ArticleJMIR public health and surveillance2025
Assessment of Bidirectional and Threshold-Response Associations Between Cognitive Function and Physical Performance: Nationwide Cross-Sectional Study.
Article in JMIR public health and surveillance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Correction (Authors' Contribution): Assessment of Bidirectional and Threshold-Response Associations Between Cognitive Function and Physical Performance: Nationwide Cross-Sectional Study.JMIR public health and surveillance · 2025Article
- Correction: Assessment of Bidirectional and Threshold-Response Associations Between Cognitive Function and Physical Performance: Nationwide Cross-Sectional Study.JMIR public health and surveillance · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The global aging population faces increasing risks of cognitive and physical decline, yet the bidirectional and nonlinear dynamics between these domains remain poorly understood. Objective: This study aims to investigate the bidirectional and nonlinear associations between cognitive function and physical performance in older adults and to identify threshold effects and population subgroups at elevated risk. Methods: This multicenter study of 20,868 older adults in China analyzed the bidirectional asymmetric and threshold-response associations between cognitive and physical function using logistic or linear regression and restricted cubic spline, with subgroup and interaction analyses. Results: The study revealed an asymmetrical bidirectional relationship between cognitive function and physical performance, with cognitive impairment having a stronger association with physical function (Short Physical Performance Battery [SPPB], odds ratio [OR] 2.45, P<.05 vs 1.16,P=.051; gait speed: OR 2.36,P<.05 vs 1.89, P<.050). Restricted cubic spline analysis identified 3 key inflection points at Mini-Mental State Examination (MMSE) scores of 19, 24, and 29. When MMSE <24, cognitive improvement significantly protected physical performance (SPPB: OR 0.86, 95% CI 0.84-0.87; gait speed: OR 0.84, 95% CI 0.82-0.85). The critical intervention window was between MMSE 19-24 (SPPB, OR 0.66, 95% CI 0.57-0.77). At MMSE ≥24, balance protection remained significant (OR 0.69, 95% CI 0.68-0.70), but overall physical performance showed diminished effects, with SPPB demonstrating a weaker, marginal association (P=.051). A paradoxical reversal effect was observed for gait speed (OR 1.05, 95% CI 1.04-1.07). High-income (OR 5.24, 95% CI 3.91-7.02) and high-education subgroups (OR 3.98, 95% CI 1.48-10.70) exhibited heightened vulnerability. Conclusions: This study demonstrates a bidirectional, asymmetric relationship between cognitive function and physical performance, identifies a nonlinear threshold effect, and highlights population heterogeneity.
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Registered trials
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