ArticleBrain and behavior2026
The Chain Mediating Effect of Instrumental Activities of Daily Living and Regular Exercise in the Relationship Between Physical Performance and Cognitive Function Among Older Adults Comorbid With Diabetes Mellitus and Hypertension.
Article in Brain and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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5 authors.
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Abstract
purposeTo develop a chain mediation model to elucidate the relationship among physical performance, instrumental activities of daily living (IADL), regular exercise, and cognitive function among older adults who are comorbid with diabetes mellitus and hypertension (OA-DM&HTN).
methodsA total of 656 participants were investigated with the Mini-Mental State Examination, the Short Physical Performance Battery, the Instrumental Activities of Daily Living, and a questionnaire on regular exercise frequency between January and September 2022. Sequential multiple mediation models were conducted to analyze the data.
resultsThe average age of the participants was 73.47 ± 7.40 years, and 49.24% (n = 323) of participants were female. The average cognitive function score was 22.36 ± 6.14, and 32.62% (n = 214) of participants exhibited cognitive impairment. Cognitive performance exhibited significant associations with demographic factors, including gender, age, marriage status, educational background, and income level (p < 0.05). Chain mediation analysis indicated that physical performance directly predicted cognitive function (β = 0.525, 95% CI: 0.000-1.050); physical performance had indirect effects mediated by IADL (β = 0.917, 95% CI: 0.635-1.230) and regular exercise (β = 0.076, 95% CI: 0.003-0.180). A significant chain-mediating effect involving both IADL and regular exercise was also observed on the relationship between physical performance and cognitive function (β = 0.034, 95% CI: 0.002-0.071).
conclusionPhysical performance is a significant predictor of cognitive function, and it can also affect cognitive function through the independent or chain-mediating effects of IADL and regular exercise among OA-DM&HTN. Therefore, to delay cognitive decline among OA-DM&HTN, it is essential to provide tailored functional training, encourage improvement in IADL, and promote regular exercise among OA-DM&HTN.
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