This study investigated how informal caregiving moderates the relationship between leisure activity engagement and cognition using data from the Health and Retirement Study. Cognitive performance outcomes included total cognition and episodic memory. Leisure activity engagement was assessed by both the frequency and the diversity (variety) of activities. Caregivers (N = 6,275) were younger (Mcaregivers = 66.65 years, SD = 10.0; Mnon-caregivers = 70.32, SD = 9.9, p < .001), had a higher proportion of non-White individuals (31.62% vs. 14.82%), and females (63.06% vs. 57.76%) compared to non-caregivers (N = 4,271). Compared to non-caregivers, caregivers reported more frequent and more diverse activity engagement (p < .001), yet had lower total cognition (p < .001) and memory scores (p = 0.006). For both activity measures, higher scores were related to better total cognition and memory (p < .001). Moderation analyses indicated that higher activity frequency and diversity were related with better total cognition and memory, but the beneficial impact was attenuated among caregivers. Future work should investigate this relationship by considering caregiver-specific factors.
BertrandR. M.SaczynskiJ. S.MezzacappaC.HulseM.EnsrudK.FredmanL. (2012). Caregiving and cognitive function in older women: Evidence for the healthy caregiver hypothesis. Journal of Aging and Health, 24(1), 48–66. https://doi.org/10.1177/0898264311421367
4.
BielakA. A. M. (2010). How can we not ‘lose it’ if we still don’t understand how to ‘use it’? Unanswered questions about the influence of activity participation on cognitive performance in older age – A mini-review. Gerontology, 56(5), 507–519. https://doi.org/10.1159/000264918
5.
BielakA. A. M.GerstorfD.AnsteyK. J.LuszczM. A. (2014). Longitudinal associations between activity and cognition vary by age, activity type, and cognitive domain. Psychology and Aging, 29(4), 863–872. https://doi.org/10.1037/a0036960
6.
BielakA. A. M.GowA. J. (2022). A decade later on how to “use it” so we don’t “lose it”: An update on the unanswered questions about the influence of activity participation on cognitive performance in older age. Gerontology, 1–20(3), 336–355. https://doi.org/10.1159/000524666
7.
BielakA. A. M.MogleJ. A.SliwinskiM. J. (2019). Two sides of the same coin? Association of variety and frequency of activity with cognition. Psychology and Aging, 34(3), 457–466. https://doi.org/10.1037/pag0000350
8.
BrownC. J.JeonS.NgY. T.LeeS.FingermanK. L.CharlesS. T. (2023). Switching it up: Activity diversity and cognitive functioning in later life. Psychology and Aging, 38(6), 483–493. https://doi.org/10.1037/pag0000770
9.
CarlsonM. C.ParisiJ. M.XiaJ.XueQ.-L.RebokG. W.Bandeen-RocheK.FriedL. P. (2012). Lifestyle activities and memory: Variety may be the spice of life. The women’s health and aging study ii. Journal of the International Neuropsychological Society: JINS, 18(2), 286–294. https://doi.org/10.1017/S135561771100169X
10.
CorrêaM. S.de LimaD. B.GiacobboB. L.VedovelliK.ArgimonI. I. L.BrombergE. (2019). Mental health in familial caregivers of Alzheimer’s disease patients: Are the effects of chronic stress on cognition inevitable?Stress, 22(1), 83–92. https://doi.org/10.1080/10253890.2018.1510485
11.
DasselK. B.CarrD. C.VitalianoP. (2017). Does caring for a spouse with dementia accelerate cognitive decline? Findings from the health and retirement study. The Gerontologist, 57(2), 319–328. https://doi.org/10.1093/geront/gnv148
12.
de VugtM. E.JollesJ.van OschL.StevensF.AaltenP.LousbergR.VerheyF. R. J. (2006). Cognitive functioning in spousal caregivers of dementia patients: Findings from the prospective MAASBED study. Age and Ageing, 35(2), 160–166. https://doi.org/10.1093/ageing/afj044
13.
ElayoubiJ.HaleyW. E.WaltersM. E.RothD. L.HowardV. J.CroweM.HülürG. (2025). Longitudinal impact of transition to caregiving on cognitive functioning: A matched case-control study. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 80(10), gbaf141. https://doi.org/10.1093/geronb/gbaf141
14.
ElayoubiJ.NelsonM. E.MuC. X.HaleyW. E.WadleyV. G.ClayO. J.CroweM.CushmanM.GrantJ. S.RothD. L.AndelR. (2023). The role of caregiving in cognitive function and change: The REGARDS study. Psychology and Aging, 38(7), 712–724. https://doi.org/10.1037/pag0000766
15.
FredmanL.CauleyJ. A.SatterfieldS.SimonsickE.SpencerS. M.AyonayonH. N.HarrisT. B.Health ABC Study Group. (2008). Caregiving, mortality, and mobility decline: The health, aging, and body composition (Health ABC) study. Archives of Internal Medicine, 168(19), 2154–2162. https://doi.org/10.1001/archinte.168.19.2154
16.
García-CastroF. J.BendayanR.DobsonR. J. B.BlancaM. J. (2022). Cognition in informal caregivers: Evidence from an English population study. Aging & Mental Health, 26(3), 507–518. https://doi.org/10.1080/13607863.2021.1893270
17.
GhislettaP.BickelJ.-F.LövdénM. (2006). Does activity engagement protect against cognitive decline in old age? Methodological and analytical considerations. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 61(5), P253–P261. https://doi.org/10.1093/geronb/61.5.P253
18.
HayesA. (2012). A versatile computational tool for observed variable mediation, moderation, and conditional process modeling. [White Paper]. https://www.afhayes.com/public/process2012.pdf
19.
Health and Retirement Study. (2020). [Psychosocial and Lifestyle Questionnaire], public use dataset. Produced and distributed by the University of Michigan with funding from the National Institute on Aging (grant number NIA U01AG009740). Health and Retirement Study.
20.
HertzogC.KramerA. F.WilsonR. S.LindenbergerU. (2008). Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced?Psychological Science in the Public Interest: A Journal of the American Psychological Society, 9(1), 1–65. https://doi.org/10.1111/j.1539-6053.2009.01034.x
21.
HessT. M.GrowneyC. M.O’BrienE. L.NeupertS. D.SherwoodA. (2018). The role of cognitive costs, attitudes about aging, and intrinsic motivation in predicting engagement in everyday activities. Psychology and Aging, 33(6), 953–964. https://doi.org/10.1037/pag0000289
22.
HultschD. F.HertzogC.SmallB. J.DixonR. A. (1999). Use it or lose it: Engaged lifestyle as a buffer of cognitive decline in aging?Psychology and Aging, 14(2), 245–263. https://doi.org/10.1037/0882-7974.14.2.245
23.
JamesB. D.WilsonR. S.BarnesL. L.BennettD. A. (2011). Late-life social activity and cognitive decline in old age. Journal of the International Neuropsychological Society: JINS, 17(6), 998–1005. https://doi.org/10.1017/S1355617711000531
24.
LeeS.CharlesS. T.AlmeidaD. M. (2020). Change is good for the brain: Activity diversity and cognitive functioning across adulthood. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 76(6), 1036–1048. https://doi.org/10.1093/geronb/gbaa020
25.
LeeS.KofferR. E.SpragueB. N.CharlesS. T.RamN.AlmeidaD. M. (2018). Activity diversity and its associations with psychological well-being across adulthood. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 73(6), 985–995. https://doi.org/10.1093/geronb/gbw118
26.
LeeY.XuL.KimB. J.ChenL. (2020). Leisure activity, gender and depressive symptoms among dementia caregivers: Findings from the REACH II. Aging & Mental Health, 24(11), 1886–1893. https://doi.org/10.1080/13607863.2019.1660853
27.
LuoM.MoulderR. G.BreitfelderL. K.RöckeC. (2023). Daily activity diversity and daily working memory in community-dwelling older adults. Neuropsychology, 37(2), 181–193. https://doi.org/10.1037/neu0000878
28.
LvG.ZhangY.LiuS.ZhuJ.ChenX.WuH.LiuC.ChaiW.LvJ.WangR. (2025). Effect of leisure activities on cognitive and memory function in older adults: A systematic review and meta-analysis of randomized controlled trials. Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia, 133, 111055. https://doi.org/10.1016/j.jocn.2025.111055
29.
MackenzieC. S.WiprzyckaU. J.HasherL.GoldsteinD. (2009). Associations between psychological distress, learning, and memory in spouse caregivers of older adults. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 64B(6), 742–746. https://doi.org/10.1093/geronb/gbp076
30.
MoninJ. K.LevyB.DoyleM.SchulzR.KershawT. (2019). The impact of both spousal caregivers’ and care recipients’ health on relationship satisfaction in the caregiver health effects study. Journal of Health Psychology, 24(12), 1744–1755. https://doi.org/10.1177/1359105317699682
31.
O’SullivanM.BrennanS.LawlorB. A.HanniganC.RobertsonI. H.PertlM. M. (2019). Cognitive functioning among cognitively intact dementia caregivers compared to matched self-selected and population controls. Aging & Mental Health, 23(5), 566–573. https://doi.org/10.1080/13607863.2018.1428937
32.
Romero-MartínezÁ.Hidalgo-MorenoG.Moya-AlbiolL. (2018). Neuropsychological consequences of chronic stress: The case of informal caregivers. Aging & Mental Health, 24(2), 259–271. https://doi.org/10.1080/13607863.2018.1537360
33.
SalaG.JoppD.GobetF.OgawaM.IshiokaY.MasuiY.InagakiH.NakagawaT.YasumotoS.IshizakiT.AraiY.IkebeK.KamideK.GondoY. (2019). The impact of leisure activities on older adults’ cognitive function, physical function, and mental health. PLoS ONE, 14(11), e0225006. https://doi.org/10.1371/journal.pone.0225006
34.
SchüzB.CzerniawskiA.DavieN.MillerL.QuinnM. G.KingC.CarrA.ElliottK.-E. J.RobinsonA.ScottJ. L. (2015). Leisure time activities and mental health in informal dementia caregivers. Applied Psychology. Health and Well-Being, 7(2), 230–248. https://doi.org/10.1111/aphw.12046
35.
SmallB. J.DixonR. A.McArdleJ. J.GrimmK. J. (2012). Do changes in lifestyle engagement moderate cognitive decline in normal aging? Evidence from the Victoria longitudinal study. Neuropsychology, 26(2), 144–155. https://doi.org/10.1037/a0026579
36.
TangW.KannaleyK.FriedmanD. B.EdwardsV. J.WilcoxS.LevkoffS. E.HunterR. H.IrmiterC.BelzaB. (2017). Concern about developing Alzheimer’s disease or dementia and intention to be screened: An analysis of national survey data. Archives of Gerontology and Geriatrics, 71, 43–49. https://doi.org/10.1016/j.archger.2017.02.013
37.
WalkerG. J.DengJ.DieserR. B. (2005). Culture, self-construal, and leisure theory and practice. Journal of Leisure Research, 37(1), 77–99. https://doi.org/10.1080/00222216.2005.11950041
38.
WangH.-X.JinY.HendrieH. C.LiangC.YangL.ChengY.UnverzagtF. W.MaF.HallK. S.MurrellJ. R.LiP.BianJ.PeiJ.-J.GaoS. (2013). Late life leisure activities and risk of cognitive decline. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 68(2), 205–213. https://doi.org/10.1093/gerona/gls153
39.
YatesL. A.ZiserS.SpectorA.OrrellM. (2016). Cognitive leisure activities and future risk of cognitive impairment and dementia: Systematic review and meta-analysis. International Psychogeriatrics, 28(11), 1791–1806. https://doi.org/10.1017/S1041610216001137
