Hui-Xin Wang, Ph.D

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Social and leisure activities in relation to
dementia
Hui-Xin Wang, Ph.D Div. Geriatric
Epidemiology Dept. NEUROTEC, Karolinska
Institutet Stockholm Gerontology Research
Center
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Social and leisure activities in relation to
dementia
Findings from Different studies
Biological plausibility
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Social and leisure activities in relation to
dementia
Findings from different studies
Social network
Physical activities
Mental activities
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Social network 1
The Kungsholmen Project Fratiglioni et al, Lancet
2000 3551315-1319
Relative risks (RR) for dementia
Poor
Limited
Moderate
Rich
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Social network 2
PAQUID study Helmer et al, Neurology
1999531953-58 Marital status RR for
dementia Never married 1.9
(1.1-3.2) EPESE- New Haven cohort Bassuk et al,
Ann Intern Med 1999131165 Social ties
OR for cog decline 0 vs 5 1.9
(1.1- 3.2)
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Social network 3
Possible explanations
Instrumental support or mental stimulation
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Mental activities 1
RR for dementia from follow-up studies
Manhattan Study Scarmeas et al, Neurol.
2001572236-42 Leisure activity 0.6 (0.5-0.8)
PAQUID Study Fabrigoule et al, JAGS
199543485-90 Travelling 0.5 (0.2-0.9)
Knitting 0.5 (0.3-0.8) Gardening 0.5
(0.3-0.9)
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Mental activities 2
RR for dementia from follow-up studies
The Kungsholmen Project
Wang et al, Am J Epidemiol 2002,1551081-7 Mental
activities 0.7 (0.4-1.0)
The Religious Order Study Wilson et al, JAMA
2002287742-8 Cognitive activity score 0.7
(0.5-0.9) (1-point increase)
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Social and leisure activities
Wang et al, Am J Epidemiol 20221551081-7
RR (95 CI) for dementia NO lt
Weekly Daily Mental Activity 1 0.8
(0.5-1.3) 0.6 (0.4-0.9) Social Activity 1
0.9 (0.5-1.4) 0.6 (0.4-0.9) Productive
Activity 1 0.8 (0.3-2.6) 0.6 (0.4-0.9)
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Physical activities 1
Canadian Study of Health and Aging
Laurin et al, Arch Neurol 200158
498-504 OR for dementia None 1 Low 0.64
(0.41-1.02) Moderate 0.69 (0.50-0.95) High 0
.63 (0.40-0.96)
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Physical activities 2
The Kungsholmen Project Wang et al, Am J
Epidemiol 2002 1551081-7 OR for dementia
None 1 Weekly 0.97 (0.4-2.2) Daily 0.41
(0.1-1.3)
3 / 5 cross-sectional studies and 2 / 3
longitudinal studies reported no association
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Social and leisure activities in relation to
dementia
Biological plausibility
Experimental studies
Studies on other diseases
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Studies on other diseases
1. Physical activity increases survival and
protects against CVD (Bassey 2000)2.
Psychosocial factors (depression and social
support) are independent etiological and
prognostic factors for CHD (Hemingway and
Marmot, BMJ 1999)3. Social, productive, and
cultural activities have a positive influence on
survival (Bygren et al, BMJ 1996 Glass et al,
BMJ 1999)
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Experimental studies
1. Physical activity sustains CBF, and improves
aerobic capacity (Laurin 2001)2. Enriched
environment improves the plasticity and
thickness of old rats cerebral cortex (Powell
1994)3. Poor social network affects the immune
system (Seeman 1996)
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Conclusions Most studies on the topic suport
that social and leisure activities may
decrease the risk of dementia However Data
concerning this topic are limited. More
longitudinal studies with better control of
confounders and experimental data are
necessary.