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Community engagement and dementia risk: time-to-event analyses from a national cohort study

BACKGROUND: There is increasing interest in the potential health benefits of referring older adults to engage in community leisure activities (‘social prescribing’) to help promote healthy cognitive ageing. However, it remains unclear whether beneficial effects of community engagement are independen...

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Autores principales: Fancourt, Daisy, Steptoe, Andrew, Cadar, Dorina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929705/
https://www.ncbi.nlm.nih.gov/pubmed/31662344
http://dx.doi.org/10.1136/jech-2019-213029
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author Fancourt, Daisy
Steptoe, Andrew
Cadar, Dorina
author_facet Fancourt, Daisy
Steptoe, Andrew
Cadar, Dorina
author_sort Fancourt, Daisy
collection PubMed
description BACKGROUND: There is increasing interest in the potential health benefits of referring older adults to engage in community leisure activities (‘social prescribing’) to help promote healthy cognitive ageing. However, it remains unclear whether beneficial effects of community engagement are independent of the well-known protective effects of broader structural, functional and subjective social factors. METHODS: We analysed data from 9550 adults aged 50+ from the English Longitudinal Study of Ageing, with baseline from 2004 to 2005. We assessed associations between different types of community engagement and dementia incidence over a 12-year period. Specifically, we used Cox proportional hazards models, competing risk regressions models, and modified Fine and Gray subdistribution hazards models while controlling for all identified demographic, health-related, and social covariates. RESULTS: Community cultural engagement (eg, visiting museums, galleries, the theatre) was associated with a lower hazard of developing dementia in older age independent of demographic, health-related and a broad range of social factors, using all three statistical approaches (fully adjusted Cox models: HR 0.58, 95% CI 0.41 to 0.80). Community group engagement (eg, attending clubs or societies) was only associated with dementia prior to adjustment for social factors. Results were robust to sensitivity analyses considering reverse causality, over-adjustment and baseline cognitive function. CONCLUSION: It is not just social factors that are associated with reduced risk of dementia onset, but community engagement may also be protective, particularly when relating to cultural activities. These findings are of relevance when considering the current interest in social prescribing to support healthy ageing.
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spelling pubmed-69297052020-01-06 Community engagement and dementia risk: time-to-event analyses from a national cohort study Fancourt, Daisy Steptoe, Andrew Cadar, Dorina J Epidemiol Community Health Research Report BACKGROUND: There is increasing interest in the potential health benefits of referring older adults to engage in community leisure activities (‘social prescribing’) to help promote healthy cognitive ageing. However, it remains unclear whether beneficial effects of community engagement are independent of the well-known protective effects of broader structural, functional and subjective social factors. METHODS: We analysed data from 9550 adults aged 50+ from the English Longitudinal Study of Ageing, with baseline from 2004 to 2005. We assessed associations between different types of community engagement and dementia incidence over a 12-year period. Specifically, we used Cox proportional hazards models, competing risk regressions models, and modified Fine and Gray subdistribution hazards models while controlling for all identified demographic, health-related, and social covariates. RESULTS: Community cultural engagement (eg, visiting museums, galleries, the theatre) was associated with a lower hazard of developing dementia in older age independent of demographic, health-related and a broad range of social factors, using all three statistical approaches (fully adjusted Cox models: HR 0.58, 95% CI 0.41 to 0.80). Community group engagement (eg, attending clubs or societies) was only associated with dementia prior to adjustment for social factors. Results were robust to sensitivity analyses considering reverse causality, over-adjustment and baseline cognitive function. CONCLUSION: It is not just social factors that are associated with reduced risk of dementia onset, but community engagement may also be protective, particularly when relating to cultural activities. These findings are of relevance when considering the current interest in social prescribing to support healthy ageing. BMJ Publishing Group 2020-01 2019-10-29 /pmc/articles/PMC6929705/ /pubmed/31662344 http://dx.doi.org/10.1136/jech-2019-213029 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Research Report
Fancourt, Daisy
Steptoe, Andrew
Cadar, Dorina
Community engagement and dementia risk: time-to-event analyses from a national cohort study
title Community engagement and dementia risk: time-to-event analyses from a national cohort study
title_full Community engagement and dementia risk: time-to-event analyses from a national cohort study
title_fullStr Community engagement and dementia risk: time-to-event analyses from a national cohort study
title_full_unstemmed Community engagement and dementia risk: time-to-event analyses from a national cohort study
title_short Community engagement and dementia risk: time-to-event analyses from a national cohort study
title_sort community engagement and dementia risk: time-to-event analyses from a national cohort study
topic Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929705/
https://www.ncbi.nlm.nih.gov/pubmed/31662344
http://dx.doi.org/10.1136/jech-2019-213029
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