Associations of exercise, nutritional status, and smoking with cognitive decline among older adults in Taiwan: Results of a longitudinal population-based study.

This study aimed to explore the long-term effects of exercise, smoking, and nutritional status on cognitive reserve and changes in cognitive function among Taiwanese adults aged ≥65 years. Data were obtained from the Taiwan Longitudinal Study of Aging, a national representative population-based cohort study. Results showed that the average baseline scores on the Short Portable Mental Status Questionnaire (SPMSQ) and Mini-Nutritional Assessment (MNA) were 9.07 and 26.01, respectively. The proportions of smoking and exercising at baseline were 24.12% and 58.67%, respectively. A linear regression analysis indicated that old adults who were current and consistent exercisers had better subsequent 4-year SPMSQ scores than those who were not exercisers (P < 0.05). The MNA score was positively associated with subsequent 4- and 8-year SPMSQ scores for the 65-74-year-old adults (P <  0.05). The logistic regression analysis showed that current and consistent exercise was negatively associated with subsequent 4-year cognitive decline (P < 0.05). Previous exercise experience was positively associated with subsequent 8-year cognitive decline for the ≥75-year-old adults (P < 0.05). The MNA score was negatively correlated with subsequent 4- and 8-year cognitive decline among the 65-74-year-old adults. Among the adults aged ≥75 years, consistent smoking was positively associated with cognitive decline over 4 years (P < 0.05). Therefore, current and consistent exercise and good nutritional status benefit cognitive function and reserve, and have protective effects on cognitive decline among old adults, whereas discontinued exercise, poor nutrition, and cigarette smoking are likely to raise the risk of cognitive decline.