Participation In Cognitive Leisure Activities Research Articles

Relationships between cognitive leisure activities and cognitive function in older adults with depressive symptoms: a cross-sectional study

ObjectivesThe current study aimed to elucidate the associations between cognitive leisure activities and cognitive function in an older population stratified by having or not having depressive symptoms.DesignA retrospective cross-sectional study...

Reclassified cognitive leisure activity and risk of cognitive impairment in Chinese older adults aged ≥80 years: A 16-year prospective cohort study.

There is accumulating evidence that participation in cognitive leisure activities might be related to a reduced risk of cognitive impairment. However, there is no consensus regarding the classification of cognitive leisure activities, and it cannot clearly define each activity and quantitatively evaluate the effect of it. In the present study, we propose a new classification method, and examine the relationship between reclassified cognitive leisure activities and cognitive function. The analysis included 4830 participants of the Chinese Longitudinal Healthy Longevity Survey, who were aged >80 years and free of cognitive impairment at 1998. They were followed up six times. Six cognitive leisure activities were mainly grouped into intrapersonal and interpersonal cognitive leisure activity by categorical principal component analysis. Cox proportional hazards analysis was used to evaluate the relationship between reclassified cognitive leisure activities and the risk of cognitive impairment. After a median follow-up period of 16 years, 1763 participants suffered from cognitive impairment (Mini-Mental State Examination score <24). Reading newspapers or books, taking part in some social activities and sometimes playing cards or mahjong were associated with a decreased risk of cognitive impairment (P < 0.05 for all). In multivariable adjusted models, compared with those with lower intensities, the hazard ratios (95% confident intervals) of cognitive impairment were 0.86 (0.74-0.99) and 0.71 (0.60-0.83) for participants with high intensities of intrapersonal and interpersonal cognitive leisure activity, respectively. A high frequency of participation in intrapersonal and interpersonal cognitive leisure activities showed a lower risk of cognitive impairment among the oldest-old in China. Geriatr Gerontol Int 2019; 19: 1041-1047.

The Association of Clinic-Based Mobility Tasks and Measures of Community Performance and Risk

IntroductionGait speed is recognized as an important predictor of adverse outcomes in older people. However, it is unknown whether other more complex mobility tasks are better predictors of such outcomes. ObjectiveTo examine a range of clinic-based mobility tests and determine which were most strongly associated with measures of community performance and risk (CP&R). DesignCross-sectional study. SettingCentral Control Mobility and Aging Study, Westchester County, New York. ParticipantsAged ≥65 years (n = 424). MethodsClinic-based mobility measures included gait speed measured during normal and dual-task conditions, the Floor Maze Immediate and Delay tasks, and stair ascending and descending. CP&R measures were self-reported by the use of standardized questionnaires and classified into measures of performance (distance walked, travel outside one’s home [life space], activities of daily living, and participation in cognitive leisure activities) or risk (balance confidence, fear of falling, and past falls). Linear and logistic regression were used to examine associations between the clinic-based mobility measures and CP&R measures adjusting for covariates. ResultsThe mean age of the sample was 77.8 (SD 6.4) years, and 55.2% (n = 234) were female. In final models, faster normal walking speed was most strongly associated with 5 of the 7 community measures (greater distance walked, greater life space, better activities of daily living function, higher balance confidence, and less fear of falling; all P < .05). More complex tasks (walking while talking and maze immediate) were associated with cognitive leisure activity (P < .05), and ascending stairs was the only measure associated with a history of falls (P < .05). ConclusionNormal walking speed is a simple and inexpensive clinic-based mobility test that is associated with a wide range of CP&R measures. In addition, poorer performance ascending stairs may assist in identifying those at risk of falls. Poorer performance in more complex mobility tasks (walking while talking and maze immediate) may suggest inability to participate in cognitive leisure activities. Level of EvidenceIII

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

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. 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)). 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). 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.

Cognitive reserve in multiple sclerosis

Cognitive impairment is common among persons with multiple sclerosis (MS), but some patients are able to withstand considerable disease burden (e.g. white matter lesions, cerebral atrophy) without cognitive impairment (cognitive inefficiency, memory decline). What protects these patients from cognitive impairment? We review the literature on cognitive reserve in MS, which shows that heritable (larger maximal lifetime brain growth) and environmental (greater intellectual enrichment) factors attenuate the negative effect of disease burden on cognitive status. That is, persons with larger maximal lifetime brain growth, greater vocabulary knowledge, and/or greater early life participation in cognitive leisure activities (e.g. reading, hobbies) are better able to cope with MS disease without cognitive impairment. We review evidence that benefits of intellectual enrichment on cognitive status may stem from more efficient patterns of brain function. We discuss clinical implications and highlight important unanswered questions for future research on reserve against cognitive impairment in MS.

Cognitive activity, education and socioeconomic status as preventive factors for mild cognitive impairment and Alzheimer's disease

Growing epidemiological evidence suggests that premorbid participation in cognitive leisure activities (CLA) reduces the risk of dementia by increasing cognitive reserve. We investigated the differential effect of CLA, education, and socioeconomic status (SES) on the development of mild cognitive impairment (MCI) and Alzheimer's disease (AD). Participants in the prospective population-based ILSE study (*1930–1932; 12-year follow-up) were examined in three examination waves (t1:1993/94; t2:1997/98; t3:2005/07). In total, 381 subjects of the original cohort (n=500) were re-examined at t3. Of these subjects 29% received the diagnosis of MCI and 7% of AD. Subjects participated in a thorough psychogeriatric examination and neuropsychological testing. Moreover, they took part in a detailed autobiographical interview and completed questionnaires including socio-demographic data and current frequency of participation in CLA. Subjects who were highly cognitively active at t1 had a significantly reduced risk of developing MCI/AD at t3 (scores adjusted for education, SES, gender, and depressive symptoms). Additionally, high education and high SES separately reduced the risk of MCI and AD. Our results confirm the hypothesis that a high level of CLA acts as a protective factor against the development of MCI and AD by increasing cognitive reserve. This effect is not accounted for by important potential confounders.

Cognitive leisure activities and their role in preventing dementia: a systematic review.

Dementia is a debilitating syndrome that inflicts a tremendous burden of care on one's family, individual caregivers, health care professionals and on the use of resources. Existing therapeutic interventions can only help control or reduce symptoms, and slow the disease's progression. Identifying protective factors or effective prevention strategies would result in considerable benefits. Participation in cognitive leisure activities has been implicated as a possible prevention strategy. The objective of the review was to establish best practice in relation to cognitive leisure activities in preventing dementia among older adults. Randomised controlled trials (RCTs), other experimental studies, cohort studies, case-controlled studies and cross-sectional studies were considered for the review.Participants of interest were adults aged 60 years and older with or without a clinical diagnosis of dementia, living in the community or residential care setting.The review focussed on any cognitive leisure activity that required a mental response from the individual taking part in the activity e.g. reading and playing board games.The primary outcome of the review was the presence or absence of dementia, determined by cognitive function tests, mental examination scores, DSM classification (Diagnostic and Statistical Manual of Mental Disorders), and other valid dementia diagnostic tools. A search for published and unpublished literature in the English language was conducted using all major electronic databases. There was no publication date restriction. A three-step search strategy was developed using MeSH terminology and keywords to ensure that all material relevant to the review was captured. The methodological quality of included studies was assessed by two reviewers, who appraised each study independently, using standard Joanna Briggs Institute (JBI) critical appraisal tools. Data was extracted from the studies that were identified as meeting the criteria for methodological quality using the standard JBI data extraction tools. Due to the heterogeneity of populations and interventions, meta-analyses were not possible and results are presented in narrative form. Thirteen longitudinal studies were included in the review. Studies were grouped by stage of adult life participation when interventions were undertaken i.e. early-middle adulthood and late life. Five out of six studies demonstrated a positive association between engagement in activities and a reduced risk of developing Alzheimer's disease (AD) when interventions were undertaken in middle adulthood and six out of seven studies produced a positive association for late life participation. Results indicated that some activities might be more beneficial than others.Actively participating in cognitive leisure activities during mid or late life may be beneficial in preventing the risk of dementia in the elderly however the evidence is currently not strong enough to infer a direct causal relationship.Participating in selected cognitive leisure activities may be more favourable than others but currently there is no strong evidence to recommend one over the other.