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Objectives: To explore the association between drinking water sources and cognitive functioning among older adults residing in rural China. Methods: Data were extracted from the 2008–2018 Chinese Longitudinal Healthy Longevity Survey. Drinking water sources were categorized according to whether purification measures were employed. The Chinese version of the Mini‐Mental State Examination was used for cognitive functioning assessment, and the score of <24 was considered as having cognitive dysfunction. Cox regression analyses were conducted to derive hazard ratios (HRs) and 95% confidence intervals (CIs) for the effects of various drinking water sources, changes in such sources, and its interaction with exercise on cognition dysfunction. Results: We included 2304 respondents aged 79.67 ± 10.02 years; of them, 1084 (44.49%) were men. Our adjusted model revealed that respondents consistently drinking tap water were 21% less likely to experience cognitive dysfunction compared with those drinking untreated water (HR = 0.79, 95% CI: 0.70–0.90). Respondents transitioning from natural to tap water showed were 33% less likely to experience cognitive dysfunction (HR = 0.67, 95% CI: 0.58–0.78). Moreover, the HR (95% CI) for the interaction between drinking tap water and exercising was 0.86 (0.75–1.00) when compared with that between drinking untreated water and not exercising. All results adjusted for age, occupation, exercise, and body mass index. Conclusions: Prolonged tap water consumption and switching from untreated water to tap water were associated with a decreased risk of cognitive dysfunction in older individuals. Additionally, exercising and drinking tap water was synergistically associated with the low incidence of cognitive dysfunction. These findings demonstrate the importance of prioritizing drinking water health in rural areas, indicating that purified tap water can enhance cognitive function among older adults. Key points: Prolonged untreated water use raised cognitive dysfunction in rural older adults.Changing untreated water to tap water is associated with low cognitive dysfunction.Exercise and tap water were synergistically associated with low cognitive function. [ABSTRACT FROM AUTHOR]

• 24.8% of Chinese older adults reported raising domestic animals frequently. • 8.4% of participants developed dementia during the 10-year follow-up, with a prevalence of 9.5% for 'never' of raising domestic animals, 6.4% for 'occasional', and 5.6% for 'frequent'. • Raising domestic animals frequently led to a 21% decreased risk of developing dementia in older adults. This study explored the causal relationship between raising domestic animals and the risk of dementia occurrence. A 10-year cohort study was carried out drawing the data from Chinese Longitudinal Health Longevity Survey (CLHLS) 2008-2018. The Cox regression model was applied to analyze the association between raising domestic animals and the risk of developing dementia. Meanwhile, a subgroup analysis stratified by gender and exercise was performed. Participants were 8 170 older adults in China. The prevalence of raising domestic animals frequently was 24.8%. Older people who raised domestic animals frequently had a decreased risk of developing dementia by 21% than those who did not raise animals. The benefit of raising domestic animals frequently in decreasing the development of dementia was only in female non-exercise older adults. These findings strengthened the role of raising domestic animals in prevention of dementia risk occurrence among older Chinese adults. [ABSTRACT FROM AUTHOR]

• This study included both cross-sectional and cohort analyses. • There is a clear bidirectional relationship between frailty and cognitive function. • This bidirectional relationship varied by sex. Frailty and cognitive function are two common aging-related conditions among older adults. This study examined the bidirectional relationship between frailty and cognitive function according to sex. All older adults aged ≥65 years who participated in the 2008 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey were included in this study. Binary logistic regression and generalized estimating equation models were used to determine the bidirectional relationship between frailty and cognitive function in cross-sectional and cohort studies, and sex differences were assessed. We included 12,708 participants who were interviewed in the baseline study. The participants' mean (standard deviation) age was 85.6 (11.1%) years. In the cross-sectional study, the multivariate-adjusted odds ratio (OR; 95% confidence interval [CI]) for pre-frailty and frailty among participants with cognitive impairment was 3.68 (3.29–4.13). Older adults with pre-frailty and frailty had higher risks of cognitive impairment (OR = 3.79, 95% CI: 3.38–4.25). The GEE models showed that pre-frailty and frailty predicted a higher likelihood of cognitive impairment (OR = 2.02, 95% CI, 1.67–2.46) during follow-up. Moreover, the temporal relationship between these relationships differed slightly by sex. Older women with cognitive impairment at baseline were more likely to develop pre-frailty or frailty than did older men. This study demonstrated a significant bidirectional relationship between frailty and cognitive function. Moreover, this bidirectional relationship varied by sex. These findings confirm the need to integrate sex-specific interventions for frailty and cognitive functioning problems to improve the quality of life of older adults. [ABSTRACT FROM AUTHOR]