The association between 'weekend warrior', regular exercise, and cognitive function in elderly individuals with and without depressive symptoms: A cross-sectional analysis from NHANES 2011-2014

Background: While previous studies have suggested that both 'Weekend Warrior' (WW) and Regular Exercise (RE) patterns confer health benefits, the relationship between different types of physical activity (PA) and cognitive function (CF) in elderly individuals with and without depressive symptoms remains unclear. Methods: Our study leveraged the NHANES 2011-2014 dataset, focusing on older adults. We explore the relationship between PA and CF, stratifying by depressive status. Our statistical approach included multivariable regression analysis to identify relationships between PA levels and cognitive outcomes, along with advanced techniques such as smoothed curve fitting and threshold effect analysis to examine potential nonlinear associations and identify optimal PA pattern for cognitive health. Results: Analysis revealed a positive correlation between PA time and CF across all participants (beta-depressive symptoms = 0.03, 95 % CI: 0.01-0.05; beta-non-depressive symptoms = 0.01, 95%CI: 0.00-0.02). When comparing against the inactive, non-depressed participants partaking in WW showed improved cognitive scores (beta-WW = 0.22, 95 % CI: 0.05-0.39), similar to those engaging in RE (beta-RE = 0.15, 95 % CI: 0.09-0.21). However, among the depressed participants, significant cognitive improvements were observed in the RE (beta-RE = 0.15, 95 % CI: 0.04-0.25), with the WW showing less definitive results (beta-WW = 0.22, 95 % CI: -0.02-0.47). Limitation: The cross-sectional nature limits causal inferences. Conclusion: Our findings affirm the potential role of PA in enhancing CF among older subjects without depressive symptoms. However, only RE was associated with improved CF in those with depressive symptoms. These results are critical for crafting personalized PA guidelines to enhance cognitive health in the aging population.