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Leisure activities at old age and their influence on dementia development
Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.ORCID iD: 0000-0002-1968-2326
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis aims to describe the participation in leisure activities of elderly subjects and to detect their possible effect, if any, on the development of dementia. The data were derived from the Kungsholmen Project, which is a community-based prospective study on aging and dementia in people aged over 74 years, living in Stockholm, Sweden. The major findings are summarized below. Study I. The pattern of participation in leisure activities was related to contextual factors as well as to mental and physical health conditions. In spite of the advanced age, the majority of the population was active, as 70% participated in at least one activity. Reading (19%) was the most prevalent individual activity, and mental activities (43%) the most prevalent activity type. Older age, female gender, low education, poor or limited social network, mental disorders, and physical limitation were all correlated with a decreased engagement in at least one activity . Contextual factors and health-related factors were differentially associated with the five activity types. Study II. We aimed to verify the hypothesis that mental, social and physical components are relevant protective factors against dementia, and that a combined beneficial effect may be present over a 6-year follow-up period. Multi-adjusted relative risks (RRs) of dementia for subjects with higher mental, physical and social component scores were 0.71 (95% CI: 0.49 1.03), 0.61 (95% CI: 0.42 0.87) and 0.68 (95% CI: 0.47 0.99), respectively. The most beneficial effect was present for subjects with high scores in all or in two of the components (RR of dementia=0.53; 95% CI: 0.36 0.78). Study III. The hypothesis that an active lifestyle may protect against dementia development was further tested by using principal component analysis to characterize the exposure. Among a set of lifestyle variables, three underlying factors were identified: physical, mental and social factors. All the factors showed an independent protective effect on dementia development. The relative risks (RRs) ranged from 0.60 to 0.70. When these factors were integrated into an Active Lifestyle Index, a significant dose-response association was observed, Compared with low level of engagement (low in at least two of the factors), the RR of dementia was 0.66 (95% CI: 0.49-0.89) for the moderate level (high scores in two factors), and RR=0.51 (95% CI: 0.31-0.85) for the high level (high scores in all three factors). Study IV. The hypothesis that an active lifestyle delays the dementia onset was verified over a 9-year follow-up period. The lifestyle factors of the mental, social and physical component scores estimated in a previous study (study II) were studied in relation to age at dementia onset. Results showed that dementia developed at a significantly later age in individuals who had a higher level of participation in activities with high physical, mental or social components. When the three components were integrated, we found that the broader spectrum of participation (higher levels in at least two of the components) the later the age at dementia onset (β 0.62; P<0.01). Conclusions. Even in the advanced age, elderly persons are still active, being limited in their participation only by mental disorders or by physical limitation. An active lifestyle, defined as a higher level of participation in leisure activities with either mental, social or physical component may decrease the risk of dementia and postpone its onset.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet , 2009. , 59 p.
Keyword [en]
Demens
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:rkh:diva-1049ISBN: 9789174094022 (print)OAI: oai:DiVA.org:rkh-1049DiVA: diva2:749781
Available from: 2014-09-25 Created: 2014-09-17 Last updated: 2015-01-28Bibliographically approved
List of papers
1. Pattern of participation in leisure activities among older people in relation to their health conditions and contextual factors: a survey in a Swedish urban area
Open this publication in new window or tab >>Pattern of participation in leisure activities among older people in relation to their health conditions and contextual factors: a survey in a Swedish urban area
2009 (English)In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, ISSN 0144-686X, Vol. 29, no 5, 803-821 p.Article in journal (Refereed) Published
Abstract [en]

The objective of this study is to describe the pattern of participation in leisure activities in an older population in relation to contextual factors as well as to mental and physical health. A cohort of 1,623 participants aged 75 or older living in Stockholm, Sweden was asked to list all the leisure activities they were engaged in. These were successively organised into 31 major categories and further grouped into mental, social, physical, productive and recreational types. The pattern of participation was examined in relation to age, gender, contextual factors (education, social network) and health status (depressive symptoms, cognitive impairment, dementia, somatic diseases and physical limitation). In spite of their advanced age, the majority of the population was active, as 70 per cent had participated in at least one activity. Reading (19%) was the most prevalent individual activity, and mental activities (43%) the most prevalent activity type. Older age, female gender, low education status, having a poor or limited social network, mental disorders, and physical limitation, were all factors correlated with a decreased engagement in 'at least one activity '. Contextual factors and health-related factors were related to the five activity types in different ways. The pattern of participation in leisure activities is associated with multiple factors and their recognition is essential to the facilitation of an active lifestyle in the older population

Keyword
leisure activities, mental disorders, physical limitation, elderly population
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-370 (URN)10.1017/S0144686X08008337 (DOI)
Available from: 2012-09-26 Created: 2012-09-26 Last updated: 2015-01-28Bibliographically approved
2. Mental, physical and social components in leisure activities equally contribute to decrease dementia risk
Open this publication in new window or tab >>Mental, physical and social components in leisure activities equally contribute to decrease dementia risk
Show others...
2006 (English)In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, ISSN 1420-8008, Vol. 21, no 2, 65-73 p.Article in journal (Refereed) Published
Abstract [en]

Background: There is accumulating evidence in the literature that leisure engagement has a beneficial effect on dementia. Most studies have grouped activities according to whether they were predominantly mental, physical or social. Since many activities contain more than one component, we aimed to verify the effect of all three major components on the dementia risk, as well as their combined effect. Methods: A mental, social and physical component score was estimated for each activity by the researchers and a sample of elderly persons. The correlation between the ratings of the authors and the means of the elderly subjects' ratings was 0.86. The study population consisted of 776 nondemented subjects, aged 75 years and above, living in Stockholm, Sweden, who were still nondemented after 3 years and were followed for 3 more years to detect incident dementia cases. Results: Multi-adjusted relative risks (RRs) of dementia for subjects with higher mental, physical and social component score sums were 0.71 (95% CI: 0.49-1.03), 0.61 (95% CI: 0.42-0.87) and 0.68 (95% CI: 0.47-0.99), respectively. The most beneficial effect was present for subjects with high scores in all or in two of the components (RR of dementia = 0.53; 95% CI: 0.36-0.78). Conclusions: These findings suggest that a broad spectrum of activities containing more than one of the components seems to be more beneficial than to be engaged in only one type of activity

Keyword
dementia, leisure activities, aged
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-369 (URN)10.1159/000089919 (DOI)16319455 (PubMedID)
Available from: 2012-09-26 Created: 2012-09-26 Last updated: 2015-01-28Bibliographically approved
3. Leisure activities in late life in relation to dementia risk: principal component analysis
Open this publication in new window or tab >>Leisure activities in late life in relation to dementia risk: principal component analysis
2009 (English)In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, ISSN 1420-8008, Vol. 28, no 2, 136-144 p.Article in journal (Refereed) Published
Abstract [en]

AIMS: To explore the underlying dimensions of a set of interrelated lifestyle factors and test the hypothesis that an active lifestyle may protect against dementia. METHODS: The study population consisted of 776 participants aged >or=75 years who were dementia-free at both baseline and the first follow-up examinations. Participation in leisure activities was assessed at baseline of the survey, and principal component analysis was used to identify their underlying factors. RESULTS: During the 9-year follow-up from exposure assessment, 212 subjects developed dementia. Higher factor scores of physical, mental, and social dimensions of an active lifestyle was each related to a lower dementia risk. A significant dose-response association between participation in the diverse dimensions and lower dementia risk was observed. CONCLUSION: An active lifestyle may protect older people against dementia, and the higher level of engagement the stronger protection.

Keyword
dementia, life style, leisure activities
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-371 (URN)10.1159/000235576 (DOI)19690416 (PubMedID)
Available from: 2012-09-26 Created: 2012-09-26 Last updated: 2015-01-28Bibliographically approved
4. Does a stimulating lifestyle postpone the onset of dementia?
Open this publication in new window or tab >>Does a stimulating lifestyle postpone the onset of dementia?
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-1053 (URN)
Note

Som manuskript i avhandling. As manuscript in dissertation.

Available from: 2014-09-25 Created: 2014-09-25 Last updated: 2015-01-28Bibliographically approved

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