A number of studies have suggested that participating in leisure activities like playing cards or watching movies may help to lower the risk of Alzheimer’s disease and other forms of dementia. But a large new British study of older men and women suggests another explanation: people who stop participating in these activities may be showing early signs of dementia. The activities may not be preventive at all; rather, it’s just that people who are not demented continue to participate in them because they still enjoy and are able to perform them, making it look like the activities are what’s keeping them cognitively healthy.
The study looked at 8,280 people who were followed for an average of 18 years, starting in their mid-50s. They filled out questionnaires detailing their leisure time activities, and how frequently they typically performed them during the week. They also completed follow-up questionnaires on leisure activities five and 10 years later.
The researchers assessed a variety of leisure activities, asking participants, “In your spare time are you involved in any of the following activities” and “how often have you taken part in these activities in the last 12 months?” The activities included:
- Reading or listening to music
- Using a home computer for leisure activities
- Taking educational courses or evening classes
- Being involved in clubs or organizations
- Visiting galleries, or going to plays, movies or live music events
- Playing cards, bingo, chess or other social games
- Doing hand crafts like pottery or drawing
- Going to church or participating in church activities
- Socializing at bars or social clubs
- Visiting friends or relatives
During the study, 360 people developed Alzheimer’s disease or other forms of dementia. The researchers found no relationship between taking part in more leisure activities at the beginning of the study, when people were in their mid-50s, and having a lower dementia risk nearly 20 years later.
When leisure activity participation was assessed later in life, however, the researchers did find an association between leisure activities and dementia risk. People who took part in more leisure activities at the average age of 66 were less likely to have dementia diagnosed over the next eight years than people who had lower participation.
With every one standard deviation increase in leisure activities, equivalent to doing about three new leisure activities monthly or two activities weekly, people were 18 percent less likely to be diagnosed with dementia eight years later. These results took into account other factors that could affect risk of dementia, such as diabetes, high blood pressure and body mass index.
The researchers also found that some people who are later diagnosed with dementia stopped participating in leisure activities years before they are diagnosed.
“Our study suggests that changes in the amount of leisure activity may be an early sign of dementia, possibly due to symptoms such as apathy or other social changes or early cognitive difficulties,” said study author Andrew Sommerlad, of University College London. “It’s plausible that people may slow down their activity level up to 10 years before dementia is actually diagnosed, due to subtle changes and symptoms that are not yet recognized.” Doctors increasingly recognize that subtle signs of Alzheimer’s may occur years before memory loss and other hallmark symptoms of the disease become evident. This reduction in the amount of leisure activity might further accelerate the deterioration of cognitive functions.
“Simply increasing leisure activity, however, may not be a strategy for preventing dementia,” Dr. Sommerlad said. “Of course, there are many reasons to participate in leisure activities, and this finding does not question the importance of keeping active for general health and well-being.”
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University
Source: Andrew Sommerlad, PhD; Séverine Sabia, PhD; Gill Livingston, MD; et al: “Leisure activity participation and risk of dementia: 18 year follow-up of the Whitehall II Study.” Neurology, October 28, 2020