Abstract
BACKGROUND: Active engagement in intellectually enriching activities reportedly lowers the risk of cognitive decline; however, few studies have examined this association, including engagement in traditional cultural activities. This study aimed to elucidate the types of cultural engagement associated with lower risk of cognitive impairment. METHODS: We examined the association between cultural engagement and cognitive impairment using Cox proportional hazards models in a cohort of 44,985 participants (20,772 males and 24,213 females) aged 65 years or older of the Japan Gerontological Evaluation Study from 2010 to 2016. Intellectual activities (eg, reading books, magazines, and/or newspapers), creative activities (eg, crafts and painting), and traditional cultural activities (eg, poetry composition [haiku], calligraphy, and tea ceremony/flower arrangement) were included among cultural engagement activities. RESULTS: Over a follow-up period of 6 years, incident cognitive disability was observed in 4,198 respondents (9.3%). After adjusting for potential confounders, such as depression and social support, intellectual activities were protectively associated with the risk of cognitive impairment (hazard ratio [HR] for those who read and stated that reading was their hobby, 0.75; 95% confidence interval [CI] 0.66-0.85 and HR for those who read but did not consider reading a hobby, 0.72; 95% CI, 0.65-0.80). Engagement in creative activities was also significantly correlated with lower risk of cognitive impairment (crafts: HR 0.71; 95% CI, 0.62-0.81 and painting: HR 0.80; 95% CI, 0.66-0.96). The association between traditional cultural activities and the risk of cognitive impairment was not statistically significant. CONCLUSIONS: Engagement in intellectual and creative activities may be associated with reduced risk of dementia.