Tourism experiences reduce the risk of cognitive impairment in the Chinese older adult: a prospective cohort study

Qian Li; Zheng Guo; Fangli Hu; Mengfei Xiao; Qiang Zhang; Jun Wen; Tianyu Ying; Danni Zheng; Youxin Wang; Song Yang; Haifeng Hou

doi:10.3389/fpubh.2023.1271319

Tourism experiences reduce the risk of cognitive impairment in the Chinese older adult: a prospective cohort study

Front Public Health. 2023 Oct 24:11:1271319. doi: 10.3389/fpubh.2023.1271319. eCollection 2023.

Authors

Qian Li¹, Zheng Guo², Fangli Hu³, Mengfei Xiao¹, Qiang Zhang⁴, Jun Wen⁵, Tianyu Ying⁶, Danni Zheng⁷, Youxin Wang⁸, Song Yang⁹, Haifeng Hou¹

Affiliations

¹ School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
² Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
³ Centre for Precision Health, Edith Cowan University, Joondalup, WA, Australia.
⁴ Department of Thoracic Surgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, China.
⁵ School of Business and Law, Edith Cowan University, Joondalup, WA, Australia.
⁶ Department of Tourism and Hotel Management, Zhejiang University, Hangzhou, China.
⁷ Department of Tourism, Fudan University, Shanghai, China.
⁸ Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
⁹ Department of Endocrinology, The Affiliated Taian City Central Hospital of Qingdao University, Taian, China.

Abstract

Background: Given the etiological complexity of cognitive impairment, no effective cure currently exists for precise treatment of dementia. Although scholars have noted tourism's potential role in managing cognitive impairment and mild dementia, more robust empirical investigation is needed in this area. This study aimed to examine the associations between tourism and cognitive impairment and dementia in older Chinese adults.

Method: From a nationwide community-based cohort, 6,717 individuals aged ≥60 were recruited from 2011 to 2014, of whom 669 (9.96%) had had at least one tourism experience in the 2 years prior to enrollment. All the participants were then prospectively followed up until 2018. The association between tourism and cognitive impairment was examined by the Cox proportional hazards regression model. The adjusted hazard ratio (aHR) and its 95% confidence interval (CI) were calculated to evaluate the effect of tourism experience on cognitive impairment and dementia.

Results: A total of 1,416 individuals were newly diagnosed with cognitive impairment and 139 individuals with dementia onset during follow-up. The incidence of cognitive impairment was significantly lower among participants with tourism experiences (316.94 per 10,000 person-years) than those without such experiences (552.38 per 10,000 person-years). Cox regression showed that tourism decreased the risk of cognitive impairment (aHR = 0.69, 95% CI: 0.41-0.62) when adjusted for behavioral covariates and characteristics. Compared with participants without tourism experiences, those with 1, 2, and ≥3 tourism experiences had a lower risk of cognitive impairment with the aHRs of 0.72 (95% CI: 0.52-0.99), 0.65 (0.42-1.01), and 0.68 (0.44-0.98), respectively. Tourism experiences also reduced participants' risk of dementia (aHR = 0.41, 95% CI: 0.19-0.89).

Conclusion: Our findings demonstrated associations between tourism and reduced risks of cognitive impairment and dementia in older Chinese adults. Thus, tourism could serve as a novel approach to dementia prevention.

Keywords: cognitive impairment; cohort study; dementia; incidence; prevention; tourism.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cognitive Dysfunction* / epidemiology
Dementia* / epidemiology
East Asian People
Humans
Middle Aged
Prospective Studies
Tourism

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by European Commission Horizon 2020 (779238-PRODEMOS); National key research and development program of China (2017YFE0118800).