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. 2021 Apr 9;21(1):236.
doi: 10.1186/s12877-021-02180-3.

Cognitive leisure activity and all-cause mortality in older adults: a 4-year community-based cohort

Xin Liu #  1   2 , Ye Ruan #  3   4 , Limei Huang  5 , Yanfei Guo  5 , Shuangyuan Sun  5 , Hao Chen  1   2 , Junling Gao  1   2 , Yan Shi  6   7 , Qianyi Xiao  8   9
Affiliations

Cognitive leisure activity and all-cause mortality in older adults: a 4-year community-based cohort

Xin Liu et al. BMC Geriatr. .

Abstract

Background: Cognitive leisure activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous studies suggest a negative correlation between cognitive leisure activity and cognitive impairment. However, the relationship between cognitive leisure activity and all-cause mortality has rarely been reported.

Objectives: This study aims to explore the relationships between cognitive leisure activity and all-cause mortality in a community-based older people cohort in China.

Methods: The current study sample comprised 4003 community residents aged ≥60 y who were enrolled in June 2015, and were followed up every year from 2015 to 2018. Reading, playing mahjong or cards and computer use were measured by questionnaires and summed into a cognitive leisure activity index (CLAI) score. Time-Dependent Cox Regression Model and Kaplan-Meier survival analysis were used to examine the association of cognitive leisure activity with all-cause mortality.

Results: During the 4-year follow-up of 4003 participants, 208 (5.2%) deaths were registered. Of all participants, 66.8, 26.7, 6.1 and 0.35% reported CLAI scores of 0, 1, 2 and 3, respectively. A strong association was noted between the CLA score and all-cause mortality (adjusted hazard ratio [HR] = 0.72, 95% confidence intervals [CI]: 0.54-0.97, P = 0.028). Stratified analysis suggested that a higher CLAI score was significantly associated with a decreased risk of all-cause mortality mainly among those who were male, aged ≥80 y, cognitively impaired, and not diagnosed with cancer (P < 0.05).

Conclusion: Cognitive leisure activity was positively associated with reduced risk of death from all cause among the older people in major city of China, which helped promote a comprehensive understanding of health characteristics at advanced ages.

Keywords: Cognitive leisure activity; Cohort study; Mortality; Older adults.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival curves of cognitive leisure activity index with survival
Fig. 2
Fig. 2
Crude cumulative death rates and hazard ratios for all-cause mortality by cognitive leisure activity index score among a community-based Chinese elderly samples (2015–2018, n = 4003). HR = hazard ratio; CI = confidence interval. a HR adjusted for age, sex, BMI, smoking status, alcohol use status, marital status, education level, work status, physical activity, cardiovascular disease, cancer
Fig. 3
Fig. 3
The association between cognitive leisure activity index and risk of all-cause mortality in stratified subgroup. HR = hazard ratio; CI = confidence interval. a HR adjusted for age, sex, BMI, smoking status, alcohol use status, marital status, education level, work status, physical activity, cardiovascular disease, cancer
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