Objective: To examine how lifestyles and leisure activities are associated with cognitive health expectancy among older adults.

Results: For young-old (aged 65), an absolute increase in life years without cognitive impairment was found among those with a healthy diet, engaging in mental activities and in social activities. For old-old (aged 85), an absolute increase was found for men engaging in physical activities besides those. Compared with counterparts in a high risk group, the young-old in a medium-low risk group had a smaller proportion of years without cognitive impairment. Old-old in a low risk group had a greater proportion.

Conclusion: Extra years of life gained by a healthy dietary pattern, mental activities, and social activities are free of cognitive impairment for both sexes across ages. The beneficial impact of individual and combined modifiable factors on cognitive health is most prominent in old-old.

Methods: Data come from The Chinese Longitudinal Healthy Longevity Survey, a population-based cohort study of 27,193 participants aged 65+ conducted between 2002 and 2014. Smoking status, alcohol consumption, dietary pattern, marital status, physical, mental, social, and productive activities were assessed at baseline. Cognitive status was measured using the Chinese version of the MMSE.