Armstrong Nicole M, Tom Sarah E, Harrati Amal, Casaletto Kaitlin, Pa Judy, Arce Rentería Miguel, Gu Yian, Rajan Kumar B, Schupf Nicole, Fieo Robert, Weuve Jennifer, Simonsick Eleanor M, Manly Jennifer J, Stern Yaakov, Zahodne Laura B
Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA.
Gerontologist. 2022 Mar 28;62(3):352-363. doi: 10.1093/geront/gnab046.
Leisure activity engagement (LAE) may reduce the risk of incident dementia. However, cognitive performance may predict LAE change. We evaluated the temporal ordering of overall and subtypes of LAE (intellectual, physical, and social) and cognitive performance (global, language, memory, and visuospatial function) among non-demented older adults.
The Washington Heights-Inwood Columbia Aging Project concurrently administered a survey measure of 13 leisure activities and a neuropsychological battery every 18-24 months for up to 14 years to 5,384 racially and ethnically diverse participants. We used parallel process conditional latent growth curve models to examine temporal ordering in the overall sample and within baseline diagnostic groups (mild cognitive impairment [MCI] vs. cognitively normal).
Levels and changes of overall and subtypes of LAE were positively correlated with cognitive performance in the overall sample and within each diagnostic group. In the overall sample, higher initial memory was associated with slower declines in social LAE (estimate = 0.019, 95% confidence interval [95% CI]: 0.001-0.037). Among MCI, higher initial physical LAE was associated with slower declines in memory (estimate = 0.034, 95% CI: 0.001-0.067), but higher initial intellectual LAE was related to steeper declines in visuospatial function (estimate = -0.028, 95% CI: -0.052 to -0.004). Among cognitively normal, higher initial memory was associated with slower declines in intellectual LAE (estimate = 0.012, 95% CI: 0.002-0.022).
Dynamic interplay of LAE with cognitive performance was observed across diagnostic groups. Levels of LAE subtypes could be more predictive of change in certain cognitive domains within older adults with MCI.
参与休闲活动（LAE）可能会降低患痴呆症的风险。然而，认知表现可能预测LAE的变化。我们评估了非痴呆老年人中总体LAE及其亚型（智力、身体和社交方面）与认知表现（整体、语言、记忆和视觉空间功能）的时间顺序。
华盛顿高地-因伍德哥伦比亚衰老项目每18至24个月对5384名种族和民族多样的参与者同时进行一次包含13项休闲活动的调查测量和一次神经心理测试，持续长达14年。我们使用平行过程条件潜在增长曲线模型来研究总体样本以及基线诊断组（轻度认知障碍[MCI]与认知正常）内的时间顺序。
在总体样本和每个诊断组中，LAE的总体水平及亚型的水平和变化与认知表现呈正相关。在总体样本中，较高的初始记忆与社交LAE较慢的下降相关（估计值 = 0.019，95%置信区间[95%CI]：0.001 - 0.037）。在MCI患者中，较高的初始身体LAE与记忆较慢的下降相关（估计值 = 0.034，95%CI：0.001 - 0.067），但较高的初始智力LAE与视觉空间功能更快的下降相关（估计值 = -0.028，95%CI：-0.052至-0.004）。在认知正常者中，较高的初始记忆与智力LAE较慢的下降相关（估计值 = 0.012，95%CI：0.002 - 0.022）。
在各诊断组中均观察到LAE与认知表现之间的动态相互作用。LAE亚型的水平可能更能预测MCI老年人某些认知领域的变化。
