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Cognitive leisure activities and future risk of cognitive impairment and dementia: systematic review and meta-analysis

Published online by Cambridge University Press:  09 August 2016

Lauren A Yates ,
Shier Ziser ,
Aimee Spector  and
Martin Orrell
Lauren A Yates*
Affiliation:
Institute of Mental Health, University of Nottingham, Nottingham, UK
Shier Ziser
Affiliation:
School of Medicine, University College London (UCL), London, UK
Aimee Spector
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
Martin Orrell
Affiliation:
Institute of Mental Health, University of Nottingham, Nottingham, UK
*
Correspondence should be addressed to: Lauren Yates, B Floor, School of Medicine, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Innovation Park, Triumph Road, Nottingham NG7 2TU, UK. Phone: +0115 748 4208. Email: [email protected].
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Abstract

Background:

As life expectancies continue to rise, modifiable lifestyle factors that may prevent cognitive decline and dementia in later life become increasingly important in order to maintain quality of life in old age.

Methods:

Five meta-analyses were conducted on data from papers identified in a systematic review. Studies were grouped according to outcomes (dementia, cognitive impairment including amnestic Mild Cognitive Impairment (aMCI), Mild Cognitive Impairment (MCI), and cognitive decline) and output (risk (RR), odds (OR), or hazard ratios (HR)).

Results:

Nineteen studies met our inclusion criteria and quality assessments. Four of five meta-analyses showed significant associations between participation in cognitive leisure activities and reduced risk of cognitive impairment (OR = 0.69, 95% CI: 0.56–0.85) and dementia (HR = 0.58, 95% CI: 0.46–0.74; RR = 0.61, 95% CI: 0.42–0.90; OR = 0.78, 95% CI: 0.67–0.90). However, one pooled analysis of cognitive impairment studies did not reach significance (HR = 0.85, 95% CI: 0.71–1.02). Mentally stimulating leisure activities were significantly associated with later life cognition (β = 0.11, p = 0.05), better memory (β = 0.20, 95% CI: 0.11–0.29), speed of processing (β = 0.37, 95% CI: 0.29–0.45), and executive functioning (β = 0.23, 95% CI: 0.15–0.29), and less decline in overall cognition (β = −0.23, p < 0.01), language (β = −0.11, p < 0.05), and executive functioning (β = −0.13, p < 0.05). Activities were also shown to reduce rate of cognitive decline (estimate = 0.03, SE = 0.01, p = 0.00).

Conclusions:

There is increasing evidence that participation in cognitively stimulating leisure activities may contribute to a reduction of risk of dementia and cognitive impairment in later life. Promoting involvement in such activities across lifespan could be an important focus for primary prevention strategies for governments and health services.

Keywords

cognitive impairmentcognitive activitycognitive reservedementiarisk factorsleisure activities
Type
Review Article
Information
International Psychogeriatrics , Volume 28 , Issue 11 , November 2016 , pp. 1791 - 1806
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Adler, N. E. and Ostrove, J. M. (1999). Socioeconomic status and health: what we know and what we don't. Annals of the New York Academy of Sciences, 896, 3–15.Google Scholar
Akbaraly, T. N. et al. (2009). Leisure activities and the risk of Dementia in the elderly: results from the three-city study. Neurology, 73, 854–861.CrossRefGoogle ScholarPubMed
Almeida, O. P., Yeap, B. B., Alfonso, H., Hankey, G. J., Flicker, L. and Norman, P. E. (2012). Older men who use computers have lower risk of dementia. PLoS One, 7, e44239.Google Scholar
Alzheimer's Disease International. World Alzheimer Report (2009). Alzheimer's Disease International, 2009. http://www.alz.co.uk/research/files/WorldAlzheimerReport.pdf; last accessed 8 January 2014.Google Scholar
American Psychiatric Association (APA). (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn., text rev.. Washington, DC: American Psychiatric Association.Google Scholar
Baltes, P. B. and Baltes, , , M. M. (Eds.). (1993). Successful Aging: Perspectives from the Behavioural Sciences, vol. 4. Cambridge: Cambridge University Press.Google Scholar
Baltes, P. B. and Singer, T. (2001). Plasticity and the ageing mind: an exemplar of the Bio-cultural orchestration of brain and behaviour. European Review, 9, 59–76.Google Scholar
Bennett, D. A., Schneider, J. A., Buchman, A. S., Mendes de Leon, C., Bienias, J. L. and Wilson, R. S. (2005). The rush memory and aging project: study design and baseline characteristics of the study cohort. Neuroepidemiology, 25, 163–175.CrossRefGoogle ScholarPubMed
Borenstein, M., Hedges, L. and Rothstein, H. (2007). Meta-analysis: fixed effects vs. random effects. www.Meta-Analysis.com; last accessed 9 January 2014.Google Scholar
Brookmeyer, R., Gray, S. and Kawas, C. (1998). Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. American Journal of Public Health, 88, 1337–1342.Google Scholar
Brookmeyer, R., Johnson, E., Ziegler-Graham, K. and Arrighi, H. M. (2007). Forecasting the global burden of Alzheimer's disease. Alzheimers and Dementia, 3, 186–191.CrossRefGoogle ScholarPubMed
Carlson, M. C. et al. (2012). Lifestyle activities and memory: variety may be the spice of life. The women's health and aging study II. Journal of the International Neuropsychological Society, 18, 286–294.Google Scholar
Critical Appraisal Skills Programme (CASP). CASP Checklists. CASP (2014) (http://www.casp-uk.net/#!checklists/cb36); last accessed 8 January 2014.Google Scholar
Desai, A. K. (2011). Revitalizing the aged brain. Medical Clinics of North America, 95, 463–475.CrossRefGoogle ScholarPubMed
Desai, A. K., Grossberg, G. T. and Chibnall, J. T. (2010). Healthy brain aging: a road map. Clinics in Geriatric Medicine, 26, 1–16.CrossRefGoogle ScholarPubMed
Elias, M. F., Beiser, A., Wolf, P. A., Au, R., White, R. F. and D'Agostino, R.B. (2000). The preclinical phase of Alzheimer disease: a 22-year prospective study of the framingham cohort. Archives of Neurology, 57, 808–813.Google Scholar
Fratiglioni, L., Paillard-Borg, S. and Winblad, B. (2004). An active and socially integrated lifestyle in late life might protect against dementia. The Lancet Neurology, 3, 343–353.Google Scholar
Fratiglioni, L., Viitanen, M., Bäckman, L., Sandman, P. O. and Winblad, B. (1992). Occurrence of dementia in advanced age: the study design of the Kungsholmen project. Neuroepidemiology, 1, 29–36.CrossRefGoogle Scholar
Fritsch, T., Smyth, K. A., Debanne, S. M., Petot, G. J. and Friedland, R. P. (2005). Participation in novelty-seeking leisure activities and Alzheimer's disease. Journal of Geriatric Psychiatry and Neurology, 18, 134.Google Scholar
Geda, Y. E. et al. (2011). Engaging in cognitive activities, aging, and mild cognitive impairment: a population-based study. Journal of Neuropsychiatry and Clinical Neuroscience, 23, 149–154.CrossRefGoogle ScholarPubMed
Gold, D. P., Andres, D., Etezadi, J., Arbuckle, T., Schwartzman, A. and Chaikelson, J. (1995). Structural equation model of intellectual change and continuity and predictors of intelligence in older men. Psychology and Aging, 10, 294–303.Google Scholar
Harris, T. B. et al. (2007). Age, gene/environment susceptibility-reykjavik study: a multidisciplinary applied phenomics. American Journal of Epidemiology, 165, 1076–1087.CrossRefGoogle ScholarPubMed
Higgins, J. P. and Green, S. (Eds.), (2008). Cochrane Handbook for Systematic Reviews of Interventions. vol. 5. Chichester: Wiley-Blackwell.CrossRefGoogle Scholar
Higgins, J. and Thompson, S. G. (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine, 21, 1539–1558.CrossRefGoogle ScholarPubMed
Higgins, J., Thompson, S. G., Deeks, J. J. and Altman, D. G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327, 557.Google Scholar
Iwasa, H., Yoshida, Y., Kai, I., Suzuki, T., Kim, H. and Yoshida, H. (2012). Leisure activities and cognitive function in elderly community-dwelling Individuals in Japan: a 5-year prospective cohort study. Journal of Psychosomatic Research, 72, 159–164.Google Scholar
Kåreholt, I., Lennartsson, C., Gatz, M. and Parker, M. G. (2011). Baseline leisure time activity and cognition more than two decades later. International Journal of Geriatric Psychiatry, 26, 65–74.CrossRefGoogle ScholarPubMed
Katzman, R. (1993). Education and the prevalence of dementia and Alzheimer's disease. Neurology, 43, 13–20.Google Scholar
Lennartsson, C. and Silverstein, M. (2001). Does engagement with life enhance survival of elderly people in sweden? the role of social and leisure activities. Journal of Gerontology: B Psychological Sciences Social Sciences, 56, 335–342.Google Scholar
Li, X. et al. (2013). Prevalence of and potential risk factors for mild cognitive impairment in community-dwelling residents of Beijing. Journal of the American Geriatrics Society, 61, 2111–2119.Google Scholar
Lindstrom, H. A. et al. (2005). The relationships between television viewing in midlife and the development of Alzheimer's disease in a case-control study. Brain and Cognition, 58, 157–165.Google Scholar
Marioni, R. E. et al. (2015). Social activity, cognitive decline and dementia risk: a 20-year prospective cohort study. BMC Public Health, 15, 1089.Google Scholar
Monastero, R., Palmer, K., Qiu, C., Winblad, B. and Fratiglioni, L. (2007). Heterogeneity in risk factors for cognitive impairment, no dementia’: population-based longitudinal study from the Kungsholmen project. American Journal of Geriatric Psychiatry, 15, 60–69.Google Scholar
Mora, F., Segovia, G. and Del Arco, A. (2007). Aging, plasticity and environmental enrichment: structural changes and neurotransmitter dynamics in several areas of the brain. Brain Research Reviews, 55, 78–88.Google Scholar
Niti, M., Yap, K., Kua, E., Tan, C. and Ng, T. (2008). Physical, social and productive leisure activities, cognitive decline and interaction with APOE-ε4 genotype in Chinese older adults. International Psychogeriatrics, 20, 237–251.CrossRefGoogle Scholar
Norton, S., Matthews, F. E., Barnes, D. E., Yaffe, K. and Brayne, C. (2014). Potential for primary prevention of Alzheimer's disease: an analysis of population-based data. The Lancet Neurology, 13, 788–794.Google Scholar
Norton, S., Matthews, F. E. and Brayne, C. (2013). A commentary on studies presenting projections of the future prevalence of dementia. BMC Public Health, 13, 1.Google Scholar
Paillard-Borg, S., Fratiglioni, L., Winblad, B. and Wang, X. (2009). Leisure activities in late life in relation to dementia risk: principal component analysis. Dementia and Geriatric Cognitive Disorders, 28, 136–144.Google Scholar
Ritchie, K., Carriere, I., Ritchie, C. W., Berr, C., Artero, S. and Ancelin, M. L. (2010). Designing prevention programmes to reduce incidence of dementia: prospective cohort study of modifiable risk factors. British Medical Journal, 341, c3885.Google Scholar
Roberts, R. O. et al. (2008). The Mayo clinic study of aging: design and sampling, participation, baseline measures and sample characteristics. Neuroepidemiology, 30, 58.Google Scholar
Saczynski, J. S. et al. (2006). The effect of social engagement on incident dementia: the Honolulu-Asia aging study. American Journal of Epidemiology, 163, 433–440.Google Scholar
Saczynski, J. S. et al. (2008). White matter lesions and cognitive performance: the role of cognitively complex leisure activity. Journals of Gerontology Series A-Biological Sciences and Medical Sciences, 63A, 848–854.Google Scholar
Sattler, C., Toro, P., Schonknecht, P. and Schroder, J. (2012). Cognitive activity, education and socioeconomic status as preventative factors for mild cognitive impairment and Alzheimer's disease. Psychiatry Research, 196, 90–95.CrossRefGoogle ScholarPubMed
Scarmeas, N. and Stern, Y. (2003). Cognitive reserve and lifestyle. Journal of Clinical and Experimental Neuropsychology, 25, 625–633.CrossRefGoogle ScholarPubMed
Stern, Y. and Munn, Z. (2010). Cognitive leisure activities and their role in preventing dementia: a systematic review. International Journal of Evidence Based Healthcare, 8, 2–17.Google Scholar
Tucker-Drob, E. M., Johnson, K. E. and Jones, R. N. (2009). The cognitive reserve hypothesis: a longitudinal examination of age-associated declines in reasoning and processing speed. Developmental Psychology, 45, 431.CrossRefGoogle ScholarPubMed
Valenzuela, M. J. and Sachdev, P. (2006). Brain reserve and cognitive decline: a non-parametric systematic review. Psychological Medicine, 36, 1065–1073.CrossRefGoogle ScholarPubMed
Verghese, J. et al. (2003). Leisure activities and the risk of dementia in the elderly. New England Journal of Medicine, 348, 2508–2516.CrossRefGoogle ScholarPubMed
Verghese, J. et al. (2006). Leisure activities and the risk of amnesic mild cognitive impairment in the elderly. Neurology, 66, 821–827.CrossRefGoogle Scholar
Wang, H. X. et al. (2013). Late life leisure activities and risk of cognitive decline. Journals of Gerontology Series A-Biological Sciences and Medical Sciences, 68, 205–213.CrossRefGoogle ScholarPubMed
Wang, H. X., Xu, W. and Pei, J. J. (2012). Leisure activities, cognition, and dementia. Biochimica et Biophysica Acta (BBA) – Molecular Basis of Disease, 1822, 482–491.CrossRefGoogle ScholarPubMed
Wang, J. Y. et al. (2006). Leisure activity and risk of cognitive impairment: the chongqing aging study. Neurology, 66, 911–913.Google Scholar
Willey, J. Z. et al. (2016). Leisure-time physical activity associates with cognitive decline. The Northern Manhattan study. Neurology, 10, 1212.Google Scholar
Wilson, R. S. et al. (2010). Cognitive activity and the cognitive morbidity of Alzheimer's disease. Neurology, 75, 990–996.CrossRefGoogle Scholar
Wilson, R. S., Scherr, P. A., Schneider, J. A., Tang, Y. and Bennett, D. A. (2007). Relation of cognitive activity to risk of developing Alzheimer disease. Neurology, 69, 1911–1920.Google Scholar