Skip to main content
    • Aa
    • Aa

Physical, social and productive leisure activities, cognitive decline and interaction with APOE-ε4 genotype in Chinese older adults

  • Matthew Niti (a1) (a2), Keng-Bee Yap (a1) (a3), Ee-Heok Kua (a1) (a2), Chay-Hoon Tan (a1) (a2) and Tze-Pin Ng (a1) (a2)...

Background: We evaluated the combined and differential effects of physical, social and productive activities on cognitive decline and whether they were modified by the presence of the APOE-ε4 allele.

Methods: In a prospective cohort study of 1635 community-dwelling Chinese older adults aged 55 or older participating in the ongoing Singapore Longitudinal Aging Study, physical, social and productive leisure activities were assessed at baseline, and cognitive decline (at least one point drop) in MMSE scores between baseline and follow-up after one year.

Results: Cognitive decline was observed in 30% of the respondents. Controlling for age, gender, education and other risk factors, odds ratios (ORs) were significantly reduced in those with medium (OR: 0.60, 95% CI: 0.45–0.79) and high activity levels (OR: 0.62, 95% CI: 0.46–0.84). A stronger association was shown for productive activity (OR = 0.36), than for physical (OR = 0.78) and social activities (OR = 0.85). These associations showed statistically significant interactions with APOE genotype, being more pronounced in those with the APOE-ε4 allele.

Conclusion: Increased leisure activity, especially productive activities more than physical or social activities, was associated with a lowered risk of cognitive decline. APOE-ε4 genotype individuals appeared to be more vulnerable to the effects of low and high levels of leisure activities.

Corresponding author
Correspondence should be addressed to: Associate Professor. Tze-Pin Ng, Gerontological Research Programme, National University of Singapore, Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. Phone: +65 67724514; Fax: +65 67772191. Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

M. J. Aartsen , C. H. Smits , T. van Tilburg , K. C. Knipscheer and D. J. Deeg 2002. Activity in older adults: cause or consequence of cognitive functioning? A longitudinal study on everyday activities and cognitive performance in older adults. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 57, P153P162.

S. S. Bassuk , T. A. Glass and L. F. Berkman 1999. Social disengagement and incident cognitive decline in community- dwelling elderly persons. Annals of Internal Medicine, 131, 165173.

H. Bosma 2002. Engaged lifestyle and cognitive function in middle and old-aged, non-demented persons: a reciprocal association? Zeitschrift für Gerontologie und Geriatrie, 35, 575581.

L. Fratiglioni , S. Paillard-Borg and B. Winblad 2004. An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurology, 3, 343353.

M. Hogan 2005. Physical and cognitive activity and exercise for older adults: a review. International Journal of Aging & Human Development, 60, 95126.

D. F. Hultsch , C. Hertzog , B. J. Small and R. A. Dixon 1999. Use it or lose it: engaged lifestyle as a buffer of cognitive decline in aging? Psychology and Aging, 14, 245263.

R. Katzman 1995. Can late life social or leisure activities delay the onset of dementia? Journal of the American Geriatrics Society, 43, 583584.

M. Kivipelto 2001. Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study. BMJ, 322, 14471451.

M. P. Lawton and E. M. Brody 1969. Assessment of older people: self maintaining and instrumental activities of daily living. Gerontologist, 9, 179186.

R. W. Mahley and S. C., Jr. Rall 2000. Apolipoprotein E: far more than a lipid transport protein. Annual Review of Genomics and Human Genetics, 1, 507537.

T. P. Ng , M. Niti , P. C. Chiam and E. H. Kua 2006. Prevalence and correlates of functional disability in multiethnic elderly Singaporeans. Journal of the American Geriatrics Society, 54, 2129.

T. P. Ng , M. Niti , P. C. Chiam and E. H. Kua 2007. Ethnic differences in cognitive performance on Mini-mental State Examination in Asians. American Journal of Geriatric Psychiatry, 15, 130139.

S. Rovio 2005. Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease. Lancet Neurology, 4, 705711.

T. E. Seeman , T. M. Lusignolo , M. Albert and L. Berkman 2001. Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging. Health Psychology, 20, 243255.

H. Van Praag , B. R. Christie , T. J. Sejnowski and F. H. Gage 1999. Running enhances neurogenesis, learning, and long-term potentiation in mice. Proceedings of the National Academy of Sciences of the United States of America, 96, 1342713431.

J. Y. Wang 2006. Leisure activity and risk of cognitive impairment: the Chongqing aging study. Neurology, 66, 911913.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 7
Total number of PDF views: 124 *
Loading metrics...

Abstract views

Total abstract views: 517 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 21st September 2017. This data will be updated every 24 hours.