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Dynamic Interrelationships Among Physical Activity, Cognitive Function, and Depression in Older Adults: A Random-Intercept Cross- Lagged Panel Analysis
Zhang J, Yu C, Bian D, Han X, Shi C, Li G.. Research Square, 2026-07-23
Topic: Brain imaging, connectivity and assessment
Background Depression and physical inactivity are modifiable cognitive decline risks highlighted by the Lancet dementia commission. Existing research cannot clarify their relative within-person predictive impacts on cognitive trajectories among older adults, hindering targeted community dementia prevention strategies. Methods Data from 2,435 older adults (mean age 60.68 ± 7.27 years) in the China Health and Retirement Longitudinal Study were analyzed across three waves (2015 to 2020). Physical activity was measured using a modified International Physical Activity Questionnaire. Cognitive function was assessed through the Telephone Interview of Cognitive Status instrument. Depression was quantified using the 10-item Center for Epidemiologic Studies Depression Scale (range: 0–30 points). The Random-Intercept Cross-Lagged Panel Model was employed to examine between-person associations and within-person temporal dynamics. Results At the between-person level, cognitive function was negatively associated with depression (beta=-0.203, p < 0.01) and positively with physical activity (beta = 0.135, p < 0.01), while the physical activity-depression association was not significant. Within-person cross-lagged analyses revealed that depressive symptoms significantly predicted subsequent cognitive decline (beta=-0.046 to -0.043, p < 0.05), and cognitive function predicted subsequent physical activity engagement (beta = 0.059–0.073, p < 0.05). Notably, physical activity did not significantly predict subsequent cognitive function or depression at the within-person level. Conclusion When stable individual differences are accounted for, depressive symptoms emerge as a stronger within-person temporal predictor of cognitive decline than physical activity. These findings suggest that depression screening may warrant particular attention in dementia prevention initiatives, while highlighting the need for intervention studies to establish causal effects.
Key findings
- Results At the between-person level, cognitive function was negatively associated with depression (beta=-0.203, p < 0.01) and positively with physical activity (beta = 0.135, p < 0.01), while the physical activity-depression association was not significant.
- Within-person cross-lagged analyses revealed that depressive symptoms significantly predicted subsequent cognitive decline (beta=-0.046 to -0.043, p < 0.05), and cognitive function predicted subsequent physical activity engagement (beta = 0.059–0.073, p < 0.05).
- Notably, physical activity did not significantly predict subsequent cognitive function or depression at the within-person level.
- These findings suggest that depression screening may warrant particular attention in dementia prevention initiatives, while highlighting the need for intervention studies to establish causal effects.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 35 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for sample size, effect reported, studied in people and 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 22 of the 62 points we could judge it on, which is 35 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Research Square) |
| 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 | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| 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 | 22 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 22 of the 62 points we could judge it on is 35 out of 100. |
| Total | 35 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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APA 7th
Zhang, J., Yu, C., Bian, D., Han, X., Shi, C., & Li, G. (2026). Dynamic Interrelationships Among Physical Activity, Cognitive Function, and Depression in Older Adults: A Random-Intercept Cross- Lagged Panel Analysis. Research Square. https://doi.org/10.21203/rs.3.rs-10112749/v1
Vancouver
Zhang J, Yu C, Bian D, Han X, Shi C, Li G. Dynamic Interrelationships Among Physical Activity, Cognitive Function, and Depression in Older Adults: A Random-Intercept Cross- Lagged Panel Analysis. Research Square. 2026. doi:10.21203/rs.3.rs-10112749/v1.
BibTeX
@article{zhang2026-126bfc72,
author = {Zhang, J. and Yu, C. and Bian, D. and Han, X. and Shi, C. and Li, G.},
title = {{Dynamic Interrelationships Among Physical Activity, Cognitive Function, and Depression in Older Adults: A Random-Intercept Cross- Lagged Panel Analysis}},
journal = {Research Square},
year = {2026},
doi = {10.21203/rs.3.rs-10112749/v1},
url = {https://doi.org/10.21203/rs.3.rs-10112749/v1}
}