Background
Physical activity (PA) and sleep reduce the risk of dementia and mortality, but evidence among older stroke survivors in China is limited.
Objective
To investigate the impact of PA on dementia and all-cause mortality risks in this population and analyze its joint effect with sleep.
Methods
Utilizing data from the CLHLS, we analyzed the correlation of PA with dementia and mortality in elderly stroke survivors and explored the mediating role of dementia in the PA–mortality relationship. Joint variables of PA and sleep were constructed to assess their combined effects on dementia and mortality.
Results
Older stroke survivors engaging in regular PA had a 38% reduced risk of dementia (OR=0.62, 95% CI: 0.56-0.69, P<0.001) and a 44% lower risk of mortality (HR=0.56, 95% CI: 0.52-0.59, P<0.001). Additional protective factors against dementia included pet ownership, social activity, and reading, whereas television viewing and radio listening were linked to an increased risk of dementia. Raising domestic animals/pets, participating in outdoor activities, and performing housework were associated with a lower mortality risk (P<0.05). Dementia mediated 5.9% of PA–mortality risk relationship. The joint analysis highlighted that coupling regular PA with sleep exceeding 9 h was associated with a 42% decrease in dementia risk, whereas pairing it with 9 h or less of sleep yielded a 60% decrease in mortality risk.
Conclusion
For elderly stroke survivors, PA confers protective effects against both dementia and all-cause mortality. This association is partially mediated by the reduced risk of dementia. Furthermore, the beneficial impact of regular PA on these outcomes is moderated by sleep duration, underscoring the necessity of a joint consideration of both factors in prognostic assessments.
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