Abstract
OBJECTIVES: The current study aimed to elucidate the associations between cognitive leisure activities and cognitive function in an older population stratified by having or not having depressive symptoms. DESIGN: A retrospective cross-sectional study based on a self-report questionnaire. SETTING: Annual health check-ups in a rural community in Japan. PARTICIPANTS: A total of 11 010 community-dwelling older adults aged ≥65 years (mean age: 74.0±5.4 years) was examined. Participants with missing data for the main outcome (n=1630) were excluded. OUTCOME MEASURES: Cognitive impairment was defined as at least 1.5 SD below the reference threshold (age-adjusted and education-adjusted score) on two of more of the tests in the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Depressive symptoms were defined by a 15-item Geriatric Depression Scale score ≥6. We assessed the frequency of participation in cognitive leisure activities using the validated scale (score: 0-42). A score of ≥8 points was defined as frequent participation in cognitive leisure activities. RESULTS: A total of 12.6% (n=1186) of the participants had depressive symptoms. There was a significant association between cognitive leisure activities and cognitive impairment in older adults (adjusted OR=0.77, 95% CI=0.65 to 0.94). In older adults with depressive symptoms, a higher frequency of cognitive leisure activities was negatively associated with cognitive impairment (adjusted OR=0.45, 95% CI=0.28 to 0.70). In contrast, there was no significant association in older adults without depressive symptoms (adjusted OR=0.85, 95% CI=0.70 to 1.02). CONCLUSIONS: Engaging in cognitive leisure activities in late life is associated with better cognitive function in older adults with depressive symptoms.