Leisure Participation and Cognitive Impairment Among Healthy Older Adults in China

Association of leisure activity changes and reversion from mild cognitive impairment to normal cognitive function among older adults: A prospective cohort study

Background

Older adults with mild cognitive impairment (MCI) have the possibility of reverting to normal cognitive function. Leisure activity engagement (LAE) plays a critical role in the progress of the cognitive function. A better understanding of the dynamic relationship between LAE and MCI reversion would inform the implementation of preclinical dementia interventions. This study aimed to investigate the association between change patterns of LAE and MCI reversion among older adults using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database.

Study design

Longitudinal population-based study.

Methods

Older adults with MCI at the baseline were enrolled in this study. Information about cognitive function, overall, cognitively stimulating, physically active/demanding, and socially engaged LAE was collected at baseline and follow-up. Adjusted hazard ratios (HRs) for reversion and 95% confidence intervals (CIs) were calculated by Cox hazard models with time as the underlying time metric. We also assessed potential effect modifications by creating a cross-product of the stratifying variable with LAE change patterns in the fully adjusted model.

Results

The restricted cubic spline showed that the association between LAE change scores and MCI reversion rate was statistically significant and nonlinear (p<0.01). Taking participants in the low-low group as a reference, participants in the low-medium, low-high, medium-medium, medium-high, high-medium, and high-high groups had increased possibilities of MCI reversion with HRs (95% CI) of 2.19 (1.57-3.06), 2.97 (2.13-4.13), 0.87 (0.64-1.19), 2.28 (1.71-3.03), 2.78 (2.10-3.69), 1.93 (1.43-2.59), and 2.74 (2.09-3.60), respectively. Further stratified models showed that the impact of LAE change patterns on MCI reversion varied in different ages (nonagenarian, octogenarian, and younger elderly) and gender.

Conclusions

Participants who maintained the highest LAE had the greatest possibility of MCI reversion. Meanwhile, a higher level of LAE maintenance was associated with the increased possibility of MCI reversion. These results provide a practical message to older adults about how dynamic changes in LAE are associated with improved cognitive function.

Changes in leisure activities of the elderly due to the COVID-19 in Korea

Recreational activities such as physical and social activities are key components of a healthy life for the elderly. Since the outbreak of Corona 19, leisure facilities such as indoor sports facilities, religious facilities, and cultural facilities have been closed, and group activities such as volunteer activities and clubs are also being held under control. These measures are expected to bring about many changes in the leisure activities of the elderly. In this study, an empirical analysis was made on how COVID-19 caused changes in leisure activities of the elderly using national statistical data. For the data analysis, raw data of the "2019 National Leisure Activities Survey" and "2020 National Leisure Activities Survey" conducted by the Ministry of Culture, Sports and Tourism were used, and data of a total of 5,069 elderly people were analyzed. As for the analysis method, the changes in leisure activities of the elderly before and after COVID-19 in terms of participation rate were compared and analyzed. In addition, the changes in leisure activities of the elderly in terms of the type of leisure activities were examined before and after COVID-19 as well. As a result of the analysis, the participation rate in sports activities, hobbies and entertainment activities, and leisure activities increased, while the participation rates in culture and art viewing and participation activities, sports viewing activities, tourism activities, and social activities decreased. In particular, it was found that the proportion of the elderly spending leisure time centered on active and social activities decreased, and the proportion of the elderly consuming leisure time centered on passive activities increased. As a result, it was found that the leisure activities of the elderly are changing passively due to COVID-19. Leisure support policies for active leisure activities of the elderly are likely to be necessary.