Moderate-Intensity Physical Activity, Music and Art Activities Preserved Cognitive Health in Older Adults: An Argument for Social Prescribing Solution

Abstract

Introduction: Rates of dementia are projected to increase over the coming years as global populations age. Without a treatment to slow the progression of dementia, many health policies are focusing on preventing dementia by slowing the rate of cognitive decline with age. However, it is unclear which lifestyle changes in old age meaningfully reduce the rate of cognitive decline associated with aging. Objectives: Use existing, multi-year longitudinal health data to determine if engagement in a variety of different lifestyle activities can slow the rate of cognitive decline as older adults age. Method: Data from the English Longitudinal Study of Aging was analyzed using a quasi-experimental, efficient matched-pair design inspired by the clinical trial methodology. Changes in short-term memory scores were assessed over a multi-year interval for groups who undertook one of 11 different lifestyle activities, compared to control groups matched across confounding socioeconomic and lifestyle factors. Results: Two factors, moderate-intensity physical activity and learning activities, resulted in significant positive impact on cognitive function. Conclusion: Our analysis brings cognitive benefit arguments in favor of two lifestyle activities, moderate-intensity physical activity and learning activities, while rejecting other factors advanced by the literature such as vigorous-intensity physical activity. Those findings justify and encourage the development of new lifestyle health programs by health authorities and bring forward the new health system solution, social prescribing.

Keywords: Alzheimer's disease; cognitive function; dementia; longitudinal observational studies; modifiable lifestyle factors.

Figure 1

Histogram of the age variable for samples at wave 1.

Figure 2

Overview of the method; schematic overview of the steps involved in the QED.

Figure 3

Distribution of p-values for (A) individual and (B) merged populations. In both cases, learning activities and moderate-intensity physical activity pass multiple hypothesis testing.

Figure 4

Boxplot of p-values of each candidate. Learning activities and moderate-intensity physical activity pass the statistical test after p-value adjustment even for the more conservative adjustment method, Bonferroni. “Merged BH” and “Wave BH” indicate the significance thresholds for Benjamini-Hochberg method performed on p-values of merged waves and individual waves, respectively.

Figure 5

The mean difference in MI between treatment and control group. Engagement in moderate-intensity physical activity and learning activities leads to approximately 0.75 points increase in MI.