Leisure Activities and the Risk of Dementia: A Systematic Review and Meta-analysis

BACKGROUND AND OBJECTIVES: Leisure activities are major components of modifiable and healthy lifestyles and are proposed to help prevent the development of dementia. This study aimed to assess the effects of different types of leisure activities, including cognitive, physical, and social activities, on the incidence of all-cause dementia (ACD), Alzheimer disease (AD), and vascular dementia (VD). METHODS: We performed a systematic review and meta-analysis of the Cochrane, PubMed, Embase, and Web of Science databases to identify longitudinal studies that examined associations between leisure activities and dementia. Relative risks (RRs) and 95% CIs were pooled using random-effects meta-analysis. Subgroup analyses were used to estimate potential effect modifiers. The study was registered with PROSPERO (CRD42019116857). RESULTS: A total of 38 longitudinal studies, with 2,154,818 participants at baseline, 74,700 ACD cases, 2,848 AD cases, and 1,423 VD cases during follow-up, were included in the meta-analysis. The subgroup analyses showed that physical (RR 0.83, 95% CI 0.78–0.88), cognitive (RR 0.77; 95% CI 0.68–0.87), and social (RR 0.93; 95% CI 0.87–0.99) activities were associated with a decreased incidence of ACD. In addition, physical (RR 0.87; 95% CI 0.78–0.96) and cognitive (RR 0.66; 95% CI 0.52–0.85) activities were related to a reduced risk of AD. Physical activity (RR 0.67; 95% CI 0.53–0.85) was associated with a lower incidence of VD. DISCUSSION: Our findings suggest that leisure activities are inversely associated with a risk of ACD, AD, and VD.