eprintid: 10053422 rev_number: 29 eprint_status: archive userid: 608 dir: disk0/10/05/34/22 datestamp: 2018-07-30 14:20:00 lastmod: 2021-12-06 00:12:54 status_changed: 2018-07-30 14:20:00 type: article metadata_visibility: show creators_name: Lee, ATC creators_name: Richards, M creators_name: Chan, WC creators_name: Chiu, HFK creators_name: Lee, RSY creators_name: Lam, LCW title: Association of Daily Intellectual Activities With Lower Risk of Incident Dementia Among Older Chinese Adults ispublished: pub divisions: UCL divisions: B02 divisions: D14 divisions: GA3 divisions: G17 keywords: Science & Technology, Life Sciences & Biomedicine, Psychiatry, LEISURE ACTIVITIES, LIFE-STYLE, ALZHEIMERS-DISEASE, COGNITIVE RESERVE, HONG-KONG, PARTICIPATION, PREVENTION, PREVALENCE, MECHANISMS, COHORT note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Importance Associations between late-life participation in intellectual activities and decreased odds of developing dementia have been reported. However, reverse causality and confounding effects due to other health behaviors or problems have not been adequately addressed. Objective To examine whether late-life participation in intellectual activities is associated with a lower risk of incident dementia years later, independent of other lifestyle and health-related factors. Design, Setting, and Participants A longitudinal observational study was conducted at all Elderly Health Centres of the Department of Health of the Government of Hong Kong among 15 582 community-living Chinese individuals age 65 years or older at baseline who were free of dementia, with baseline evaluations performed January 1 to June 30, 2005, and follow-up assessments performed from January 1, 2006, to December 31, 2012. Statistical analysis was performed from January 1, 2015, to December 31, 2016. Main Outcomes and Measures The main outcome was incident dementia as diagnosed by geriatric psychiatrists in accordance with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, or a Clinical Dementia Rating of 1 to 3. At baseline and follow-up interviews, self-reported information on participation in intellectual activities within 1 month before assessment was collected. Examples of intellectual activities, which were described by a local validated classification system, were reading books, newspapers, or magazines; playing board games, Mahjong, or card games; and betting on horse racing. Other important variables including demographics (age, sex, and educational level), physical and psychiatric comorbidities (cardiovascular risks, depression, visual and hearing impairments, and poor mobility), and lifestyle factors (physical exercise, adequate fruit and vegetable intake, smoking, and recreational and social activities) were also assessed. Results Of the 15 582 individuals in the study, 9950 (63.9%) were women, and the median age at baseline was 74 years (interquartile range, 71-77 years). A total of 1349 individuals (8.7%) developed dementia during a median follow-up period of 5.0 years. Multivariable logistic regression analysis showed that the estimated odds ratio for incident dementia was 0.71 (95% CI, 0.60-0.84; P < .001) for those with intellectual activities at baseline, after excluding those who developed dementia within 3 years after baseline and adjusting for health behaviors, physical and psychiatric comorbidities, and sociodemographic factors. Conclusions and Relevance Active participation in intellectual activities, even in late life, might help delay or prevent dementia in older adults. date: 2018-05-30 date_type: published publisher: AMER MEDICAL ASSOC official_url: https://doi.org/10.1001/jamapsychiatry.2018.0657 full_text_type: other language: eng article_type_text: Article verified: verified_manual elements_id: 1559431 doi: 10.1001/jamapsychiatry.2018.0657 lyricists_name: Richards, Marcus lyricists_id: MRICH78 actors_name: Stacey, Thomas actors_id: TSSTA20 actors_role: owner full_text_status: restricted publication: JAMA Psychiatry volume: 75 number: 7 pagerange: 697-703 pages: 7 issn: 2168-6238 citation: Lee, ATC; Richards, M; Chan, WC; Chiu, HFK; Lee, RSY; Lam, LCW; (2018) Association of Daily Intellectual Activities With Lower Risk of Incident Dementia Among Older Chinese Adults. JAMA Psychiatry , 75 (7) pp. 697-703. 10.1001/jamapsychiatry.2018.0657 <https://doi.org/10.1001/jamapsychiatry.2018.0657>. document_url: https://discovery.ucl.ac.uk/id/eprint/10053422/1/Richards%20Lee%20et%20al.%20JAMA%20Psychiatry%202018.pdf