Chores, exercise, and social visits linked to lower risk of dementia

Physical and mental activities, such as household chores, exercise, and visiting with family and friends, may help lower the risk of dementia, according to a new study published in the July 27, 2022, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study looked at the effects of these activities, as well as mental activities and use of electronic devices in people both with and without higher genetic risk for dementia.

"Many studies have identified potential risk factors for dementia, but we wanted to know more about a wide variety of lifestyle habits and their potential role in the prevention of dementia," said study author Huan Song, MD, PhD, of Sichuan University in Chengdu, China. "Our study found that exercise, household chores, and social visits were linked to a reduced risk of various types of dementia."

The study involved 501,376 people from a UK database without dementia with an average age of 56.

Participants filled out questionnaires at the beginning of the study, including one on physical activities. They were asked how often they participated in activities such as climbing a flight of stairs, walking, and participating in strenuous sports. They were also asked about household chores, job-related activities, and what kind of transportation they used, including walking or biking to work.

Participants completed another questionnaire on mental activities. They were asked about their education level, whether they attend adult education classes, how often they visit with friends and family, visit pubs or social clubs or religious groups, and how often they use electronic devices such as playing computer games, watching TV, and talking on the phone.

Additionally, participants reported whether they had any immediate family members with dementia. This helped researchers determine if they had a genetic risk for Alzheimer's disease. Study participants were followed an average of 11 years. At the end of the study, 5,185 people had developed dementia.

After adjusting for multiple factors such as age, income, and smoking, researchers found that most physical and mental activities studied showed links to the risk of dementia. Importantly, the findings remain after considering the high correlations and interactions of these activities. People who were highly engaged in activity patterns including frequent exercises, household chores, and daily visits of family and friends had 35%, 21%, and 15% lower risk of dementia, respectively, compared to people who were the least engaged in these activity patterns.

Researchers also looked at dementia incidence rates by identified activity patterns. The rate in people who exercised frequently was 0.45 cases for every 1,000 person-years compared to 1.59 for people who rarely exercised. Person-years take into account the number of people in a study as well as the amount of time spent in the study. Those who frequently did household chores had a rate of 0.86 cases for every 1,000 person-years compared to 1.02 for people who rarely did household chores. People who visited family daily had a rate of 0.62 cases for every 1,000 person-years compared to 0.8 cases for those who only visited friends and family once every few months.

"Our study has found that by engaging more frequently in healthy physical and mental activities people may reduce their risk of dementia," Song said. "More research is needed to confirm our findings. However, our results are encouraging that making these simple lifestyle changes may be beneficial."

The researchers found that all participants benefited from the protective effect of physical and mental activities, whether or not they had a family history of dementia.

A limitation of the study was that people reported their own physical and mental activity, so they may not have remembered and reported these activities correctly.

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Do benefits of physical, mental activity on thinking differ for men and women?

Studies have shown that physical and mental activity help preserve thinking skills and delay dementia. A new study suggests that these benefits may vary for men and women. The study is published in the July 20, 2022, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The study looked at the effects of physical and mental activities, such as reading, going to classes, or playing cards or games, on cognitive reserve in the areas of thinking speed and memory. Cognitive reserve is the buffer that occurs when people have strong thinking skills even when their brains show signs of the underlying changes associated with cognitive impairment and dementia.

"We found that greater physical activity was associated with greater thinking speed reserve in women, but not in men," said study author Judy Pa, PhD, of the University of California, San Diego. "Taking part in more mental activities was associated with greater thinking speed reserve for both men and women."

Greater physical activity was not associated with memory reserve in men or women.

The study involved 758 people with an average age of 76. Some had no thinking or memory problems, some had mild cognitive impairment, and some had dementia. The participants had brain scans and took thinking speed and memory tests. To calculate cognitive reserve, people's thinking tests scores were compared against the changes in the brain associated with dementia, such as the total volume of the hippocampus, a key brain region impacted by Alzheimer's disease.

People were also asked about their usual weekly physical activity. For mental activity, they were asked whether they participated in three types of activities in the past 13 months: reading magazines, newspapers or books; going to classes; and playing cards, games or bingo. They were given one point for each type of activity, for a maximum of three points.

For mental activity, participants averaged 1.4 points. For physical activity, participants took part in an average of at least 15 minutes per week of activities that elevate heart rates such as brisk walking and biking.

Pa said that each additional mental activity people participated in corresponded to 13 fewer years of aging in their processing speed in their thinking skills -- 17 years among men and 10 years among women.

"As we have arguably few-to-no effective treatments for Alzheimer's disease, prevention is crucial. An ounce of prevention is worth a pound of treatment," Pa said. "To know that people could potentially improve their cognitive reserve by taking simple steps such as going to classes at the community center, playing bingo with their friends or spending more time walking or gardening is very exciting."

Pa said that based on the effect sizes seen in the study, a doubling of the amount of physical activity would be equivalent to an estimated 2.75 fewer years of aging when it comes to women's processing speed in their thinking skills.

Researchers also looked at whether the relationship between physical and mental activities and cognitive reserve was affected by the gene that carries the strongest risk for Alzheimer's, called APOE e4. They found that for women, having the gene lessens the effects of the beneficial relationship between physical and mental activities and cognitive reserve.

The study does not prove that physical and mental activities help improve cognitive reserve. It only shows an association.

A limitation of the study was that people reported their own physical and mental activity, so they may not have remembered correctly. Also, structural and societal factors that affect cognitive reserve, such as education, were not measured in the study.

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