Cardiovascular disease (CVD) is a global health problem, and it is not known whether socioeconomic status (SES) and healthy lifestyle (HL) have an impact on CVD onset.

To understand the relationship between SES, HL and CVD, and to provide a basis for the prevention and control of CVD in the population.

A multi-stage cluster random sampling method was employed to select 9 280 residents aged 18 and above from 12 counties and districts in Guizhou Province as the baseline sample in 2010. In 2016-2020 follow the cohort, face to face interview by unified training and qualified personnel, including basic situation, lifestyle (smoking, drinking, vegetables and vegetables, etc.), previous disease history, according to the survey was divided into CVD group (123) and non-CVD group (4 025) ; we used COX proportional hazard regression models were used to analyze the effect of SES and HL on CVD incidence. Additionally, an accelerated failure time model was utilized to assess the impact of different SES and HL at the time of CVD onset.

After excluding baseline CVD patients, lost-to-follow-up and missing information, the valid sample size included in the analysis was 4 148, CVD onset 123, and the incidence density was 4.13 / 1 000 person-years. The results of multivariate analysis showed that compared with low SES (≤7 points), the risk of CVD in high SES (>7 points) decreased by 40.60% (HR=0.594, 95%CI=0.402-0.878). Compared with 6 HL populations, the population with 8 and 9 HL decreased by 44.40% (HR=0.556, 95%CI=0.320-0.968) and 49.20% (HR=0.508, 95%CI=0.284-0.912). Compared with the population in the low SES group and with HL ≤ 6 conditions, there was no statistically significant risk of CVD incidence in the population in the low SES group with HL of 7, 8, or ≥ 9 conditions (P>0.05) ; those with high SES (>7 points) and HL of 8 or 9 decreased CVD risk by 61.80% (HR=0.382, 95%CI=0.163-0.894) and 70.20% (HR=0.298, 95%CI=0.119-0.748, respectively), showing a decreasing trend. The results of the accelerated failure time model showed that those with high SES (>7 points), those with 8 species and 9 HL were delayed by 1.148 years (95%CI=0.049-2.287) and 1.407 (95%CI=0.227-2.588) .

Different SES and HL are negatively associated with CVD onset; in high SES population, the duration of CVD onset increases with increasing HL species. Low SES population is the key population of CVD prevention and control in Guizhou Province, so measures should be taken to improve their health literacy, and the health education and health promotion of CVD should be carried out accordingly.

With the aggravation of population aging, the prevalence of cognitive disfunction is increasing year by year. Cardiovascular metabolic diseases, as an important influencing factor, are closely related to cognitive function. At present, there are few studies on the association between duration of cardiovascular metabolic diseases and mild cognitive impairment (MCI), which lack comprehensive consideration of lifestyle factors and large-scale surveys of elderly people in Chinese communities. The comprehensiveness and reliability of the research need to be further verified.

To explore the association between the duration of cardiovascular metabolic diseases and MCI in the elderly, and to evaluate the potential role of lifestyle factors in MCI, so as to provide scientific basis for the prevention and intervention of MCI.

The data from Hubei Memory and Aging Cohort Study (HMACS), a cluster sampling method was used to select the elderly aged 65 and over in 3 communities and 48 villages in Dawu County, Wuhan City, Hubei Province from 2018 to 2023. The standardized scale was used to evaluate the cognitive function. Six factors including smoking, drinking, eating habits, physical exercise, intellectual activity and body mass index (BMI) were used for lifestyle assessment to analyze the prevalence of MCI and its influencing factors. Multivariate Logistic regression analysis was used to analyze the correlation between the duration of cardiovascular metabolic diseases and MCI, the effect of lifestyle on the correlation between the duration of disease and MCI .

A total of 8 635 subjects were included, and the prevalence of MCI was 26.9%. Multivariate Logistic regression analysis showed that among hypertension (OR=1.263, 95%CI=1.093-1.458, P=0.002), diabetes (OR=1.907, 95%CI=1.476-2.463, P<0.001), coronary heart disease (OR=1.550, 95%CI=1.173-2.047, P=0.002), cerebrovascular disease (OR=2.129, 95%CI=1.627-2.786, P<0.001) the duration of illness was influencing factors for MCI in the elderly. Duration of hypertension >10 years (General: OR=1.367, 95%CI=1.086-1.720, P=0.008; Unhealthy: OR=2.377, 95%CI=1.560-3.623, P<0.001), diabetes duration >10 years (General: OR=1.688, 95%CI=1.134-2.514, P=0.010; Unhealthy: OR=2.083, 95%CI=1.035-4.194, P=0.040) duration of coronary heart disease≤10 years (General: OR=1.495, 95%CI=1.030-2.169, P=0.034; Unhealthy: OR=2.062, 95%CI=1.155-3.682, P=0.014), life style was the influencing factor of MCI. In patients with diabetes duration ≤10 years, general lifestyle (OR=1.611, 95%CI=1.065-2.437, P=0.024) was the influencing factor for MCI. Duration of coronary heart disease >10 years (OR=2.859, 95%CI=1.118-7.307, P=0.028), duration of cerebrovascular disease ≤10 years (OR=1.778, 95%CI=1.079-2.930, P=0.024), duration of cerebrovascular disease >10 years (OR=2.589, 95%CI=1.056-6.345, P=0.038), unhealthy lifestyle was the influencing factor for MCI.

The longer the duration of cardiovascular disease in the elderly, the higher the risk of MCI and the unhealthy lifestyle exacerbates this risk. It is recommended to reduce the incidence of MCI early by improving lifestyle and effectively managing chronic cardiovascular disease.

Lifestyle Medicine, which emerged in the 1980s, is an interdisciplinary discipline involving various fields such as medicine, nutrition, exercise science, epidemiology, psychology, etc. It serves as a crucial bridge between public health promotion and clinical treatment, and plays a significant role in preventing, treating, and rehabilitating various diseases. This paper presents a comprehensive review of the definition, connotation, origin, development, and evaluation tools for assessing the effectiveness of Lifestyle Medicine. The findings reveal that Lifestyle Medicine aligns remarkably well with the principle of traditional Chinese medicine (TCM) regarding disease prevention and treatment. Despite notable research advancements in chronic disease management in China, the field of lifestyle medicine is still at an early stage of development. However, there remains a lack of specific, quantified, and standardized guidelines for implementing lifestyle interventions as well as clinical protocols and evaluation systems. The localization of Lifestyle Medicine in China still needs to consider local conditions, while increasing national policy support to establish a national data monitoring system and decision support system. Emphasizing health equity and optimising resource allocation across different regions are also essential aspects to be considered. Furthermore, integrating the advantages of TCM, including of its characteristic therapies, simplicity and cost-effectiveness, will promote the application and dissemination of Lifestyle Medicine for preventing and managing chronic diseases, thereby enhancing overall population health.

The incidence of stroke is increasing year by year, and behavioral control is a direct and effective intervention means to prevent stroke. Proactive health medical model improves the initiative and accessibility of chronic disease prevention and control, while the concept of proactive health behavior in stroke patients remains to be explored.

To explore the level of proactive health cognition and behavior in stroke patients, and construct the conceptual framework of proactive health behavior in stroke patients.

From August to October 2023, a total of 26 inpatients with stroke in the Department of Neurology of the Second Affiliated Hospital of Zhengzhou University were selected as the study objects by means of purposive sampling method. Following the grounded theory methodology of interpretivism, 26 patients with stroke were interviewed by semi-structured method, and the data were analyzed by coding and persistence comparison methods.

The 10 main categories and 4 core categories of the theme "proactive health behavior of stroke patients" were separated out, including 3 intrinsic behaviors of "health motivation, health responsibility and mental health", 1 habitual behavior of "lifestyle management", 3 social behaviors of "active compliance with doctors, social relations and information seeking", and 3 intervention conditions of "consciousness awakenings, self-control and resource availability". And establish the conceptual framework.

The conceptual framework of proactive health behavior in stroke patients includes intrinsic behavior, habitual behavior, social behavior and intervention conditions. This framework may be helpful for the further development of assessment tools and the formulation of personalized intervention measures, and has guiding significance for promoting the research and practice of proactive health behavior in stroke patients.

Craniopharyngioma-related hypothalamic obesity (CHO) has become a key issue in postoperative management of craniopharyngioma. Modified low calorie diet and exercise interventions have been found by some studies to be effective in relieving CHO, and suggested to be used as non-pharmacological treatments for weight management of craniopharyngioma patients. However, there are few relevant studies in China. We reviewed the latest developments in prevalence, hazards and risk factors as well as diet and exercise interventions towards CHO, in order to improve the outcomes and quality of life of CHO patients. In addition, we put forward recommendations on comprehensively improving the quality of life of CHO patients, such as making efforts to value CHO clinically, carrying out prospective studies on weight control in CHO, and developing rigorous diet and exercise interventions.

At present, there has been a dramatic increase in the number of obese children and adolescents globally, among which the prevalence of obesity in children aged 5 to 19 years has increased by about 8 times, and the prevalence of obesity in children aged 2 to 4 years has increased by about 1 times. Exercise intervention has an important effect on improving obesity and enhancing cardiorespiratory fitness. However, studies on the effects of combined motion intervention on obese female adolescents aged 14-16 years have not been addressed.

To investigate the effects of 12-week combined motion intervention on body composition, cardiovascular risk factors and cardiopulmonary fitness in obese female adolescents.

From May to July 2022, 48 obese female adolescents aged 14 to 16 years old in Qufu City, Shandong Province were selected as research objects, numbered and divided into the experimental group (n=24) and control group (n=24) using random numbers. The experimental group finally included 20 female adolescents based on the inclusion and exclusion criteria, and the whole intervention lasted for 12 weeks, including rope skipping intervention and taekwondo intervention; while the control group did not perform any exercise intervention and other dietary or pharmacological interventions throughout the 12 weeks. The indicators such as height, body mass, body fat rate (BFR) , waist circumference, BMI, blood pressure (BP) , fasting plasma glucose (FPG) , insulin, insulin resistance index (HOMA-IR) and maximal oxygen uptake (VO_2max) were detected before and after the 12-week combined motion intervention and compared between the two groups, as well as before and after the intervention. Pearson correlation analysis was used to explore the correlation of BFR and waist circumference with VO_2max in obese female adolescents.

Before the intervention, there was no significant difference in age, height, body mass, BFR, waist circumference, BMI, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , pulse pressure difference, FPG, insulin, HOMA-IR, maximal number of completions (Laps) , maximal aerobic speed (MAS) , and VO_2max between the two groups (P>0.05) . After 12-week combined motion intervention, BFR, waist circumference, SBP, DBP, FPG, insulin and HOMA-IR in the experimental group were lower than the control group, while Laps, MAS, VO_2max was significantly higher than the control group (P<0.05) . Compared with pre-intervention, the BFR, waist circumference, SBP, DBP, FPG, insulin and HOMA-IR were decreased and Laps, MAS, VO_2max were increased after 12-week combined motion intervention (P<0.05) . The results of correlation analysis showed that body fat percentage and circumference were negatively correlated with VO_2max in obese female adolescents (r=-0.55, P<0.001; r=-0.41, P<0.001) .

The 12-week combined motion intervention can improve body composition and cardiovascular risk factors in obese female adolescents, and also enhance cardiopulmonary fitness by increasing VO_2max.

Patients with type 2 diabetes usually lack sufficient awareness of safe exercise and have poor exercise compliance, which requires the management of exercise interventions by professionals to improve the health status of patients with type 2 diabetes. A strategy worth considering is the management of exercise interventions for patients by community health workers. Currently, there is a lack of research on the management of exercise interventions, and studies on the health management of patients with type 2 diabetes usually only mention exercise without specific exercise management measures. Additionally, there is a lack of quantitative systematic reviews.

To systematically review the health effects of exercise interventions based on community health workers' management for patients with type 2 diabetes and specific exercise intervention programs.

Eight Chinese and English databases, including PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang Data, VIP and CBM were searched by computer from inception to October 17, 2022, to screen randomized controlled trials on the effects of exercise interventions based on community health workers' management for patients with type 2 diabetes, in which the intervention group adopted an exercise intervention program based on community health workers' management and the control group adopted conventional care. Literature screening, quality assessment, and data extraction were performed independently by 2 investigators. Meta-analysis was performed using RevMan 5.4 and Stata 15.1 software. Sensitivity and subgroup analyses were carried out to find sources of heterogeneity. Pre-identified subgroups were intervention duration (3 months; 6 months; >6 months), frequency of exercise (3 times/week; >3 times/week), and duration of the single exercise session (≤30 min/session; >30 min/session) .

A total of 1 079 subjects from 11 articles were finally included in this review, of which 550 were in the intervention group and 529 in the control group. The results of the Meta-analysis revealed that the exercise interventions based on community health workers' management were more effective than the control groups in reducing glycated hemoglobin (MD=-1.07, 95%CI=-1.31 to -0.83, P<0.000 01), fasting blood glucose (MD=-1.26, 95%CI=-1.57 to -0.96, P<0.000 01), 2-hour plasma glucose (MD=-1.47, 95%CI=-1.90 to -1.04, P<0.000 01), total cholesterol (MD=-1.02, 95%CI=-1.52 to -0.51, P<0.000 1), low-density lipoprotein (MD=-0.62, 95%CI=-0.87 to -0.37, and P<0.000 01) and triglyceride levels (MD=-0.71, 95%CI=-1.13 to -0.28, P=0.001), whereas there was no significant difference in the improvement of high-density lipoprotein (MD=0.09, 95%CI=-0.02 to 0.21, P=0.11). Subgroup analysis showed more significant improvements in total cholesterol with exercise frequency of more than three times/week compared with three times/week (P=0.02) ; improvement in 2-hour plasma glucose was more significant with >30 min/session compared with ≤30 min/session (P=0.001) ; single exercise session of three months duration showed more significant improvements in glycated hemoglobin (P<0.000 01) and triglycerides (P=0.008) compared with duration of six months and longer. Egger's test indicated that glycated hemoglobin (P=0.34), and fasting blood glucose (P=0.281) did not show any significant publication bias. The quality of evidence evaluation demonstrated that glycated hemoglobin and fasting blood glucose were low-level evidence, and 2-hour plasma glucose and lipid-related outcomes were very low-level evidence.

Exercise interventions based on community health workers' management could significantly improve blood glucose and lipid levels in patients with type 2 diabetes. Community health workers are recommended to develop an exercise program based on aerobic exercise intervention of >30 min/session, >3 sessions/week, and duration of ≥3 months in future exercise intervention management for type 2 diabetes. If the patients with type 2 diabetes mellitus have concurrent dyslipidemia, it is recommended that the duration of the exercise intervention should ideally last for more than 6 months.

Hypertension and diabetes are two major chronic diseases affecting population health, and need to be controlled through chronic diseases follow-up. However, there is currently insufficient understanding of the impact of different chronic diseases follow-up forms and contents on disease control and healthy behaviors of patients.

To explore the impact of the chronic diseases follow-up on health behaviors and blood pressure/glucose control of patients with hypertension and diabetes in the context of treatment-prevention integration.

Yiyang County in Henan Province, Xianfeng County in Hubei Province and Yangqu County in Shanxi Province were selected as study sites to collect data from the basic public health information system from 2017-01-01 to 2022-06-30. Patient survey was conducted in July 2022 to collect information on basic public health follow-up receiving, health behaviors and disease control of patients. Finally, 102 769 patients with hypertension and 26 586 patients with diabetes were obtained from the basic public health information system, the data of 1 172 patients with hypertension and 456 patients with diabetes were obtained through patient surveys. Multivariate Logistic regression was used to analyze the effects of the standard-reaching frequency of follow-up, follow-up forms and contents on health behaviors and disease control of patients.

In 2021, the standard-reaching rates of follow-up frequency of patients with hypertension and diabetes were 90.83% (67 709/74 545) and 83.35% (13 390/16 065) , with frequency≥4 times/year as the standard. The follow-up forms included household follow-up〔25.74% (408/1 585) 〕, follow-up at institutional visits〔58.80% (932/1 585) 〕, telephone or network follow-up〔15.46% (245/1 585) 〕. The follow-up contents included blood pressure and blood glucose measurements〔91.15% (1 484/1 628) 〕, lifestyle guidance〔74.14% (1 207/1 628) 〕, disease inquiry〔70.02% (1 140/1 628) 〕, and drug use understanding〔69.29% (1 128/1 628) 〕. Multivariate Logistic regression analysis showed that patients with higher standard-reaching rates of follow-up frequency had higher rates of blood pressure control (OR=1.09, P<0.05) and glucose control (OR=1.31, P<0.05) , lower rates of smoking and drinking (OR=0.83, P<0.05) , and higher rates of regular exercise habits (OR=1.30, P<0.05) . The proportions of smoking and alcohol cessation (OR=2.38, P<0.05) and regular exercise habits (OR=1.62, P<0.05) were higher in the patients followed up at institutional visits than those followed up by telephone or network. The proportions of smoking and alcohol cessation (OR=2.33, P<0.05) and regular exercise habits (OR=2.54, P<0.05) of patients received household follow up were higher than those followed up by telephone or network. Patients who received lifestyle guidance, disease inquiry, and drug use understanding had higher rates of blood pressure control (OR=1.61, 1.34, and 1.62, respectively; P<0.05) , smoking and alcohol cessation (OR=3.59, 3.54, and 2.91, respectively; P<0.05) and regular exercise habits (OR=3.16, 2.15, 2.45, respectively; P<0.05) .

Receiving chronic diseases follow-up at least 4 times per year, with follow-up at institutional visits and household follow-up as the forms, provided with blood pressure and blood glucose measurements, lifestyle guidance, disease inquiry and drug use understanding as the contents in patients were positive correlated with blood pressure/glucose control, smoking and alcohol cessation, and regular exercise habits.

The prevention and delay of disability is important for promoting healthy aging. Exercise intervention is an efficient strategy for disability prevention. Besides, exercise intervention presents significant therapeutic advantages and broad application prospects due to low cost, low implementation difficulty, high acceptance and wide application scenarios. Therefore, Nursing Group of Chinese Society of Geriatrics, Committee on Geriatric Nursing of Chinese Association of Geriatric Research, China Gerontological Nursing Alliance, National Center of Gerontology, Institute of Geriatric Medicine of Chinese Academy of Medical Sciences jointly developed and published Clinical Practice Guidelines for Exercise Interventions for the Prevention of Disability in Older Adults (2023). According to the methodologies specified in WHO Handbook for Guideline Development, the guidelines finally involve 32 recommendations and 18 clinical issues containing exercise principles, effectiveness and plans of different types of exercise, facilitators and barriers during exercise, aiming to provide a reference for the development and implementation of exercise programs for older adults at risk of disability and standardize clinical practice, thus promoting the gateway to improving physical function of the older adults, reducing the prevalence of disability, improving quality of life, contributing to healthy aging.

Lifestyle factors are important modifiable influencing factors for cognitive decline and dementia. Understanding the status and influencing factors of community-dwelling middle-aged and elderly adults adhering to the lifestyles conducive to dementia risk reduction will be a basis for medical workers to formulate individualized interventions for primary prevention of dementia, yet there are still few related studies.

To understand the status and influencing factors of dementia risk reduction lifestyle in community-dwelling middle-aged and elderly adults.

Five hundred and six middle-aged and elderly adults (aged 45 years and older) who had received free health check-ups in a community health center were selected from five communities in Chongqing's Shapingba District by convenience sampling from January to October 2021. The self-designed general information questionnaire and the Dementia Risk Reduction Lifestyle Scale (DRRLS) were used to investigate. The level of DRRLS score in the participants was compare by sociodemographic characteristics. Ordinal and multinomial Logistic regression analysis was performed to identify the influencing factors of the levels of DRRLS scores.

The average score of DRRLS was (88.00±13.27). The median scores of items in mental activity and brain-benefiting exercise were at a low level (≤2.00). The level of DRRLS score in the participants varied significantly by gender, age, personal monthly income and experience of receiving dementia-related health education (P<0.05). Ordinal and multinomial Logistic regression revealed that gender, educational level, personal monthly income and experience of receiving dementia-related health education were important influencing factors of the level of DRRLS score (P<0.05) .

In general, the lifestyles for dementia risk reduction were assessed at a moderate level in the community-dwelling middle-aged and elderly adults. In the primary prevention of dementia, the effects of mental activity and brain-benefiting exercise should be emphasized. Moreover, priority in community health management should be given to men, those with a low educational level or no previous experience of receiving dementia-related health education, and relevant health education and preventive interventions should be strengthened for them. All these efforts will urge these adults to adopt a lifestyle for dementia risk reduction and brain health promotion.

The incidence of dementia is gradually increasing in China. Lifestyle is an important modifiable factor for dementia, and the health belief model can be widely used to explain and predict health-related behaviors.

To analyze the impact of dementia prevention beliefs on health promoting lifestyle in Chinese adults, providing a scientific basis for the development of targeted dementia prevention regimens based on the health belief model.

An online survey was used for collecting data including sociodemographics, dementia-related knowledge and prevention beliefs as well as health promoting lifestyle level of 1 202 Chinese adults using a self-developed electronic questionnaire〔consisting of general information questionnaire, dementia prevention knowledge questionnaire (DPKQ), Chinese version of the Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR) scale, and Chinese version of the revised Health Promoting Lifestyle ProfileⅡ (HPLP-Ⅱ R) 〕from February to March 2020. Multiple linear regression was used to analyze the effect of dementia prevention beliefs on health-promoting lifestyle.

A total of 1 201 cases returned responsive questionnaires, with a response rate of 99.92%. The average score of DPKQ of the respondents was (7.46±2.85), and the rate of correctly answering the questions in DPKQ was 67.82%. The average total score and average item score of the MCLHB-DRR in the respondents were (92.67±12.68), and (3.43±0.47), respectively. The average total score of HPLP-Ⅱ R was (100.00±15.81). The HPLP-Ⅱ R scores were affected by five domain scores of the Chinese version of MCLHB-DRR (perceived susceptibility, perceived benefits, perceived barriers, self-efficacy and general health motivation), the total score of DPKQ, living area (rural or urban), education level and the history of contacting with dementia patients.

The health promoting lifestyle of adults is partially affected by partial dimensions of dementia prevention beliefs and some sociodemographic characteristics. Therefore, health care workers can provide preventive interventions for adults to prevent dementia based on the relationship between the health belief model and health-related behaviors.

Exercise is one of inexpensive and effective interventions for the prevention and treatment of postmenopausal osteoporosis, but relevant pieces of evidence are wide-ranging and fragmented, and there is no standardized and comprehensive exercise guidance program on clinic.

To screen and assess the evidence of exercise interventions for postmenopausal osteoporosis, then summarize the best pieces.

We systematically searched clinical practice guidelines, clinical decisions, evidence summaries, expert consensuses and systematic reviews regarding exercise interventions for postmenopausal osteoporosis in databases of BMJ Best Practice, Up To Date, DynaMed, National Institute for Health and Care Excellence, Guidelines International Network, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, webs of Registered Nurses' Association of Ontario, International Osteoporosis Foundation, Royal Osteoporosis Society, National Osteoporosis Foundation, Royal Australian College of General Practitioners, American College of Obstetricians and Gynecologists, Society of Obstetrics and Gynaecologists of Canada, Medlive, JBI, Cochrane Library, CINAHL, Web of Science, PubMed, Embase, CNKI and SinoMed from inception to January 2022. All relevant evidence was summarized and extracted according to the theme. Appraisal of Guidelines for Research and Evaluation (AGREEⅡ) was used to evaluate the quality of the guidelines, Critical Appraisal for Summaries of Evidence (CASE) was used to evaluate the quality of clinical decisions, the authenticity assessment tool of the expert consensus of the JBI Evidence-Based Health Care Center in Australia (2016 edition) was used to evaluate the quality of expert consensuses, the Australian JBI Evidence-based Health Care Centre System Evaluation Methodology Quality Evaluation Tool (2016 edition) was used to evaluate the quality of the systematic reviews.

A total of 18 studies were included, including seven guidelines, two clinical decisions, four expert consensuses and five systematic reviews. Twenty-two pieces of evidence were extracted, involving five aspects: pre-exercise assessment, exercise type, exercise intensity and time, health education and precautions.

This paper extracts the best evidence of exercise intervention for postmenopausal osteoporosis patients from five aspects: pre-exercise assessment, exercise type, exercise intensity and time, health education and precautions. To reduce the risks of falls and fractures and improve quality of life in postmenopausal women with osteoporosis, it is suggested to provide these women with rational exercise guidance developed based on the best evidence.

Maintaining brain health is an advanced goal of healthy ageing. As an important intervention to promote brain health and reduce the risk of cognitive impairment, physical activity is highly recommended in the WHO Guidelines on Risk Reduction of Cognitive Decline and Dementia. However, due to the lack of specific guidance on the types of exercise, amount of exercise and intervention methods, it is difficult to carry out physical activity in the community.

To construct a community-based physical activity intervention program to promote brain health in community-dwelling Chinese residents.

A draft of Community-based Physical Activity Intervention Program Promoting Brain Health (CPAIPPBH) was developed in December 2021 based on the evidence extracted from studies searched systematically after being screened and assessed in terms of quality by two researchers independently, and review results of our research group. Then from February to March 2022, the draft was revised in accordance with the results of a two-round email-based Delphi survey with 13 experts, and response rate, authority coefficient, Kendall's W, weight of each indicator, and the logical consistency of indicators at all levels were calculated, and finally the formal version was developed.

Altogether, 26 out of the 8 943 searched studies were enrolled, from which 27 pieces of evidence were summarized, involving target group and principles of physical activity, type of physical activity, intensity and time of physical activity, effect and relevant evaluation of physical activity, and considerations for physical activity. The draft CPAIPPBH consisted of 6 primary indicators and 32 secondary indicators. The response rate, authority coefficient, and Kendall's W were 100.0%, 0.940, and 0.257 (χ²=123.386, P<0.001), respectively, for the first round of survey, and were 100.0%, 0.925, and 0.275 (χ²=139.548, P<0.001), respectively, for the second round of survey. The final program includes 7 primary indicators (including target group and principles of physical activity, pre-intervention assessment, form of intervention, type of physical activity, intensity and time of physical activity, effect and relevant evaluation of physical activity, and considerations for physical activity, with corresponding weights of 0.213, 0.213, 0.213, 0.066, 0.116, 0.116, 0.066, respectively) and 33 secondary indicators. The consistency ratios of primary and secondary indicators were all <0.100 0.

The CPAIPPBH developed by us has proven to be scientific and practical, which could be used to guide the management of community-based physical activity interventions for brain health by community medical workers.

Exploring the factors influencing healthy lifestyle in adolescents is beneficial to promoting the physical and mental health of adolescents, which is an important initiative to promote the achievement of the goals of Healthy China. Moreover, it is also an important means to achieve the goals of health poverty alleviation and targeted poverty alleviation projects in both left-behind and non-left-behind rural adolescents.

To investigate the longitudinal effect of cumulative ecological risk on healthy lifestyle and the mediating effect of future time perspective between them in rural left-behind and non-left-behind adolescents.

Rural left-behind and non-left-behind adolescents from 24 classes in 12 schools in Shijiazhuang, Hebei Province were selected from October 2020 to October 2021. Three surveys (the first, second and third were on cumulative ecological risk, future time perspective and healthy lifestyle, respectively) were conducted with them, and had 1 135, 1 102 and 1 053 responders, respectively. Person correlation analysis was used to analyze the correlation between cumulative ecological risk, future time perspective and healthy lifestyle. Structural equation model was used for mediation analysis, and Bootstrap sampling method was used to further assess the mediating effect of future time perspective.

Finally, 1 053 cases who effectively responded to each of the three surveys were included for analysis, including 335 left-behind adolescents (31.81%) and 718 non-left-behind adolescents (68.19%) . The scores of annual cumulative ecological risk (October 2020) , future time perspective (April 2021) and healthy lifestyle (October 2021) were (2.78±1.45) , (53.40±13.80) and (150.72±24.67) , respectively for left-behind responders, and were (2.34±1.24) , (59.21±8.46) and (159.07±14.43) , respectively for non-left-behind responders. Correlation analysis showed that cumulative ecological risk was negatively correlated with both future time perspective and healthy lifestyle (P<0.05) , and future time perspective was negatively correlated with healthy lifestyle (P<0.05) . Forced regression indicated that the healthy lifestyle was inversely and longitudinally influenced by cumulative ecological risk in rural left-behind adolescents (β=-0.31, P<0.01) , showing a trend of sharp and positively accelerated decline. The healthy lifestyle was also inversely and longitudinally influenced by cumulative ecological risk in non-left-behind adolescents (β=-0.22, P<0.01) , demonstrating a relatively liner trend of mild decline. Mediating analysis using Bootstrap sampling revealed that future time perspective played a mediating role in the longitudinal effect produced by cumulative ecological risk on the healthy lifestyle in both rural left-behind and non-left-behind adolescents (P<0.01) .

The cumulative ecological risk may be a longitudinal predictor of the healthy lifestyle in left-behind and non-left-behind adolescents, and its predictive value was higher in the latter. Future time perspective was a mediator in the relationship between cumulative ecological risk and healthy lifestyle in both left-behind and non-left-behind adolescents.

Lifestyle factors are important modifiable risk factors for cognitive decline and dementia. The lifestyle intervention based on scientific assessment will be an important strategy and an orientation towards the implementation of primary prevention of dementia. So far, there is no special instrument to evaluate whether a lifestyle can help to reduce the risk of dementia in community-living residents.

To develop the Dementia Risk Reduction Lifestyle Scale (DRRLS) and test its reliability and validity, providing an instrument for scientifically evaluating whether a lifestyle is conducive to reducing the risk of dementia in community-living Chinese residents.

The item pool of the DRRLS was created based on the review of related theories of health promotion and literature analysis, then was used to form the initial version of the scale after the revision in accordance with the results of expert consultations and group discussion. After this, the initial version of the scale was pretested in a convenience sample of 30 middle-aged and elderly people in the community in January 2021, and was developed to be a revised version after revising items according to the pretest results. Then from January to October, 2021, the revised scale was tested in a large convenience sample of 506 community-dwelling middle-aged and elderly individuals. After screening items using item analysis of the test results of all 506 cases, exploratory factor analysis and confirmatory factor analysis were carried out with the test results of two randomly subdivided subsamples of the sample, subsample 1 (n=253) and subsample 2 (n=253) , respectively. Finally, the test results of the total sample were used for examining internal consistency and test-retest reliability, and the formal scale was formed eventually.

The formal Dementia Risk Reduction Lifestyle Scale consists of 32 items. Eight common factors were extracted by exploratory factor analysis (Health responsibility, Brain strengthening exercise, Brain healthy diet, mental activity, smoking control behavior, interpersonal relationship, stress management, spiritual growth) , explaining 60.189% variance of the total. Confirmatory factor analysis showed that the goodness-of-fit indices of the formal scale were acceptable: χ²/df=1.657, RMSEA=0.051, GFI=0.852, AGFI=0.819, NFI=0.743, TLI=0.858, IFI=0.880 and CFI=0.876. The content validity index, Cronbach's α, split-half reliability (odd-even) , and test-retest reliability of the formal scale were 0.943, 0.862, 0.909, and 0.864, respectively.

Our scale has been tested with good reliability and validity, which could be used as a suitable instrument for evaluating whether a lifestyle helps to reduce the risk of dementia in middle-aged and elderly people in the community.