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Association Between Combined Multiple Behaviors and Cognitive Impairment in Older Adults: A 10-Year Cohort Study
Zhao S, Ren X, Zhang J, Chen C, Chang J, Zhang X, Zhao Y.. Preprints.org, 2026-09-09
Topic: Brain imaging, connectivity and assessment
Of total 8,321 participants, 24.88% (2,070) developed cognitive impairment during a 10-year follow-up. This study showed a significant association of combined multiple behaviors with cognitive impairment [hazard ratio (HR) 0.55, 95%CI: 0.35 - 0.86]. Compared with participants who had unhealthy lifestyle activity and dietary behaviors, HR for cognitive impairment was 0.65 (95% CI: 0.45 - 0.94) and 0.91 (95% CI: 0.82 - 0.99) in those who had good lifestyle activity and dietary behaviors, respectively. Subgroup analyses revealed significant relationships in females and individuals with lowest education. Adherence to a broad range of healthy lifestyle factors was associated with a significantly lower risk of cognitive impairment. Behavioral lifestyle modification through multifactorial approaches should be a priority for prevention and delayed onset of cognitive impairment and dementia.
Key findings
- Of total 8,321 participants, 24.88% (2,070) developed cognitive impairment during a 10-year follow-up.
- This study showed a significant association of combined multiple behaviors with cognitive impairment [hazard ratio (HR) 0.55, 95%CI: 0.35 - 0.86].
- Compared with participants who had unhealthy lifestyle activity and dietary behaviors, HR for cognitive impairment was 0.65 (95% CI: 0.45 - 0.94) and 0.91 (95% CI: 0.82 - 0.99) in those who had good lifestyle activity and dietary behaviors, respectively.
- Subgroup analyses revealed significant relationships in females and individuals with lowest education.
- Adherence to a broad range of healthy lifestyle factors was associated with a significantly lower risk of cognitive impairment.
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Study details
- Study designlongitudinal study
- Participants8,321
- Effect size24.88%
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 48 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 30 of the 62 points we could judge it on, which is 48 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Preprints.org) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 8,321 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 30 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 30 of the 62 points we could judge it on is 48 out of 100. |
| Total | 48 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Zhao, S., Ren, X., Zhang, J., Chen, C., Chang, J., Zhang, X., et al. (2026). Association Between Combined Multiple Behaviors and Cognitive Impairment in Older Adults: A 10-Year Cohort Study. Preprints.org. https://doi.org/10.20944/preprints202609.0693.v1
Vancouver
Zhao S, Ren X, Zhang J, Chen C, Chang J, Zhang X, et al. Association Between Combined Multiple Behaviors and Cognitive Impairment in Older Adults: A 10-Year Cohort Study. Preprints.org. 2026. doi:10.20944/preprints202609.0693.v1.
BibTeX
@article{zhao2026-3d59b282,
author = {Zhao, S. and Ren, X. and Zhang, J. and Chen, C. and Chang, J. and Zhang, X. and Zhao, Y.},
title = {{Association Between Combined Multiple Behaviors and Cognitive Impairment in Older Adults: A 10-Year Cohort Study}},
journal = {Preprints.org},
year = {2026},
doi = {10.20944/preprints202609.0693.v1},
url = {https://doi.org/10.20944/preprints202609.0693.v1}
}