Cognitively Stimulating Leisure Activities, Emotional Health, and Cognitive Functions Among Older Adults with Mild Cognitive Impairment: A Longitudinal Analysis

Objectives: The purpose of this study was to investigate the longitudinal relationship between different levels of Cognitively Stimulating Leisure Activity (CSLA) participation and emotional health and cognitive function among older adults with Mild Cognitive Impairment (MCI). Methods: The current study employed the Health and Retirement Study (HRS) data from 2012 to 2020 (n = 5,932). Three cognitive function tests based on Montreal Cognitive Assessment (MoCA) were used to assess three domains of cognition (i.e., memory, working memory, attention and processing speed) and screen whether the respondents have MCI. Using a Repeated-Measured Multivariate Analysis of Covariance (RM-MANCOVA), this study investigated (a) group mean differences in the positive and negative affect and (b) group mean differences in three cognitive functions in three CSLA groups (low, mid, and high participation).Results: (a) The high CSLA group showed higher positive affect and lower negative affect than the mid and low groups. Also, the mid-CSLA group presented higher positive affect and lower negative affect than the low CSLA group. (b) Both positive and negative affect showed significant differences between years and indicated a continuously declining slope year by year without exceptions. (c) The high CSLA group not only presented higher positive affect and lower negative affect during the period but also solely showed a rebounding feature in the declining slope on both emotions. (d) The high CSLA group indicated higher memory, working memory, and attention and processing speed than the mid and low groups. The mid-CSLA group showed higher working memory and attention and processing speed than the low CSLA group but not in working memory. (e) All three cognitive functions displayed significant differences between years and display a declining slope but the differences between the year 2014 and other years are not significant. (f) The high CSLA group always exhibited higher cognitive functions during the period and maintained a similar level of cognitive functions compared to the other groups. Discussion: The findings of this study provide valuable support for the design and implementation of CSLA participation programs and clinical guidelines for older adults with MCI. The results highlight the importance of determining the optimal level of CSLA engagement that is required to promote emotional health and cognitive function in this population. By incorporating the findings of this study into clinical guidelines, healthcare providers are able to offer an optimal level of CSLA programs offered at least four to three times a week. Further, efforts should be made to create strategies to overcome the barriers to CSLA participation, such as caregiver support and financial constraints, by establishing public care services, subsidies, and community support networks. These implications will contribute to the promotion of cognitive function and the potential prevention of dementia in older adults with MCI, and enhance their overall well-being and quality of life.