). In each of four surveys, one interquartile decrease in relative HS was associated with an increased risk of hypertension by 44% (OR = 1.44, 95%CI: 1.40-1.47), 58% (OR = 1.58, 95%CI: 1.54-1.62), 48% (OR = 1.48, 95%CI: 1.45-1.52), 43% (OR = 1.43, 95%CI: 1.40-1.47), respectively. CONCLUSION: In the Chinese adult population, the relative HS level decreased from 2000 to 2014 across all ages in both males and females. A lower relative HS was associated with a higher risk of hypertension. The findings provided evidence for the association between muscle strength and hypertension in large-scaled population.

Association among Weather Conditions, Ambient Air Temperature, and Sedentary Time in Chinese Adults.

This study is aimed to quantify the association among weather conditions, ambient air temperature, and sedentary time in Chinese adults. The participants were 3,270 Chinese users of a wrist-worn activity tracker. Their daily activity data were collected using an algorithm based on raw data to determine the sedentary time. The data of ambient air temperature and weather were collected from the meteorological data released by China Central Meteorological Observatory. Two-level linear regression analyses showed that weather conditions had a significant influence on sedentary time in Chinese adults after adjustments for some covariates were made. When the weather condition changed from rainy days to sunny and cloudy days, sedentary time might decrease by about 6.89 and 5.60 min, respectively. In conclusion, weather conditions were independently associated with sedentary time in Chinese adults. The daily sedentary time was shorter on sunny and cloudy days than on rainy days.

Association of socioeconomic status and health-related behavior with elderly health in China.

Previous health studies have focused on the correlation between socioeconomic status (SES) and health. We pooled data from the Chinese Longitudinal Healthy Longevity Survey (N = 9765) conducted in 2011, and examined the association of SES and health-related behavior with elderly health in China. The cumulative health disadvantage of the elderly caused by SES can be relieved by lifelong health-related behavior. In the same SES, the odds of self-rated health (SRH) as "good," mini-mental state examination (MMSE) as "not impaired," and activities of daily living (ADLs) as "not impaired" among the elderly who exercised regularly, were 46.9%, 28.6%, and 62.3% lower for the elderly who rarely exercised. The elderly who started doing regular exercise from 30 years old, achieved higher SRH, ADL, and MMSE scores to some extent. The health improvement advantage for the elderly who started doing regular exercises after 60 years old, was reduced. However, the odds of SRH as "good," MMSE as "not impaired," and ADLs as "not impaired" were still 3.4%, 12.5%, and 17.8%, respectively, higher than the respondents who never exercised. The health-related behaviors not only promote elderly health improvement, but its duration has also been found to be associated with the extent of health improvement.

Aerobic exercise regulates blood lipid and insulin resistance via the toll­like receptor 4­mediated extracellular signal­regulated kinases/AMP­activated protein kinases signaling pathway.

Diabetes mellitus is a complicated metabolic disease with symptoms of hyperglycemia, insulin resistance, chronic damage and dysfunction of tissues, and metabolic syndrome for insufficient insulin production. Evidence has indicated that exercise treatments are essential in the progression of type­Ð†Ð† diabetes mellitus, and affect insulin resistance and activity of islet ß­cells. In the present study, the efficacy and signaling mechanism of aerobic exercise on blood lipids and insulin resistance were investigated in the progression of type­Ð†Ð† diabetes mellitus. Body weight, glucose metabolism and insulin serum levels were investigated in mouse models of type­Ð†Ð† diabetes mellitus following experienced aerobic exercise. Expression levels of inflammatory factors, interleukin (IL)­6, high­sensitivity C­reactive protein, tumor necrosis factor­α and leucocyte differentiation antigens, soluble CD40 ligand in the serum were analyzed in the experimental mice. In addition, expression levels of toll­like receptor 4 (TLR­4) were analyzed in the liver cells of experimental mice. Changes of oxidative stress indicators, including reactive oxygen species, superoxide dismutase, glutathione and catalase were examined in the liver cells of experimental mice treated by aerobic exercise. Expression levels and activity of extracellular signal­regulated kinases (ERK) and AMP­activated protein kinase (AMPK) signaling pathways were investigated in the liver cells of mouse models of type­Ð†Ð† diabetes mellitus after undergoing aerobic exercise. Aerobic exercise decreased the expression levels of inflammatory factors in the serum of mouse models of type­Ð†Ð† diabetes mellitus. The results indicated that aerobic exercise downregulated oxidative stress indicators in liver cells from mouse models of type­Ð†Ð† diabetes mellitus. In addition, the ERK and AMPK signaling pathways were inactivated by aerobic exercise in liver cells in mouse models of type­Ð†Ð† diabetes mellitus. The activity of ERK and AMPK, and the function of islet ß­cells were observed to be improved in experimental mice treated with aerobic exercise. Furthermore, blood lipid metabolism and insulin resistance were improved by treatment with aerobic exercise. Body weight and glucose concentration of serology was markedly improved in mouse models of type­Ð†Ð† diabetes mellitus. Furthermore, TLR­4 inhibition markedly promoted ERK and AMPK expression levels and activity. Thus, these results indicate that aerobic exercise may improve blood lipid metabolism, insulin resistance and glucose plasma concentration in mouse models of type­Ð†Ð† diabetes mellitus. Thus indicating aerobic exercise is beneficial for improvement of blood lipid and insulin resistance via the TLR­4­mediated ERK/AMPK signaling pathway in the progression of type­Ð†Ð† diabetes mellitus.

Is economic environment associated with the physical activity levels and obesity in Chinese adults? A cross-sectional study of 30 regions in China.

BACKGROUND: Based on the 2014 survey of physical activity and physical fitness data of 20 - 69 year old Chinese, this study aims to investigate the relationship between economic development and people's physical activity in China. METHODS: A total of 43,389 adults from 30 different regions in mainland China were recruited. The GDP per capita of the 30 regions were determined based on the 2013 annual statistical report released by the national bureau of statistics of China and provincial level statistics bureaus. A questionnaire was used to determine the participants' exercise frequency, duration, and intensity. RESULTS: For the 30 regions surveyed, the correlation coefficients between GDP per capita and weekly activity were 0.23 for men and 0.15 for women. The correlation coefficients between GDP per capita and obesity rates were 0.52 for men and 0.39 for women. CONCLUSIONS: Although people in economically advanced regions in China currently engage in more physical activities than those in less economically developed regions, overweight and obesity persist as serious problems.

BMI, leisure-time physical activity, and physical fitness in adults in China: results from a series of national surveys, 2000-14.

BACKGROUND: Obesity, physical inactivity, and reduced physical fitness contribute to the rising burden of chronic diseases in China. We investigated these factors in Chinese adults over a 14-year period (2000-14) using data from randomised national surveys. METHODS: We did four national surveys in 2000, 2005, 2010, and 2014 among Chinese adults aged 20-59 years. We used BMI to assess underweight (<18·5 kg/m(2)), overweight (≥23·0 to <27·5 kg/m(2)), and obesity (≥27·5 kg/m(2)). Central obesity was defined as a waist circumference greater than 90 cm in men and greater than 85 cm in women. We assessed leisure-time physical activity (LTPA) by whether or not participants had completed the recommended minimum 150 min of moderate or 75 min of vigorous exercise per week. Indices for assessment of physical fitness were forced vital capacity, resting heart rate, hand grip strength, sit and reach distance, and time standing on one leg. FINDINGS: 151 656 (78%) of 193 440 adults responded to the survey in 2000, 163 386 (84%) in 2005, 154 931 (80%) in 2010, and 146 703 (76%) in 2014. The prevalence of obesity increased from 8·6% in 2000, to 10·3% in 2005, 12·2% in 2010, and 12·9% in 2014 (estimated increase 0·32% per year, 95% CI 0·30-0·33; p<0·0001). The equivalent estimates were 37·4%, 39·2%, 40·7%, and 41·2% for overweight (estimated increase 0·27% per year, 95% CI 0·25-0·30; p<0·0001) and 13·9%, 18·3%, 22·1%, and 24·9% for central obesity (estimated increase 0·78% per year, 0·76-0·80; p<0·0001). The prevalence of overweight, obesity, and central obesity increased with age (all p<0·0001) and was higher in men than in women (all p<0·0001). We noted a simultaneous decrease in the prevalence of underweight (estimated decrease of 0·06% per year, 95% CI 0·04-0·07; p<0·0001). The proportion of adults meeting the minimum LTPA recommendation increased over time (17·2% in 2000, 18·1% in 2005, and 22·8% in 2014), with the estimated prevalence change per year being 0·33% (95% CI 0·24-0·42; p<0·0001) for underweight people, 0·50% (0·47-0·53; p<0·0001) for normal-weight people, 0·37% (0·34-0·40; p<0·0001) for overweight people, and 0·06% (0·00-0·13; p=0·044) for obese people. We noted deteriorations over time in all measures of physical fitness in normal-weight adults (all p<0·0001), apart from resting heart rate (p=0·69). INTERPRETATION: Despite increased participation in LTPA, we noted increases in overweight or obesity and a decrease in physical fitness in Chinese adults. Continued nationwide interventions are needed to promote physical activity and other healthy lifestyle behaviours in China. FUNDING: National Physical Fitness Surveillance Center and Ministry of Science and Technology of the People's Republic of China.