{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T10:42:54Z","timestamp":1782643374479,"version":"3.54.5"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Engagement in cognitive leisure activities (CLA) may reduce the risk of dementia, but findings are often challenged by reverse causation and unmeasured cognitive reserve.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To examine the association between CLA and incident dementia whilst accounting for reverse causation and lifelong cognitive enrichment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective cohort study with a 12-year follow-up, including a 7-year exposure-outcome time lag.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Community-dwelling older adults from the three-city study conducted in France.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Subjects<\/jats:title>\n                  <jats:p>A total of 3326 participants aged 65 and older, free of dementia at baseline and during the time-lag period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>At baseline, participants reported frequency of engagement in five cognitively stimulating activities. A global CLA score was calculated and categorised into low, moderate, and high engagement. Incident dementia and Alzheimer\u2019s disease (AD) were ascertained during the 5-year follow-up. Delayed-entry Cox models with age as the time scale were used, adjusting for socio-demographic, health-related, and genetic factors including APOE \u03b54 and past occupational grade.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared to low CLA engagement, moderate and high engagement were associated with lower risk of dementia (hazard ratios [HR]\u2009=\u20090.50 [95% CI: 0.33\u20130.76] and 0.53 [0.35\u20130.80]) and AD (HR\u2009=\u20090.35 [0.20\u20130.59] and 0.45 [0.28\u20130.73]). Frequent engagement in crosswords and artistic activities showed the strongest independent associations with reduced dementia risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>CLA in late life is associated with lower dementia risk, beyond the influence of cognitive reserve and reverse causation. Promoting such activities may be a valuable component of dementia prevention strategies in older adults.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaf286","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:55:21Z","timestamp":1760032521000},"source":"Crossref","is-referenced-by-count":3,"title":["Cognitive leisure and dementia risk: evidence beyond reverse causation"],"prefix":"10.1093","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6420-1336","authenticated-orcid":false,"given":"Thibault","family":"Mura","sequence":"first","affiliation":[{"name":"Department of Biostatistics, Epidemiology & Public Health, University Hospital Centre Nimes , Nimes, Occitanie ,","place":["France"]},{"name":"INSERM U1298 - Montpellier Neuroscience Institute, \u00a0 Montpellier, Occitanie ,","place":["France"]},{"name":"University of Montpellier , Montpellier, Occitanie 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