Specific Activities and the Trajectories of Cognitive Decline among Middle-aged and Older Adults: A Five-year Longitudinal Cohort Study

Background: Emerging evidence indicates that leisure activities are associated with higher risk of cognitive impairment and dementia among the older adults, but how specific activities influence cognitive decline among different age groups, especially the late middle-aged and the early old, remains inadequately studied. This study aims to examine association between specific activities with trajectories of cognitive functions in different age groups in China. Methods: : This longitudinal cohort study included 14,161 Chinese individuals aged 45 years or above from the China Health and Retirement Longitudinal Study (CHARLS). Data were collected bi-annually from 2011 to 2015. Cognitive function, including memory and mental status, was measured by Telephone Interview of Cognitive Status (TICS) battery. Mixed effects growth models were applied to analyse the association between specific activities and cognitive functions. Results: : Four activities, respectively interacting with friends, playing Mah-jong or other card games, going to a sport and providing help to others, were found to be significantly associated with participants’ cognitive functioning. All four activities are associated with better memory. Infrequently playing Mah-jong or other card games and daily sports are significantly associated with better mental status. In addition, specific effect of each activity varies among population of different age, education level, gender and residence. Conclusions: : This study identifies four social activities that are associated with better cognitive functions, and provides a comprehensive, in-depth understanding on the specific protective effect of each activity among different subgroups. These findings have practical implications for feasible and personalized cognitive health interventions.