Effects of Novel Cognitive Stimulating Activities (CSAs) on Cognitive Decline and Depressive Symptom: A Naturalistic Study

There is a scarcity of naturalistic follow-up studies on cognitive stimulating activities (CSAs), particularly in a real-world setting. We investigated a pooled novel CSA intervention to prevent cognitive decline amongst community-dwelling older adults without dementia. Within a cohort of older adults (N=991), four single-blinded randomized controlled trials involving four novel CSAs were conducted with a subset of the cohort (n=264). At cohort’s 5-year follow-up, we examined if involvements in the CSAs improved cognition, compared to controls (n=727). The primary outcomes were changes in global cognition and cognitive domain scores measured by the mini-mental state examination (MMSE). Exploratory subgroup analyses stratified by baseline cognitive status and the number of CSAs were also conducted. Compared to the control group, there was a small improvement in the CSA group on the total MMSE score (d=0.108) and MMSE-immediate recall score (d=0.199). Furthermore, subgroup analyses revealed medium effect sizes of improvements (d=0.420) in cognitive domains in MCI (versus cognitively healthy) and those involved in two CSAs (versus one CSA). In summary, a CSA intervention improved cognition. MCI and those involved in two CSAs gained greater benefits from the CSAs. These sustained improvements in cognitive functions could have a significant impact on delaying or preventing dementia.