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Previous Volume 348:2508-2516 June 19, 2003 Number 25 Next

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ABSTRACT

Background Participation in leisure activities has been associated with a lower risk of dementia. It is unclear whether increased participation in leisure activities lowers the risk of dementia or participation in leisure activities declines during the preclinical phase of dementia.

Methods We examined the relation between leisure activities and the risk of dementia in a prospective cohort of 469 subjects older than 75 years of age who resided in the community and did not have dementia at base line. We examined the frequency of participation in leisure activities at enrollment and derived cognitive-activity and physical-activity scales in which the units of measure were activity-days per week. Cox proportional-hazards analysis was used to evaluate the risk of dementia according to the base-line level of participation in leisure activities, with adjustment for age, sex, educational level, presence or absence of chronic medical illnesses, and base-line cognitive status.

Results Over a median follow-up period of 5.1 years, dementia developed in 124 subjects (Alzheimer's disease in 61 subjects, vascular dementia in 30, mixed dementia in 25, and other types of dementia in 8). Among leisure activities, reading, playing board games, playing musical instruments, and dancing were associated with a reduced risk of dementia. A one-point increment in the cognitive-activity score was significantly associated with a reduced risk of dementia (hazard ratio, 0.93 [95 percent confidence interval, 0.90 to 0.97]), but a one-point increment in the physical-activity score was not (hazard ratio, 1.00). The association with the cognitive-activity score persisted after the exclusion of the subjects with possible preclinical dementia at base line. Results were similar for Alzheimer's disease and vascular dementia. In linear mixed models, increased participation in cognitive activities at base line was associated with reduced rates of decline in memory.

Conclusions Participation in leisure activities is associated with a reduced risk of dementia, even after adjustment for base-line cognitive status and after the exclusion of subjects with possible preclinical dementia. Controlled trials are needed to assess the protective effect of cognitive leisure activities on the risk of dementia.

Source Information

From the Einstein Aging Study (J.V., R.B.L., M.J.K., C.B.H., C.A.D., G.K., M.S., H.B.) and the Departments of Neurology (J.V., R.B.L., C.B.H., C.A.D., G.K., H.B.), Epidemiology and Social Medicine (R.B.L., C.B.H.), and Physical Medicine and Rehabilitation (A.F.A.), Albert Einstein College of Medicine, Bronx, N.Y.; and the Department of Psychology and the Center for Health and Behavior, Syracuse University, Syracuse, N.Y. (M.S.).

Address reprint requests to Dr. Verghese at the Einstein Aging Study, Albert Einstein College of Medicine, 1165 Morris Park Ave., Bronx, NY 10461, or at jverghes{at}aecom.yu.edu.

Full Text of this Article

Related Letters:

Leisure Activities and the Risk of Dementia
Vinkers D. J., Gussekloo J., Westendorp R. G.J., Epstein E. F., Verghese J., Kuslansky G., Lipton R. B.
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N Engl J Med 2003; 349:1290-1292, Sep 25, 2003. Correspondence

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