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Age Ageing. 2015 Sep;44(5):835-40. doi: 10.1093/ageing/afv099. Epub 2015 Aug 12.

Intellectual and physical activities, but not social activities, are associated with better global cognition: a multi-site evaluation of the cognition and lifestyle activity study for seniors in Asia (CLASSA).

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Department of Psychiatry, the Chinese University of Hong Kong, G/F, Multi-Centre, Tai Po Hospital, Hong Kong, SAR China.
Faculty of Medicine, Department of Neurology, Hasan Sadikin Hospital, Padjadjaran University, Bandung, Indonesia.
Department of Epidemiology, Padjadjaran University, Bandung, Indonesia.
Dementia Care and Research Centre, Peking University Institute of Mental Health (Six Hospital), Beijing Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Key Laboratory for Mental Health, Ministry of Health (Peking University), Beijing, China.
Haidan District Mental Health Centre, Beijing, China.
Institute for Neurosciences, St Luke's Medical Center, Manila, Philippines.
Department of Psychiatry and Mental Health, Hospital Sultan Ismail, Johor Bahru, Malaysia.
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.
Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.



population ageing will lead to a leap in the dementia population in Asia. However, information about potentials for low-cost and low-risk interventions is limited.


to study the associations between lifestyle activities and global cognition from the Cognitive and Lifestyle Activity Study for Seniors in Asia (CLASSA).


a cross-sectional study.


we studied the association between global cognition and lifestyle activity participation in community living older adults (60 years or over) across nine sites in East Asia. A standardised lifestyle activity questionnaire exploring activities from four categories (intellectual, physical, social and recreational) was used to measure the pattern. Global cognition was categorised by locally validated versions of Mini-mental state examination (MMSE) or Montreal Cognitive Assessment (MoCA) (good cognition, GC-scored at the top 25% among participants with no significant cognitive deficit (SCD); normal cognition, NC-middle 50% among participants with no SCD; mild cognitive deficit, MCD-lowest 25% among participants with no SCD; SCD-below local cut-offs for dementia).


two thousand four hundred and four (1,009 men; 1,395 women) participants were recruited. The mean age was 71.0 (7.2) years. A higher variety of intellectual and physical activities were associated with GC; more social activities were associated with higher risks of having impaired cognition (multinomial logistic regression). The same association was found in participants with no SCD and had regular activities for over 10 years (n = 574).


intellectual activity and physical exercise were associated with better cognitive states in Asian older adults. Community-based intervention may take considerations into specific types of activities to optimise cognition.


Asia; cognition; dementia; intellectual activities; older people; physical exercise

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