Social and cognitive activities for dementia risk reduction: A qualitative exploration of perspectives of citizens with diverse backgrounds

Background: Engagement in social and cognitive activities can reduce dementia risk, but currently, concepts are loosely defined, leading to enormous heterogeneity in available measurements. Moreover, interventions often focus on brain-training and contact between participants instead of engagement in everyday activities that seem protective. Objective: This qualitative study explores how citizens with diverse backgrounds conceptualize engagement in social and cognitive activities and identifies factors influencing engagement.Methods: Semi-structured interviews were conducted with 23 citizens of diverse backgrounds living in the Netherlands. Specific emphasis was devoted to recruiting participants with a low socioeconomic position and migration background, as they have a higher dementia risk. Two researchers independently conducted an inductive-deductive content analysis.Results: Participants conceptualized social activities as interactions with others, extending earlier definitions to also include non-human interactions (e.g., God or pets) and prioritized interaction quality (e.g., reciprocity, autonomy, and value). Participants conceptualized cognitive activities as challenging and requiring information processing, such as concentration and focus. Novelty and personal control contributed to the perceived challenge. Engagement in both activities was influenced by perceived purpose (e.g., enjoyment, fulfilment), individual disposition (e.g., mental and physical health), and contextual barriers (e.g., financial scarcity, cultural norms). Conclusions: Measurements and interventions should operationalize attributes that make certain activities socially or cognitively stimulating. Instead of relying on frequency or duration, activity measurements would benefit from assessing subjective attributes like reciprocity, autonomy, value, challenge, and novelty. Interventions would benefit from promoting engagement in purposeful activities and support in overcoming individual and contextual barriers.