title: Leisure activities, apolipoprotein E e4 status, and the risk of dementia.
abstract: OBJECTIVE
  Leisure activities have been associated with a decreased risk of dementia. However, to date, no study has explored how apolipoprotein E (ApoE) e4 status or vascular risk factors modified the association between leisure activities and dementia risks.
  
  
  METHODS
  This case-control study recruited patients (age ≥ 60 years) with Alzheimer's disease (AD; n = 292) and vascular dementia (VaD; n = 144) and healthy controls (n = 506) from three teaching hospitals in Taiwan between 2007 and 2010. Information on patient's leisure activities were obtained through a questionnaire. Conditional logistic regression models were used to assess the association of leisure activities and ApoE e4 status with the risk of dementia.
  
  
  RESULTS
  High-frequency physical activity was associated with a decreased risk of AD [adjusted odds ratio (AOR) = 0.45], and the results become more evident among ApoE e4 carriers with AD (AOR = 0.30) and VaD (AOR = 0.26). Similar findings were observed for cognitive (AOR = 0.42) and social activities (AOR = 0.55) for AD. High-frequency physical, cognitive, and social activities were associated with a decreased risk of VaD (AOR = 0.29-0.60). Physical and social activities significantly interacted with each other on the risk of VaD (pinteraction = 0.04).
  
  
  CONCLUSIONS
  Physical activity consistently protects against AD and VaD. Significant interactions were identified across different types of leisure activities in lowering dementia risk.
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Sheng-Ying
authors.initials: SY
authors.lastname: Yang
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Family Medicine, Taiwan Adventist Hospital, Taipei, Taiwan.
authors.forename: Pei-Hsuan
authors.initials: PH
authors.lastname: Weng
authors.affiliation: Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jen-Hau
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
authors.forename: Jeng-Min
authors.initials: JM
authors.lastname: Chiou
authors.affiliation: Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Chih-Yin
authors.initials: CY
authors.lastname: Lew-Ting
authors.affiliation: Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ta-Fu
authors.initials: TF
authors.lastname: Chen
authors.affiliation: Department of Neurology, En Chu Kong Hospital, Taipei, Taiwan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Laboratory Medicine, En Chu Kong Hospital, Taipei, Taiwan.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Wen
authors.affiliation: School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan; Center of Neurological Medicine, Cardinal Tien Hospital, Taipei, Taiwan.
authors.forename: Ping-Keung
authors.initials: PK
authors.lastname: Yip
authors.affiliation: Department of Laboratory Medicine, Cardinal Tien Hospital, Taipei, Taiwan.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Chu
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Research Center for Genes, Environment, and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan. Electronic address: karenchen@ntu.edu.tw.
authors.forename: Yen-Ching
authors.initials: YC
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000235:genetics*; D053327:Apolipoprotein E4 / Q000235:genetics*; D016022:Case-Control Studies; D005260:Female; D005819:Genetic Markers; D006579:Heterozygote; D006801:Humans; D007899:Leisure Activities; D016015:Logistic Models; D008297:Male; D009043:Motor Activity; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013624:Taiwan
chemical_list: D053327:Apolipoprotein E4; D005819:Genetic Markers
keywords: Alzheimer's disease; apolipoprotein E; dementia; leisure activities; vascular