Leisure activities participation tied to decline in prodromal phase of dementia

Participation in leisure activities has benefits for general health and well-being. Given the increasing numbers of people with dementia, there is considerable interest in, effective approaches for its prevention. Five of 7 studies in a recent systematic review reported that frequent participation in leisure activities is associated with the lower risk of subsequent dementia, suggesting that involvement in such activities may confer cognitive benefit. Studies with long follow-ups are needed to address bias due to reverse association, whereby the observed association may be due to the dementia prodrome, which is characterized by reduced leisure activity in the years preceding dementia diagnosis. For this purpose, researchers evaluated the association between leisure activity participation and risk of dementia in a large longitudinal study over an average 18-year follow-up.

It was a retrospective study of the Whitehall II cohort study. Researchers included 8,280 people participated in 1997–1999, 2002–2004, or 2007–2009, of whom 360 had developed dementia and 1,111 died by March 31, 2017. Researchers analyzed the comprehensive questionnaire of participants which was repeated every 5 years. Data on leisure activity participation were first collected during the 1997–1999 study wave, which therefore serves as a baseline for the current study, and repeated in the 2002–2004 and 2007–2009 waves; researchers included all Whitehall II participants who took part in at least one of these waves. The mean age at dementia diagnosis was 76.2 years, 69% of participants were male, 91% were White, and mean age at the start of follow-up (1997–1999) was 55.8 years.

Upon analysis the researchers found, participation in leisure activities at mean age 55.8 (1997-1999 assessment), with 18.0-year follow-up, was not associated with dementia (hazard ratio [HR] 0.92. However, participation in leisure activities at mean age 65.7 (2007-2009 assessment) was less likely to develop dementia (HR 0.82). They also found the decline in participation between 1997-1999 and 2007-2009 was associated with subsequent dementia risk. They didn't found any specific type of leisure activity that was consistently associated with dementia risk.

The authors concluded, "Our findings suggest that participation in leisure activities declines in the preclinical phase of dementia; there was no robust evidence for a protective association between leisure activity participation and dementia".

"Future research should investigate the socio-behavioral, cognitive, and neurobiological drivers of decline in leisure activity participation to determine potential approaches to improving social participation of those developing dementia" the authors further added.

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DOI: https://doi.org/10.1212/WNL.0000000000010966