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Cognitive leisure and dementia risk: evidence beyond reverse causation
Thibault Mura1,2,3, Marie-France Malcher2, Laure-Anne Gutierrez2
1Department of Biostatistics, Epidemiology & Public Health, University Hospital Centre Nimes, Nimes, Occitanie, France.
Age and Ageing
|October 9, 2025
Summary
Engaging in cognitive leisure activities (CLA) in later life significantly lowers dementia risk, even when accounting for cognitive reserve and reverse causation. Promoting these activities is key for dementia prevention in older adults.
Area of Science:
- Neuroscience
- Gerontology
- Public Health
Background:
- Cognitive leisure activities (CLA) may reduce dementia risk, but studies are limited by reverse causation and unmeasured cognitive reserve.
- Investigating the link between CLA and dementia requires methods that address these confounding factors.
Purpose of the Study:
- To examine the association between cognitive leisure activities (CLA) and incident dementia.
- To account for reverse causation and lifelong cognitive enrichment in the CLA-dementia relationship.
Main Methods:
- Prospective cohort study with 3326 participants aged 65+, followed for 12 years with a 7-year exposure-outcome time lag.
- Assessed CLA frequency at baseline, categorizing engagement into low, moderate, and high.
- Used Cox models adjusted for socio-demographic, health, and genetic factors (APOE ε4) to determine dementia and Alzheimer's disease (AD) risk.
Main Results:
- Moderate and high CLA engagement were associated with significantly lower dementia risk (HRs 0.50 and 0.53, respectively).
- High CLA engagement also correlated with reduced Alzheimer's disease (AD) risk (HRs 0.35 and 0.45, respectively).
- Frequent engagement in crosswords and artistic activities showed the strongest protective associations against dementia.
Conclusions:
- Cognitive leisure activities (CLA) in late life are linked to reduced dementia risk, independent of cognitive reserve and reverse causation.
- Promoting cognitive leisure activities is a potential strategy for dementia prevention in older adults.
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