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Association between exercise and the risk of dementia: results from a nationwide longitudinal study in China
  1. Zi Zhou1,2,
  2. Jian Fu1,2,
  3. Y. Alicia Hong3,
  4. Ping Wang1,2,
  5. Ya Fang1,2
  1. 1 State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
  2. 2 Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen, China
  3. 3 School of Public Health, Texas A&M University, College Station, Texas, USA
  1. Correspondence to Dr Ya Fang; fangya{at}


Objective This study was conducted to examine the causal association between exercise and the risk of dementia among older Chinese adults.

Design Longitudinal population-based study with a follow-up duration of 9 years.

Setting Data for the Chinese Longitudinal Healthy Longevity Survey waves occurring from 2002 to 2011–2012 were extracted from the survey database.

Participants In total, 7501 dementia-free subjects who were older than 65 years were included at baseline. Dementia was defined as a self-reported or proxy-reported physician’s diagnosis of the disease.

Outcome measures and methods Regular exercise and potential confounding variables were obtained via a self-report questionnaire. We generated longitudinal logistic regression models based on time-lagged generalised estimating equation to examine the causal association between exercise and dementia risk.

Results Of the 7501 older Chinese people included in this study, 338 developed dementia during the 9-year follow-up period after excluding those who were lost to follow-up or deceased. People who regularly exercised had lower odds of developing dementia (OR=0.53, 95% CI 0.33 to 0.85) than those who did not exercise regularly.

Conclusion Regular exercise was associated with decreased risk of dementia. Policy-makers should develop effective public health programmes and build exercise-friendly environments for the general public.

  • dementia
  • exercise
  • GEE
  • older adults
  • China

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  • Contributors YF conceived and designed the study, and supervised the data analysis. ZZ and JF analysed the data and wrote the paper together. YAH helped with revising the manuscript. PW gave advice on statistical analysis. All authors have given final approval of the version to be published.

  • Funding This research was funded by the National Natural Science Foundation of China (grant number: 81602941, 81573257) and the Natural Science Foundation of Fujian Province of China (grant number: 2016J0101).

  • Disclaimer The funding agencies are not responsible for the opinions presented in the manuscript. The funding bodies had no influence on the conduct of the study or the interpretation of the results.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The use of CLHLS data was approved by the Biomedical Ethics Committee of Peking University (IRB00001052-13074).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The dataset supporting the conclusions of this article is conditionally available. For details of access permitting, please check the website at

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