Key result
Severe multimorbidity predicts worse cognitive function and vice versa, mediated by physical and leisure activity.
Why the study?
Although multimorbidity and cognitive function are associated, the specific direction and underlying mechanism remain unclear, particularly regarding the role of physical and leisure activity in older adults.
Does multimorbidity affect cognitive function in older adults?
Cohort (n=5,546)
Does multimorbidity affect cognitive function in older adults?
Effect estimate: β -0.064
There is a negative bidirectional association between multimorbidity and cognitive function in older adults, which is mediated by physical and leisure activity.
Multimorbidity and cognitive function show bidirectional negative association mediated by activity in older adults; hypothesis-generating and requires prospective trials before practice change.
BACKGROUND: Previous studies have reported an association between multimorbidity and cognitive function; however, the specific direction and underlying mechanism remain unclear. The study aimed to explore the direction of this association and to examine the role of physical activity and leisure activity among older adults. METHODS: Data from 5 546 dementia-free Americans aged 60 or above of 2008 (T1) and 2016 (T2) of the Health and Retirement Study were used. Multimorbidity was measured by the multimorbidity weight index. Cognitive function was measured by the Telephone Interview of Cognitive Status. We used cross-lagged panel models to determine the associations between multimorbidity and cognitive function and examine the mediation effect of physical and leisure activity. RESULTS: There was a bidirectional association between multimorbidity and cognitive function. More severe multimorbidity predicted worse cognitive function (β = -0.064, SE = 0.016) and vice versa (β = -0.024, SE = 0.009). Paths from multimorbidity to cognitive function were stronger than those from cognitive function to multimorbidity. Physical and leisure activity mediated the association between multimorbidity (T1) and cognitive function (T2), and the association between cognitive function (T1) and multimorbidity (T2). The bidirectional association between multimorbidity and cognitive function was only observed in APOE ε4 noncarriers. CONCLUSIONS: A negative bidirectional association was observed between multimorbidity and cognitive function. Additionally, the association is mediated by physical and leisure activity.
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Wang et al. (2025) conducted a cohort in Dementia-free older adults (n=5,546). Multimorbidity was evaluated on Cognitive function (β -0.064). More severe multimorbidity predicted worse cognitive function (β = -0.064, SE = 0.016) and vice versa (β = -0.024, SE = 0.009), with the association mediated by physical and leisure activity.
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