Relationships between cognitive leisure activities and cognitive function in older adults with depressive symptoms: a cross-sectional study

Moderating role of depression in the association between leisure activity and cognitive function among the disabled older people

Background

This study delves into the complex interaction between leisure activities and cognitive function in older people with disabilities, with a particular emphasis on the moderating influence of depression. Despite the well-documented cognitive benefits of leisure activities among the older people, the intricate relationship between depression and the association between leisure activities and cognitive function in this specific demographic has been rarely reported.

Methods

Drawing on data from the 2017-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study meticulously examined a cohort of 713 participants aged 65-89 years. We constructed a moderation model to examine the impact of leisure activity on cognitive function in older people with disabilities, with depression levels as a moderating variable.

Results

We found a positive association between engagement in leisure activities and cognitive function, highlighting the potential cognitive advantages associated with leisure engagement among disabled older people. However, the present analysis also reveals a significant moderation effect of depression on this relationship, shedding light on the nuanced nature of this association. Specifically, elevated levels of depression emerge as a critical moderator, attenuating the otherwise favorable impact of leisure activities on cognitive function among older people contending with disabilities.

Conclusion

In conclusion, the findings provide a compelling rationale for tailored interventions that comprehensively target both leisure activity engagement and concurrent depression management, effectively fostering improvements in cognitive function among the cohort of disabled older people.

The mediating effect of leisure activities in the relationship between depression and cognitive decline in middle age and older adults in Taiwan

BACKGROUND

Depression can affect the development of cognitive functions, and there are many people with depressive symptoms and cognitive decline in the aging population. The role of mediators between depressive symptoms and the subsequent cognitive decline remains unclear. We aimed to investigate whether depressive symptoms can slow down cognitive decline through a mediator.

METHODS

A total of 3,135 samples were collected in 2003, 2007, and 2011. This study used the CES-D10 and SPMSQ (Short Portable Mental State Questionnaire) to measure depression and cognitive functions. The effect of depression trajectory on the subsequent cognitive dysfunction was analyzed using multivariable logistic regression, and the mediating effect was analyzed using the Sobel test.

RESULTS

The results of the multivariable linear regression analysis showed that after including different variables in each model, such as leisure activities and mobility in 2003 and 2007, women had a higher percentage of depressive symptoms in each model, compared to men. The effect of depression in 2003 on cognitive decline in 2011 was mediated by intellectual leisure activities in 2007 in men (Z=-2.01) and physical activity limitation in 2007 in women (Z=-3.02).

CONCLUSIONS

The mediation effect of this study shows that people with depressive symptoms will reduce their participation in leisure activities, which will lead to the degeneration of cognitive function. We suggest that if depressive symptoms are addressed as early as possible, people will have the ability and motivation to delay the decline of cognitive function through participation in leisure activities.

The moderating effect of cognitive function on the association between social support and depressive symptoms among community-dwelling older adults: Cross-sectional and longitudinal analyses

BACKGROUND

The moderating effect of cognitive function on the association between social support and late-life depressive symptoms has not been thoroughly investigated. Identifying cognitive function as a possible moderator of this association might help plan community-based interventions for late-life depressive symptoms.

METHODS

Participants were community-dwelling older adults who visited a community-based mental health center. The ENRICHD Social Support Instrument and the Montgomery-Asberg Depression Rating Scale were used to evaluate social support and depressive symptoms, respectively. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination. Data from 1088 and 506 participants were included in the cross-sectional and longitudinal analyses, respectively. Multiple linear regression analysis was performed to assess the effects of social support on depressive symptoms and the possible moderating effect of cognition.

RESULTS

After adjusting for possible confounders, greater social support at baseline was associated with fewer depressive symptoms in both cross-sectional (estimate = -0.25 standard error [SE] = 0.03, P < 0.001) and longitudinal analyses (estimate = -0.11, SE = 0.05, P = 0.014). Moreover, the association between social support and depressive symptoms was significantly moderated by cognitive function (P for interaction < 0.001 for cross-sectional analysis, and P for interaction = 0.011 for longitudinal analysis).

LIMITATIONS

The tool for assessing social support was self-reported. There may have been a selection bias in the study sample.

CONCLUSIONS

Greater social support was associated with fewer late-life depressive symptoms in both analyses. However, social support may have less benefits for alleviating depressive symptoms in older adults with cognitive decline.

Playing a musical instrument and the risk of dementia among older adults: a systematic review and meta-analysis of prospective cohort studies

Background

Engaging in leisure activities was suggested to protect older adults from dementia. However, the association between playing a musical instrument and the risk of dementia is not well-established. This study aimed to investigate this association in older adults using a systematic review and meta-analysis of prospective cohort studies.

Methods

Pooled hazard ratio (HR) and 95% confidence interval (CI) of having dementia for older adults playing a musical instrument were calculated using the random-effects model. We performed the I² statistic to detect heterogeneity across studies and the test for funnel plot asymmetry to assess publication bias. The risk of bias assessment was conducted using the modified Newcastle–Ottawa Scale.

Results

A total of three prospective cohort studies were found eligible: two from the U.S. and one from Japan. Playing a musical instrument, in the meta-analysis, was significantly associated with a decreased risk of dementia (HR = 0.64; 95% CI: 0.41, 0.98) among older adults. No signs of significant heterogeneity across studies (I² = 23.3% and p-heterogeneity = 0.27) or publication bias (z= -1.3 and p-publication bias = 0.18) were identified.

Conclusion

Playing a musical instrument was associated with a decreased risk of dementia among older adults. Older adults should be encouraged to engage in leisure activities, especially playing musical instruments.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12883-022-02902-z.

Effect of living arrangements on cognitive function in Chinese elders: a longitudinal observational study

OBJECTIVE

To examine how living arrangement as a social contextual factor can affect Chinese elders' cognitive function.

SETTING AND PARTICIPANTS

Our sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China's 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80-112 in China.

OUTCOME MEASURES

Cognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement was divided into living in an institution, living alone and living with household members. Generalised linear regressions were carried out to examine the associations between baseline characteristics and cognitive function, while controlling age, gender and residential area.

RESULTS

A total of 2486 participants were included in the study at baseline in 2014. Of these, 1162 (46.7%) were men and 1324 (53.3%) were women. The mean age at baseline was 75.07 (±8.31) years. The mean years of schooling were 2.86 (±3.68). The number (proportion) of the three living arrangements (lived in institutions, lived alone and lived with household members) were 93 (3.8%), 463 (18.6%) and 1930 (77.6%), respectively. Among all participants, cognitive function declined over time. Those who lived alone presented with the highest MMSE scores at baseline and showed the lowest decline after 4 years. Living arrangements had significant effects on decreasing cognitive function.

CONCLUSION

Chinese elders living in institutions were most vulnerable to cognitive decline. Living alone was not a risk condition in itself for the elderly in terms of cognitive decline. In addition, the benefits of living with household members to support cognitive function were not found in our study.

Preventive Measures against the Development of Dementia in Old Age

Dementia is a neurological condition characterized by numerous types of central nervous system diseases, which gradually deteriorates an individual’s reasoning, rational thinking, and judgment abilities. As a serious public health concern that currently affects more than 50 million older adults, dementia is one of the most significant causes of incapacity, disability, and dependency among older adults. As new cases are expected to increase exponentially in the next three decades, dementia, which is not a normal feature of healthy aging despite the fact that it generally affects older adults disproportionately, requires enormous management and care efforts due to its associated socioeconomic, psychological, and physical burdens that involve the patient, their caregivers, guardians, family members, and society at large. Presently, there is no cure for dementia; however, this condition could be prevented. This narrative review aimed to provide a broad overview of studies detailing the alternative lifestyle modification-centered preventive measures against dementia. A comprehensive search of key databases to find articles related to this topic revealed that participating in regular physical activities, healthy eating and dieting, avoiding all forms of smoking, avoiding air pollutants, halting or reducing alcohol consumption, exercising the mind and being socially dynamic, getting enough rest and establishing good sleeping habits, infection prevention, stress prevention, avoidance of injuries, preventing the effects of social isolation and lockdowns, continuing education, and depression prevention are protective measures against the development of dementia.

An Overview of Social Participation in Older Adults: Concepts and Assessments

In older adults, social participation is an important component of rehabilitation and health promotion. Several studies have attempted to describe the definition and concepts of social participation, and there were many outcomes to measure social participation. This overview provides information about representative social participation and related concepts that have been defined in the literature. A standardized definition of social participation has not been developed; commonly, recognition for social participation was proposed as focused on involvement in social activities that provide interaction with others in a society or community. Many instruments assess the various aspects of social participation. Because of operational definition and diversity in social participation, performance in social participation was adopted as an aspect of assessment. Further discussions are needed to clarify the definition of social participation and evaluate the instruments used to assess social participation for it to be useful for rehabilitation and health promotion. In doing so, determining and developing assessment and intervention based on the purpose or perspective of social participation in older adults with and without disabilities is important.

Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study

OBJECTIVES

This study aimed to investigate the relationship between disability and domain-specific cognitive function in older adults with chronic obstructive pulmonary disease (COPD).

DESIGN

Cross-sectional analyses combined with retrospective longitudinal analyses.

SETTING

We included 450 communities in China.

PARTICIPANTS

In this study, 1022 (mean age: 68.6±6.3; 612 males) and 152 (mean age: 67.0±5.2; 83 males) older adults with COPD from the China Health and Retirement Longitudinal Study were included in a cross-sectional multivariate linear regression analysis and a longitudinal logistic regression analysis, respectively.

OUTCOME MEASURES

Disability was determined by the difficulty or inability to complete 1 of the 12 activity items in basic activities of daily living (ADL) and instrumental ADL. The cognitive dimensions of episodic memory, attention/numerical ability, orientation to time, and visuospatial ability were assessed via the immediate/delayed recall task, serial sevens task, naming the current date and pentagon-figure-drawing tasks, respectively.

RESULTS

Of 1022 older respondents with COPD at wave-4, 48.5% had ADL disability. Declines in the global cognitive function (β (95% CI)=-0.627 (-1.214 to -0.040)), orientation to time (β (95% CI)=-0.207 (-0.364 to -0.050)) and visuospatial ability (β (95% CI)=-0.068 (-0.127 to -0.009)) were significantly associated with the presence of ADL disability, when demographic and health-related variables were adjusted. Of 152 older participants with COPD and without ADL disability in wave-2, 61 (40.1 %) developed disability over a 2-year follow-up. Relative to the participants without a decline in orientation to tine, those with the condition had greater odds of incidence of ADL disability increased by a factor of about 1.46 over a 2-year follow-up.

CONCLUSIONS

In older adults with COPD, orientation to time and visuospatial inability are vulnerable to the presence of a disability. Prevention of a decline in orientation to time might help prevent disability in older people with COPD.