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Social and Leisure Activities in Relation to Dementia

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Social and Leisure Activities in Relation to Dementia Powered By Docstoc
					         Hui-Xin Wang, Ph.D

      Div. Geriatric Epidemiology
Dept. NEUROTEC, Karolinska Institutet
                    &
Stockholm Gerontology Research Center
                    Hui-Xin Wang, Stockholm, Oct. 2002
 Findings from
Different studies


                         Biological
                         plausibility


                    Hui-Xin Wang, Stockholm, Oct. 2002
          Findings from different
                 studies


 Social                                  Physical
network                                  activities
                   Mental
                  activities


                          Hui-Xin Wang, Stockholm, Oct. 2002
                Social network 1
                    The Kungsholmen Project
                Fratiglioni et al, Lancet 2000; 355:1315-1319
Relative risks (RR)
for dementia
               20                               Poor

               15
                                      Limited
               10
                           Moderate
               5
                      Rich
               0
                         Social network index
                                          Hui-Xin Wang, Stockholm, Oct. 2002
       Social network 2

PAQUID study
Helmer et al, Neurology 1999;53:1953-58

Marital status RR for dementia
Never married    1.9 (1.1-3.2)

EPESE- New Haven cohort
Bassuk et al, Ann Intern Med 1999;131:165

Social ties          OR for cog decline
 0 vs 5               1.9 (1.1- 3.2)

                             Hui-Xin Wang, Stockholm, Oct. 2002
 Social network 3

  Possible explanations

Instrumental support
         or
  mental stimulation

              Hui-Xin Wang, Stockholm, Oct. 2002
                  Mental
                activities 1
RR for dementia from follow-up studies
      Manhattan Study
                    Scarmeas et al, Neurol. 2001;57:2236-42

      Leisure activity      0.6 (0.5-0.8)

      PAQUID Study
                    Fabrigoule et al, JAGS 1995;43:485-90

      Travelling            0.5 (0.2-0.9)
      Knitting              0.5 (0.3-0.8)
      Gardening             0.5 (0.3-0.9)
                               Hui-Xin Wang, Stockholm, Oct. 2002
                   Mental
                 activities 2
RR for dementia from follow-up studies
    The Kungsholmen Project
                Wang et al, Am J Epidemiol 2002,155:1081-7

    Mental activities                 0.7 (0.4-1.0)

    The Religious Order Study
                          Wilson et al, JAMA 2002;287:742-8
    Cognitive activity score          0.7 (0.5-0.9)
    (1-point increase)

                                Hui-Xin Wang, Stockholm, Oct. 2002
              Social and leisure
                  activities
                  Wang et al, Am J Epidemiol 2022;155:1081-7

                          RR (95% CI) for dementia

                          NO      < Weekly          Daily

Mental Activity           1      0.8 (0.5-1.3)       0.6 (0.4-0.9)

Social Activity           1      0.9 (0.5-1.4)       0.6 (0.4-0.9)

Productive Activity       1      0.8 (0.3-2.6)       0.6 (0.4-0.9)
                                 Hui-Xin Wang, Stockholm, Oct. 2002
              Physical
             activities 1

Canadian Study of Health and Aging
            Laurin et al, Arch Neurol 2001;58: 498-504
                       OR for dementia
 None                 1
 Low                  0.64 (0.41-1.02)
 Moderate             0.69 (0.50-0.95)
 High                 0.63 (0.40-0.96)

                            Hui-Xin Wang, Stockholm, Oct. 2002
               Physical
              activities 2
      The Kungsholmen Project
     Wang et al, Am J Epidemiol 2002; 155:1081-7

                      OR for dementia
      None               1
      Weekly             0.97 (0.4-2.2)
      Daily              0.41 (0.1-1.3)

   3 / 5 cross-sectional studies and 2 / 3
longitudinal studies reported no association
                            Hui-Xin Wang, Stockholm, Oct. 2002
            Biological
            plausibility


Studies on other       Experimental
   diseases              studies


                   Hui-Xin Wang, Stockholm, Oct. 2002
                         Studies on
                       other diseases

1. Physical activity increases survival and
     protects against CVD (Bassey 2000)
2. Psychosocial factors (depression and social
     support) are independent etiological and
     prognostic factors for CHD
     (Hemingway and Marmot, BMJ 1999)

3. Social, productive, and cultural activities have
     a positive influence on survival
     (Bygren et al, BMJ 1996; Glass et al, BMJ 1999)
                                    Hui-Xin Wang, Stockholm, Oct. 2002
               Experimental
                 studies

1. Physical activity sustains CBF, and
   improves aerobic capacity (Laurin 2001)

2. Enriched environment improves the
   plasticity and thickness of old rats’
   cerebral cortex (Powell 1994)

3. Poor social network affects the immune
   system (Seeman 1996)
                         Hui-Xin Wang, Stockholm, Oct. 2002
          Conclusions

 Most studies on the topic suport that
   social and leisure activities may
    decrease the risk of dementia

              However

Data concerning this topic are limited.
 More longitudinal studies with better
control of confounders and experimental
           data are necessary.
                     Hui-Xin Wang, Stockholm, Oct. 2002

				
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