Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Accepted for/Published in: JMIR Aging

Date Submitted: Jun 1, 2025
Date Accepted: May 28, 2026
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Associations of Solid Fuel Use and Circadian Rhythm Syndrome With Physical Function and Muscle Strength in Middle-Aged and Older Adults: Nationwide Cohort Study in China

Wang H, Mou P, Liu D, Zhao Z, Chen W, Yao Y, Shi H, Guan J, Dong J, Wei Y

Associations of Solid Fuel Use and Circadian Rhythm Syndrome With Physical Function and Muscle Strength in Middle-Aged and Older Adults: Nationwide Cohort Study in China

JMIR Aging 2026;9:e78352

DOI: 10.2196/78352

PMID: 42372255

Associations of Solid Fuel Use and Circadian Rhythm Syndrome With Physical Function and Muscle Strength in Middle-Aged and Older Adults: A Nationwide Cohort Study in China

  • Haochen Wang; 
  • Pengsen Mou; 
  • Donghao Liu; 
  • Ze Zhao; 
  • Wenzheng Chen; 
  • Yuxin Yao; 
  • Haoyan Shi; 
  • Jiaxin Guan; 
  • Jing Dong; 
  • Yingliang Wei

ABSTRACT

Background:

The relationships between circadian rhythm syndrome, physical function, and muscle strength remain unclear.

Objective:

This study aimed to demonstrate the separate and combined deleterious effects of solid fuel use and circadian rhythm syndrome on physical function and muscle strength.

Methods:

We used data from the China Health and Retirement Longitudinal Study cohort. The study population consisted of participants who underwent comprehensive assessments of metabolism, circadian rhythm, indoor air pollution, physical function, and muscle strength at the initial evaluation. Muscle strength was assessed using repeated grip strength measurements, and physical function was assessed using a composite score of muscle strength, physical performance, and balance. Circadian rhythm syndrome was derived from the five diagnostic components of metabolic syndrome, combined with sleep duration and depression. Logistic regression and linear mixed models were used to assess the relationships between solid fuel use, circadian rhythm syndrome, physical function and muscle strength. Furthermore, we analyzed the mediating role of circadian rhythm syndrome and its combined effect with solid fuel use on physical function and muscle strength.

Results:

A total of 7934 participants were included in the study, most of whom used solid fuels. Solid fuel use was positively associated with circadian rhythm syndrome (OR=1.078, P <.05). Circadian rhythm syndrome was found to be a significant risk factor for impairment of physical function (β=-0.475, P <.05) and muscle strength (β=-0.304, P <.05). Participants who used solid fuels and had circadian rhythm syndrome needed to pay more attention to changes in physical function (β=-0.698, P <.05) and muscle strength (β=-0.332, P <.05). A significant interaction was observed between solid fuel use and circadian rhythm syndrome on physical function (p for interaction = .029) and muscle strength (p for interaction = .017). Circadian rhythm syndrome partially mediated the association between solid fuel use and physical function, accounting for 2.51% of the total effect.

Conclusions:

Circadian rhythm syndrome exacerbates the adverse effects of solid fuel use on physical function and muscle strength. Fuel cleanliness and regular work and rest habits are crucial for the health of middle-aged and older adults.


 Citation

Please cite as:

Wang H, Mou P, Liu D, Zhao Z, Chen W, Yao Y, Shi H, Guan J, Dong J, Wei Y

Associations of Solid Fuel Use and Circadian Rhythm Syndrome With Physical Function and Muscle Strength in Middle-Aged and Older Adults: Nationwide Cohort Study in China

JMIR Aging 2026;9:e78352

DOI: 10.2196/78352

PMID: 42372255

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.