The proportion of moderate-to-vigorous-intensity physical activity to total volume of physical activity is associated with cognitive and mental health in middle-aged and older adults

PURPOSE: Physical activity (PA) intensity remains a key determinant in managing chronic conditions. This study investigated how the proportion of moderate-to-vigorous physical activity (MVPA) relative to total volume is independently associated with cognitive function and depressive symptoms in middle-aged and older adults. METHODS: A cross-sectional analysis was conducted utilizing data from 17,057 middle-aged and older adults in the China Health and Retirement Longitudinal Study. We used a Chinese version of the International Physical Activity Questionnaire to assess PA. Cognitive function and depressive symptoms were evaluated using the Telephone Interview for Cognitive Status and the Center of Epidemiologic Studies Depression Scale. The association between the proportion of MVPA to total PA volume and cognitive and mental health was tested using multivariable binary logistic regression analyses. RESULTS: The findings indicated a suggested U-shaped pattern: 1%-33% MVPA was associated with the lowest odds of impairment particularly among older adults, for both cognitive function (adjusted odds ratio [aOR]: 0.48, 95% CI: 0.35, 0.67) and depressive symptoms (aOR: 0.57, 95% CI: 0.43, 0.76). Conversely, 67%-100% MVPA was associated with an increase in prevalence, particularly among male participants, where the favorable association with depression was no longer statistically significant (aOR: 1.01, 95% CI: 0.83, 1.22). Notably, adjusting for socioeconomic status unmasked significant favorable associations in middle-aged adults previously obscured by negative confounding. CONCLUSION: This study finds that MVPA is significantly linked to mental and cognitive health in older adults. Our findings identify a range associated with the lowest odds for MVPA proportion, specifically 1%-33% MVPA, that is associated with the lowest odds of impairment for cognitive impairment and depressive symptoms.