Influence of leisure activity on the incidence of Alzheimer’s Disease

TLDR

High educational and occupational attainment are linked to lower dementia risk, yet the impact of leisure activities on dementia incidence remains underexplored. This study aimed to assess whether engagement in leisure activities influences the risk of developing dementia. In a longitudinal cohort of 1,772 nondemented adults aged 65 and older in northern Manhattan, baseline leisure activity levels were recorded and participants were followed for up to seven years with annual neurological and neuropsychological evaluations, and Cox proportional hazards models adjusted for age, ethnicity, education, and occupation estimated the relative risk of incident dementia. High leisure activity was associated with a 38% reduction in dementia risk (RR = 0.62, 95% CI 0.46–0.83), an effect that persisted after controlling for baseline cognition, health limitations, cerebrovascular disease, and depression, suggesting leisure may confer a reserve that delays clinical dementia onset.

Abstract

<b><i>Objective: </i></b> To determine whether leisure activities modify the risk for incident dementia. <b><i>Background: </i></b> Although high educational and occupational attainments have been associated with reduced risk of incident dementia, the relation between leisure activities and dementia risk has not been adequately investigated. <b><i>Methods: </i></b> A total of 1,772 nondemented individuals aged 65 years or older, living in northern Manhattan, New York, were identified and followed longitudinally in a community-based cohort incidence study. Subjects’ leisure activities at baseline were assessed, annual examinations with the same standardized neurologic and neuropsychological measures were performed for up to 7 years (mean 2.9 years), and incident dementia was assessed as the main outcome measure. Cox proportional hazards models, adjusting for age, ethnic group, education, and occupation, were used to estimate the relative risk (RR) of incident dementia associated with high leisure activities. <b><i>Results: </i></b> Of the 1,772 subjects, 207 became demented. The risk of dementia was decreased in subjects with high leisure activities (RR, 0.62; 95% CI 0.46 to 0.83). The association of high leisure with decreased RR of incident dementia was present even when baseline cognitive performance, health limitations interfering with desired leisure activities, cerebrovascular disease, and depression were considered. <b><i>Conclusions: </i></b> The data suggest that engagement in leisure activities may reduce the risk of incident dementia, possibly by providing a reserve that delays the onset of clinical manifestations of the disease.