Abstract
OBJECTIVE: This study examines the associations of 24-h activity patterns and chronic disease status with inhibitory control in community-dwelling older adults, and as a secondary analysis further explores whether the association differs according to chronic disease status. METHOD: A cross-sectional design was employed to facilitate sampling, enrolling 121 community-dwelling older adults aged ≥60 years (75 females; 86 with chronic diseases; mean age 71.4 ± 6.5 years). 24-h activity patterns were recorded with accelerometers, and inhibitory control was measured using the Stroop task. Questionnaires provided information on chronic disease status and other covariates. Component data analysis was applied to explore the relationships between daily activity patterns, chronic disease conditions, and inhibitory control. Results were also examined separately for participants with and without chronic diseases, including group comparisons and proportional substitution analyses. RESULTS: After adjusting for potential confounders, 24-h activity patterns were significantly related to inhibitory control (F = 5.18, p = 0.002). Chronic disease status also had a notable main effect (F = 5.95, p = 0.016), with the chronic disease group scoring 0.43-unit lower in inhibitory control than the non-chronic disease group (p = 0.016). In the proportional substitution analysis, shifting 30 min from other activities to moderate-to-vigorous-intensity physical activity (MVPA) resulted in 0.243 increase in inhibitory control (95% CI: 0.02, 0.46). On the other hand, shifting 30 min from MVPA to other activities led to 0.508 decrease in inhibitory control (95% CI: −0.97, −0.04). The interaction effect was not statistically significant. Stratified substitution analyses were treated as exploratory. Although the direction of the associations was similar in both groups, this pattern alone does not support a conclusion that the groups differed. The sensitivity analysis revealed a clear negative relationship between the number of chronic diseases and inhibitory control: each additional chronic disease was linked to an average 0.178-unit decrease in inhibitory control (95% CI: −0.28,−0.07; p = 0.0009), consistent with the main results. CONCLUSION: In older adults' 24-h activity patterns, a greater relative share of MVPA was associated with better inhibitory control, whereas having chronic diseases was independently related to poorer inhibitory control. No significant interaction was found, and the stratified results should be viewed with caution and validated in larger studies with longer follow-up.