Aging patterns based on the difference between physical fitness age and chronological age are associated with physical, mental, and cognitive health in older adults.

PURPOSE: This study examined the association between aging patterns, based on the physical fitness age (PFA) and chronological age (CA) discrepancy, and multidimensional health in 2207 older Chinese adults (aged ≥60 years). METHODS: PFA was derived using sex-stratified regression equations integrating peak expiratory flow, handgrip strength, walking speed, 5-time chair stand test, and CA, with participants categorized into decelerated (PFA-CA < -2.5 years), normal (-2.5 to +2.5 years), or accelerated (PFA-CA > +2.5 years) aging groups. RESULTS: Multivariable logistic regression models were performed. The results demonstrated that accelerated aging was associated with higher odds of relevant depressive symptoms (aOR = 1.88, 95% CI: 1.22, 2.90) and cognitive impairment (aOR = 1.76, 95% CI: 1.11, 2.79). Conversely, decelerated aging was significantly linked to higher odds of remaining free from chronic diseases (aOR = 1.77, 95% CI: 1.02, 3.07), though no significant cognitive or depression advantages were observed compared to normal aging. Further analysis identified a significant PFA × Sex interaction for cognitive impairment (p = 0.001), with the cognitive association strongly driven by females (aOR = 3.99, 95% CI: 2.20, 7.20). CONCLUSION: These findings suggest that aging patterns defined by the PFA-CA discrepancy are associated with chronic, cognitive, and mental health, and older females exhibit heightened cognitive vulnerability to accelerated physical aging.