Leisure activity participation and risk of dementia: An 18-year follow-up of the Whitehall II Study.
Leisure activity participation and risk of dementia: An 18-year follow-up of the Whitehall II Study.
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DOI：
10.1212/wnl.0000000000010966
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发表时间：
2020-11-17
期刊：
影响因子：
9.9
通讯作者：
Singh-Manoux A
中科院分区：
文献类型：
--
作者：
Sommerlad A;Sabia S;Livingston G;Kivimäki M;Lewis G;Singh-Manoux A
为了检验参与休闲活动与痴呆风险降低相关的假设，我们在一项平均随访18年的大型纵向研究中检查了参与休闲活动与痴呆事件之间的关联。我们使用了来自白厅II前瞻性队列研究的8，280名参与者的数据。一个13项量表评估了1997-1999年、2002-2004年和2007-2009年的休闲活动参与情况，并从3个全面的国家登记册中确定了痴呆症的发病率（n例= 360，诊断时的平均年龄为76.2岁，发病率为2.4/1000人-年），随访至2017年3月。主要分析基于完整病例（n = 6，050，n = 247），敏感性分析使用缺失数据的多重插补。平均年龄55.8岁时参与休闲活动的情况（1997-1999年评估），随访18.0年，与痴呆无关（风险比[HR] 0.92 [95%置信区间0.79-1.06]），但那些平均年龄为65.7岁（2007-2009年评估）的参与率较高的人在8.3年的随访中患痴呆症的可能性较小（HR 0.82 [0.69-0.98]）。没有特定类型的休闲活动与痴呆症风险始终相关。1997-1999年和2007-2009年期间参与率的下降与随后的痴呆症风险有关。我们的研究结果表明，参与休闲活动在痴呆症的临床前阶段下降;没有强有力的证据表明休闲活动参与和痴呆症之间存在保护性关联。未来的研究应该调查休闲活动参与下降的社会行为，认知和神经生物学驱动因素，以确定改善痴呆症患者社会参与的潜在方法。
To test the hypothesis that leisure activity participation is associated with lower dementia risk, we examined the association between participation in leisure activities and incident dementia in a large longitudinal study with average 18-year follow-up. We used data from 8,280 participants of the Whitehall II prospective cohort study. A 13-item scale assessed leisure activity participation in 1997–1999, 2002–2004, and 2007–2009, and incidence of dementia (n cases = 360, mean age at diagnosis 76.2 years, incidence rate 2.4 per 1,000 person-years) was ascertained from 3 comprehensive national registers with follow-up until March 2017. Primary analyses were based on complete cases (n = 6,050, n cases = 247) and sensitivity analyses used multiple imputation for missing data. Participation in leisure activities at mean age 55.8 (1997–1999 assessment), with 18.0-year follow-up, was not associated with dementia (hazard ratio [HR] 0.92 [95% confidence interval 0.79–1.06]), but those with higher participation at mean age 65.7 (2007–2009 assessment) were less likely to develop dementia with 8.3-year follow-up (HR 0.82 [0.69–0.98]). No specific type of leisure activity was consistently associated with dementia risk. Decline in participation between 1997–1999 and 2007–2009 was associated with subsequent dementia risk. Our findings suggest that participation in leisure activities declines in the preclinical phase of dementia; there was no robust evidence for a protective association between leisure activity participation and dementia. Future research should investigate the sociobehavioral, cognitive, and neurobiological drivers of decline in leisure activity participation to determine potential approaches to improving social participation of those developing dementia.