Cognitively stimulating activities reduce dementia risk in the elderly

In a recent study published in JAMA Network Open, researchers investigate the relationship between social networking, leisure activities, and dementia risks in older adults.

Study: Lifestyle Enrichment in Later Life and Its Association With Dementia Risk. Image Credit: belushi / Shutterstock.com

The impact of lifestyle on dementia risk

Older adults with dementia face significant challenges in their physical and mental health as their cognitive function declines. Current treatments for dementia are ineffective, which prompts the need for new strategies to prevent or delay its onset.

Lifestyle enrichment with stimulating activities can increase cognitive reserves and reduce dementia risk by promoting well-being through the stimulation of neuron growth and synapses. However, previous studies have often focused on individual activities or a single composite score, rather than considering health status and education.

About the study

The present study utilized data obtained from the Aspirin in Reducing Events in the Elderly (ASPREE) Longitudinal Study of Older Persons (ALSOP) study, which was conducted between March 1, 2010, and November 30, 2020. The study participants included healthy community residents of Australia 70 years of age or older without any major cognitive impairments or cardiovascular diseases.

Data obtained between December 1, 2022, and March 31, 2023 was considered for the analysis. The study exposures comprised 19 measures of social networks and leisure activities evaluated at study initiation and were categorized by performing Exploratory Factor Analysis (EFA). The main outcome measure was dementia, which was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria.

Cox proportional-type hazards regression modelling was used to calculate the adjusted hazard ratios (AHRs) for the risk of dementia over 10 years. Adjustments were made for age, ethnicity, race, sex, socioeconomic status, education, alcohol intake, smoking habits, body mass index (BMI), physical fitness, and comorbidities such as diabetes, hypertension, depression, and dyslipidemia.

Data on mentally and socially stimulating activities and social networks were collected through ALSOP questionnaires, which were distributed in the initial year of the ASPREE trial. To minimize reverse causality, a sensitivity analysis was performed by excluding individuals with a dementia diagnosis and those who were lost to follow-up in the initial three years and by adjusting for baseline cognition.

Study findings

The current study consisted of 10,318 individuals with a median age of 74 years, 53% of whom were female and 98% self-reported as White. In the adjusted analysis, frequent involvement in literacy tasks such as journaling or writing letters, using computers, and attending educational workshops and in active-type mentally stimulating activities such as playing cards, chess, or games and solving puzzles or crosswords was related to 11% and 9% lower dementia risks, respectively.

Likewise, participation in creative arts such as woodwork, metalwork, or craftwork, and drawing or painting , as well as in passive mentally stimulating activities such as reading newspapers, magazines, or books, listening to radio or music, and watching television was associated with a reduced risk of dementia. Comparatively, social activities, external outings, and interpersonal networks were unrelated to the risk of dementia.

The factor analysis indicated that seven factors accounted for 70% of the variations in the outcome measures including social activities, external outings, interpersonal networks, creative arts, adult literacy, and active or passive mentally stimulating activities.

The number of close friends was significantly influenced by social activities and interpersonal networks. The sensitivity analyses showed similar findings as the primary analysis, except for the results for passive mental activities, which became insignificant.

Active mental activities and adult literacy were most strongly associated with decreased dementia risks, thus indicating that these activities provide more cognitive stimulation. These activities include logical reasoning, critical thinking, social contact, and proactive involvement. Cognitive stimulation from these types of activities can support brain resilience by increasing the number of neurons, improving synaptic activity, and allowing for greater efficiency in utilizing brain networks.

Adult literacy includes class attendance, computer use, and writing, all of which require the processing and storing of new knowledge, slowed neurobiological aging, and protection against dementia. Writing is a complicated process of information production that involves converting thoughts into texts and utilizing cognitive capacities.

The use of an interactive interface on a computer requires the synchronization of multiple brain regions with fine motor abilities such as typing and mouse movement. Adopting new technology is also a cognitively demanding process that requires study and practice.

Active mental tasks are competitive, as they require complicated tactics and problem-solving abilities and employ several cognitive domains such as episodic memory, visuospatial abilities, computation, executive function, attention, and concentration. Crossword puzzles utilize language skills and semantic memory to solve linguistic and verbal difficulties by utilizing prior information.

Conclusions

Engaging in adult literacy, creative art, and active and passive mental activities could aid in lowering dementia risk at later ages. These findings could guide policymaking and strategy development targeting dementia prevention for the elderly.

Written by

Pooja Toshniwal Paharia

Dr. based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.