{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:03:47Z","timestamp":1790334227917,"version":"4.1.0"},"reference-count":56,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":["82401679"],"award-info":[{"award-number":["82401679"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp; Dementia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>The association between cardiorespiratory fitness (CRF) and cognition may differ across populations, but cross\u2010cultural evidence remains limited. We explored whether estimated CRF (eCRF) shows divergent associations with cognitive trajectories in Chinese and U.S. middle\u2010aged and older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We included 3458 participants from CHARLS and 6905 from HRS. Cognitive trajectories were identified using latent class growth modelling. eCRF was estimated using sex\u2010specific non\u2010exercise algorithms. The unit of eCRF is metabolic equivalents of task (MET). Multinomial logistic regression examined the association between eCRF (per 1\u2010MET increase) and trajectory membership, with the persistently high trajectory as the reference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Three cognitive trajectories\u2014persistently high, moderate, and low\u2014were identified in both cohorts. In CHARLS, higher eCRF was unexpectedly associated with increased odds of the low (odds ratio [OR]\u00a0=\u00a01.28, 95% confidence interval [CI]: 1.16\u20131.43) and moderate (OR\u00a0=\u00a01.10, 95% CI: 1.03\u20131.18) trajectories. In HRS, higher eCRF was associated with lower odds of the moderate trajectory (OR\u00a0=\u00a00.94, 95% CI: 0.90\u20130.98), with no significant association for the low trajectory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>This descriptive observation reveals divergent associations in the eCRF\u2010cognition relationship between Chinese and U.S. adults, but should be interpreted cautiously. The finding persisted across multiple sensitivity analyses. However, given the lack of direct CRF measurement and objective assessment of activity type, we cannot distinguish whether this divergence reflects measurement differences and residual confounding, or true biological heterogeneity. Context\u2010specific validation of eCRF equations and objective activity\u2010specific measures are needed to clarify eCRF's role in cognitive aging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71871","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T03:51:07Z","timestamp":1789703467000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Divergent associations of estimated cardiorespiratory fitness with cognitive trajectories in Chinese and U.S. middle\u2010aged and older adults: A descriptive cross\u2010national comparison from CHARLS and HRS"],"prefix":"10.1002","volume":"22","author":[{"given":"Jiangping","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics West China Hospital, Sichuan University  Chengdu Sichuan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics West China Hospital, Sichuan University  Chengdu Sichuan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linghao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism the Affiliated Hospital of Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingxuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics West China Hospital, Sichuan University  Chengdu Sichuan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0947-1151","authenticated-orcid":false,"given":"Huifang","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics West China Hospital, Sichuan University  Chengdu Sichuan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13809"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000461"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532\u20105415.2003.51153.x"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2468\u20102667(19)30183\u20105"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102024\u2010108257"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0000000000003903"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glt144"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbu167"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3233\/jad\u2010180897"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/trc2.70122"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbad101"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.31284"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2005.06.004"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2012.06.032"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11357\u2010022\u201000718\u2010w"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010025\u201004175\u2010y"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.4069"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xinn.2025.100886"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.5498\/wjp.v16.i2.112235"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2026.121258"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010022\u201003564\u20109"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.2196\/49790"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010025\u201004400\u20108"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10433\u2010016\u20100375\u20102"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys203"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyu067"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010023\u201016864\u20105"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2025.1497292"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2026.108968"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2025.108736"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2026.106275"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067\u2010026\u201007991\u20106"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.71300"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102831"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1159\/000360229"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.2196\/34717"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24356"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1159\/000381535"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11065\u2010017\u20109361\u20105"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2025.106121"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmen.0000211"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1057\/s41599\u2010026\u201007968\u20105"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2026.115665"},{"key":"e_1_2_14_45_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2020.00266"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12576\u2010019\u201000719\u2010z"},{"key":"e_1_2_14_47_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom13111577"},{"key":"e_1_2_14_48_1","doi-asserted-by":"publisher","DOI":"10.15857\/ksep.2026.00157"},{"key":"e_1_2_14_49_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/2737563"},{"key":"e_1_2_14_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanhl.2026.100844"},{"key":"e_1_2_14_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecoenv.2024.116008"},{"key":"e_1_2_14_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuro.2025.103364"},{"key":"e_1_2_14_53_1","doi-asserted-by":"publisher","DOI":"10.1057\/s41599\u2010025\u201006435\u2010x"},{"key":"e_1_2_14_54_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2008.086710"},{"key":"e_1_2_14_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glae116"},{"key":"e_1_2_14_56_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glac240"},{"key":"e_1_2_14_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.14525"}],"container-title":["Alzheimer's &amp; Dementia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alz.71871","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/alz.71871","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alz.71871","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:16:49Z","timestamp":1790331409000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1002\/alz.71871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":56,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/alz.71871"],"URL":"https:\/\/doi.org\/10.1002\/alz.71871","archive":["Portico"],"relation":{},"ISSN":["1552-5260","1552-5279"],"issn-type":[{"value":"1552-5260","type":"print"},{"value":"1552-5279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71871"}}