Do cognitive leisure activities really matter in the relationship between education and cognition? Evidence from the aging, demographics, and memory study (ADAMS)

Objectives: Increasing demand for early detection and prevention of dementia has shifted recent attention toward cognitive impairment with no dementia (CIND), which is often considered a possible risk path to dementia. Education and cognitive leisure activities are major predictors featured in dementia studies. However, the definition of cognitive leisure activities often has been inconsistent and diverse. This study explored different domains of these activities and their moderating roles on the relationship between education and cognition.

Method: A sample of 704 participants aged 70 or older was drawn from the national Aging, Demographics, and Memory Study. Exploratory factor analysis was conducted to assess two domains from cognitive leisure activities: literacy and visuospatial activities. Multinomial logistic regression tested the main and moderating roles of each domain on cognition categorized as no impairment, CIND, and dementia.

Results: Individuals with greater engagement in both literacy and visuospatial activities were more likely to have no cognitive impairment than CIND. Individuals with greater engagement in literacy activities were less likely to have dementia compared to CIND. Literacy activities and education years had a significant interaction effect. Individuals with higher education seem to benefit more by engaging in literacy activities, as evidenced by decreased odds of having dementia.

Conclusion: Engagement in cognitive leisure activities for both cognitively intact and impaired older adults is suggested, with more focus on literacy activities for cognitively impaired and highly educated older adults.