AbstractBackgroundStroke doubles one’s risk for dementia. Therefore, stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. Engagement in leisure activities, such as social, physical, and cognitive enrichment activities, are beneficial for healthy cognitive aging. Thus, we hypothesize that higher levels of leisure activities are associated with better cognitive performance in adults with chronic stroke and may be a promising approach to promoting cognitive health post‐stroke.MethodA cross‐sectional analysis of baseline data from the Vitality study – a randomized controlled trial examining the effects of exercise training or complex mental and social activities on cognitive function in community dwelling older adults (aged 55+ years) living with chronic stroke (i.e., stroke sequelae ≥1 year). Our primary cognitive outcome was the Alzheimer’s Disease Assessment Scale–Cognitive Subscale‐Plus (ADAS‐Cog Plus: 13‐item ADAS‐Cog and additional cognitive tests). We indexed participation in leisure activities using the Nottingham Leisure Questionnaire (NLQ); this questionnaire is specific for stroke survivors. We first investigated the bivariate correlation between leisure activities and ADAS‐Cog Plus score, and then performed multiple regression analyses to examine the independent contribution of leisure activities to explain variance in ADAS‐Cog‐Plus scores, after controlling for age, sex, education, and Montreal Cognitive Assessment (MoCA) score.ResultForty‐three females and 72 males were included in this analysis (mean age = 70.69 ±8.68, MoCA = 21.83±4.20, and NLQ = 22.84±7.26). Higher NLQ score was significantly associated with better ADAS‐Cog Plus score (r = ‐0.31; 95% CI: [‐0.47 ‐0.14]; p< 0.001). Importantly, the multiple linear regression indicated that higher NLQ scores were independently associated with better ADAS‐Cog Plus performance (b = ‐0.02 ± 0.007; p = 0.01). The adjusted R2 for the model including NLQ was significantly higher than the model without NLQ scores (F = 6.45, p<0.05).ConclusionOur findings suggest that higher levels of leisure activities are associated with better cognitive performance in adults living with chronic stroke. Future studies should explore the types of leisure activities that are most beneficial to preserve cognition and prevent dementia onset post stroke. Different physical and cognitively demanding activities may differentially affect cognitive function.