Research Paper Volume 12, Issue 11 pp 10687—10703

Leisure activities and disability in activities of daily living among the oldest-old Chinese population: evidence from the Chinese Longitudinal Healthy Longevity Study

Zhi-Hao Li1, *, , Qing Chen1, *, , Virginia Byers Kraus2, , Dong Shen1, , Xi-Ru Zhang1, , Pei-Dong Zhang1, , Wen-Fang Zhong1, , Yue-Bin Lv3, , Qing-Mei Huang1, , Wei-Qi Song1, , Dong Wang4, , Xian-Bo Wu1, , Xiao-Ming Shi3, , Chen Mao1, ,

  • 1 Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
  • 2 Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC 27701, USA
  • 3 National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
  • 4 School of Health Services Management, Southern Medical University, Guangzhou, Guangdong, China
* Equal contribution

Received: November 20, 2019       Accepted: April 27, 2020       Published: June 12, 2020
How to Cite

Copyright © 2020 Li et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Introduction: To investigate the independent and joint effects of leisure activities on disability in activities of daily living (ADL) among the oldest-old Chinese population (aged ≥ 80 years).

Results: A total of 3696 participants with ADL disability were identified during the median follow-up period of 3.1 years. Compared to the participants who “never” watched TV or listened to the radio and who “never” kept domestic animals or pets, those who engaged in these activities “almost every day” had a significantly lower ADL disability risk (adjusted hazard ratios were 0.74 and 0.66, respectively; both P < 0.001). Furthermore, participants engaging in multiple leisure activities showed a reduced risk of ADL disability (P for trend < 0.001).

Conclusions: Frequently watching TV or listening to the radio and keeping domestic animals or pets was associated with a lower risk of ADL disability among the oldest-old Chinese population.

Methods: We included 12,331 participants (aged ≥ 80 years) (mean [SD] age: 89.5 [7.0] years) who managed to perform ADL independently at baseline in the Chinese Longitudinal Healthy Longevity Survey 1998-2014 waves. Cox proportional hazards models were used to examine whether leisure activities were associated with ADL disability.


ADL: activities of daily living; BMI: body mass index; CI: confidence interval; CLHLS: Chinese Longitudinal Healthy Longevity Survey; HR: hazard ratio; MMSE: Mini-Mental State Examination; SD: standard deviations.