Table 63Leisure activities and risk of cognitive decline

StudySample (n)FollowupExposureCase definitionConfounding adjustmentResults
Bosma et al., 2002347Clinical cohort – family practice clinics (830)3 yearsSelf-report of activities described as “social activities” such as organizational memberships (e.g., clubs)Longitudinal performance on the following cognitive measures: Stroop Color-Word Test, word list memory test, a letter-digit substitution test, semantic verbal fluency test, and the MMSEAge
Educational level
Baseline cognitive status
Length of followup interval
At least 1 hour per week in social leisure activities was associated with less cognitive decline on the immediate recall trials of a word list memory task (β coefficient = 0.94; p < 0.05) and the delayed recall of the word list memory task (β = 0.30: p < 0.05)
Barnes et al., 2004336Community cohort (6158)6 years (mean)Social activities scale (0 to 8 points) constructed from responses to following items:
  1. Attending religious services
  2. Going to a museum
  3. Participation in activities or groups outside the home
  4. A part-time or full-time job
Global composite index of scores on the MMSE, the immediate and delayed recall of the East Boston Story, and the oral version of the Symbol Digit Modalities TestAge
Martial status
Educational level
0.009 unit reduction of cognitive decline on the global composite index score for every point on the social engagement scale (p < 0.001).
Niti et al. 2008352Community cohort (2611)1.5 years (median)Self-report of “social activities,” including religious services, movies, going to restaurants or sports events, day or excursion trips, playing cards or other games, senior citizen club activities, and group recreational activities such as karaoke and dancing

Self-report of “productive activities,” including reading, music, media programs, computing, painting, gardening, preparing meals, shopping, unpaid and paid community work, and other leisure paid employment or business.

Self-report of “physical activities,” including walking, active sports or swimming, and tai chi
Cognitive decline on the MMSE defined as a decrease of 1 or more points at followup assessmentsAge
Educational level
Baseline cognitive status
Functional status
Number of co morbidities
Vascular risk factor/events
Compared to those who had low leisure activity levels the OR for cognitive decline among those with high levels of leisure activity was 0.62 (95% CI 0.46 to 0.84); among those who had medium leisure activity, the OR was 0.60 (0.45 to 0.79)

Compared to those who did not engage in any productive activity, those who engaged in at least one productive activity had lower risk of cognitive decline: OR 0.36 (95% CI 0.20 to 0.65)

In the total sample, participation in at least one social or physical activity was not associated with cognitive decline.

However, in the APOE carriers, those who participated in at least one physical activity (OR 0.34; 95% CI 0.17 to 0.68) or at least one social activity (OR 0.40; CI 0.16 to 0.99) were less likely to decline on the MMSE.

Abbreviations: APOE = apolipoprotein E gene; CI = confidence interval; MMSE = Mini-Mental State Examination; OR = odds ratio

From: 3, Results

Cover of Preventing Alzheimer's Disease and Cognitive Decline
Preventing Alzheimer's Disease and Cognitive Decline.
Evidence Reports/Technology Assessments, No. 193.
Williams JW, Plassman BL, Burke J, et al.

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