{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:53:40Z","timestamp":1791892420379,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82574160"],"award-info":[{"award-number":["82574160"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008233","name":"School of Medicine, Shanghai Jiao Tong University","doi-asserted-by":"publisher","award":["KJ2\u20100112\u201023\u20100002"],"award-info":[{"award-number":["KJ2\u20100112\u201023\u20100002"]}],"id":[{"id":"10.13039\/501100008233","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Whether cognitive\u2013social engagement can compensate for insufficient structured exercise in cognitive aging remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We harmonized repeated data from four aging cohorts across Asia, North America, and Europe. Structured exercise and cognitive\u2013social engagement were cross\u2010classified at each wave into low\u2013low (LL), high exercise\u2013low engagement (HL), low exercise\u2013high engagement (LH), and high\u2013high (HH). Cohort\u2010specific Cox models and multistate life tables estimated incident cognitive impairment and cognitive impairment\u2010free life expectancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Cognitive impairment\u2010free life expectancy from age 50 was 17.5, 23.2, 20.1, and 24.7 years for the low exercise + low cognitive\u2010social engagement (LL), high exercise + low cognitive\u2010social engagement (HL), low exercise + high cognitive\u2010social engagement (LH), and high exercise + high cognitive\u2010social engagement (HH) groups, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Structured exercise and cognitive\u2013social engagement showed combined, non\u2010interchangeable benefits for cognitive aging. These findings support integrated lifestyle strategies for dementia prevention across diverse aging populations, health systems, and prevention settings worldwide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71854","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:00:16Z","timestamp":1791889216000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Structured exercise, cognitive\u2013social engagement, and cognitive impairment\u2010free life expectancy across four longitudinal aging cohorts"],"prefix":"10.1002","volume":"22","author":[{"given":"Xiangwei","family":"Li","sequence":"first","affiliation":[{"name":"School of Global Health, Chinese Centre for Tropical Diseases Research Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Hainan International Medical Center Shanghai Jiao Tong University School of Medicine  Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"China Academy of Chinese Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyu","family":"Sun","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry Psychology &amp; Neuroscience King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Global Health, Chinese Centre for Tropical Diseases Research Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Hainan International Medical Center Shanghai Jiao Tong University School of Medicine  Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqian","family":"Xu","sequence":"additional","affiliation":[{"name":"School of Global Health, Chinese Centre for Tropical Diseases Research Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Hainan International Medical Center Shanghai Jiao Tong University School of Medicine  Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongyu","family":"Ding","sequence":"additional","affiliation":[{"name":"School of Global Health, Chinese Centre for Tropical Diseases Research Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Hainan International Medical Center Shanghai Jiao Tong University School of Medicine  Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Hainan International Medical Center Shanghai Jiao Tong University School of Medicine  Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianlang","family":"Tong","sequence":"additional","affiliation":[{"name":"Hainan International Medical Center Shanghai Jiao Tong University School of Medicine  Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaojun","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Global Health, Chinese Centre for Tropical Diseases Research Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Hainan International Medical Center Shanghai Jiao Tong University School of Medicine  Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian","family":"Cui","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Center Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"GBD 2019 Dementia Forecasting Collaborators.Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the global burden of disease study 2019.Lancet Public Health2022;7:e105\u201325. doi:10.1016\/S2468\u20102667(21)00249\u20108"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)01296\u20100"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010clinpsy\u2010072720\u2010014213"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tins.2024.04.004"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.4590"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004963.pub3"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022252"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech\u20102019\u2010213029"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","unstructured":"EvansIEM MartyrA CollinsR BrayneC ClareL.Social isolation and cognitive function in later life: a systematic review and meta\u2010analysis.J Alzheimers Dis.2019;70:S119\u201344. doi:10.3233\/JAD\u2010180501","DOI":"10.3233\/JAD-180501"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(12)70191\u20106"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000779"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnss.2023.06.018"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648251316955"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.13793"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjpad.2025.100194"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102021\u2010068390"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys203"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyu067"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys168"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.4082\/kjfm.41.1E"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbr048"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2015.09.002"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwy234"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7501"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.10015"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16\u20102607"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(25)00184\u20109"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.19251\/pwod\/2025.2(1)"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010025\u201003955\u20106"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/15598276251415530"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2021.101551"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010022\u201012567\u20105"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(04)00767\u20107"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666\u20107568(24)00046\u20101"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60461\u20105"}],"container-title":["Alzheimer's &amp; 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