In a study of leisure activities undertaken by ASPREE participants, using computers, writing, and playing puzzles or games showed the strongest association with avoiding dementia, followed by crafting activities like knitting or painting.
The findings – some of the most robust on this topic to date – may help older individuals and aged care professionals plan more targeted approaches to reducing dementia risk.
In 2022, there were 55 million people worldwide living with dementia, with 10 million new cases emerging each year. Dementia impacts the physical and mental health of those afflicted, and the wellbeing of their carers and families.
The Monash University-led research, which draws on ASPREE data, found participants who routinely engaged in literacy and mental acuity tasks such as taking education classes, keeping journals, and doing crosswords were 9-11% less likely to develop dementia than their peers. Creative pursuits such as crafting conferred a 7% decrease in risk.
In contrast, the size of someone’s social network and the frequency of external outings to the cinema or restaurant were not at all associated with dementia risk reduction. However, some leisure activities already have a social component.
The link between leisure activity and dementia risk was unaffected by gender, years of formal education or socio-economic status.
Above: A/Prof Joanne Ryan
The study’s senior author, A/Prof Joanne Ryan, Co-Principal Investigator to ASPREE-XT in Australia, says the ASPREE project is uniquely positioned to help identify ways to prevent or delay dementia.
“Unlike most studies that focus on just one or two specific leisure activities, this study looked at a range of activities many older people undertake and took into account individuals’ formal education and health,” says A/Prof Ryan.
“Identifying strategies to prevent or delay dementia is a huge global priority. We had a unique opportunity to close a gap in knowledge by investigating a broad range of lifestyle enrichment activities that older people often undertake, and assess which of those were most strongly aligned with avoiding dementia.”
There’s already good evidence on the strong links between early-life education and reduced dementia risk in later life. But most studies on older people focus on just one or two specific leisure activities, rather than the spectrum of activities many older people undertake, and even fewer studies have taken into account individuals’ education and health status.
This study involved 10,318 Australian ASPREE participants, aged 70 and older, who reported social and life-enriching activities in ALSOP (ASPREE Longitudinal Study of Older Persons) sub-study questionnaires. Activities reported by participants include taking adult education classes, keeping a journal, and completing quizzes and crosswords, more passive activities such as keeping up with the news or reading, creative hobbies such as woodworking or knitting, and social activities such as meeting friends or going on planned excursions.
No significant variations were found between men and women, who were all without dementia at enrolment into ASPREE, and underwent standardised cognitive (thinking and memory) measures over a 10-year period.
Prior neurobiological research may shine some light on the mechanisms driving the results.
Many active literacy and mental acuity activities combine critical thinking, logical reasoning, and social interaction. These build resilience against brain disorders by increasing neuronal and synaptic connectivity, and driving efficiency in brain networks.
Literacy activities (such as education class attendance, computer usage and writing) require the processing and storage of new information, which helps slows brain ageing and protects against dementia. Writing is a particularly complex process utilising a broad swathe of cognitive functions.
Computer use engages multiple brain regions that must coordinate with the motor skills used when typing, and adopting new technologies is a cognitively challenging process.
Mental activities such as crosswords and puzzles, and playing games/cards/chess, often also involve a social interaction component. They’re sometimes competitive, and involve complex strategies and problem-solving. They typically engage a variety of cognitive domains, including episodic memory, visuospatial skills, calculation, executive function, attention and concentration, language skills, and semantic memory.
“I think what our results tell us is that active manipulation of previously stored knowledge may play a greater role in dementia risk reduction than more passive recreational activities,” says A/Prof Ryan. “Keeping the mind active and challenged may be particularly important.”
The results don’t completely rule out the fact that people who are naturally drawn to these leisure activities may possess specific personality traits that are otherwise beneficial, or they may generally stick to better health behaviours.
Therefore, despite any structural brain changes arising after cognitive training, it remains difficult to prove the extent to which particular leisure activities can be translated into dementia prevention programs.
Additionally, social connection may still be quite important to cognitive health and mental wellbeing, even though it didn’t show a clear link with dementia risk in the study. The participants were cognitively healthy, and were likely already leading socially active lives, such that the cognitive benefits of strong social networks may be less obvious in this group compared to the general public.
“While engaging in literacy and mental acuity activities may not be a magic pill to avoid dementia, keeping the mind active and challenged maybe particularly important to ward off dementia, in addition to lifestyle choices, such as regular exercise, a good diet and not smoking,” says A/Prof Ryan.
Article details:
Wu Z, Pandigama DH, Wrigglesworth J, et al. Lifestyle Enrichment in Later Life and Its Association With Dementia Risk. JAMA Netw Open. 2023;6(7):e2323690. doi:10.1001/jamanetworkopen.2023.23690
This article is modified version of an article published by Monash University. Images by Vlad Sargu and Centre for Ageing Better, Unsplash