Table 4.

Hazard ratios and 95% confidence intervals (CI) for the joint effect of leisure activities (including physical, mental, and social dimensions) and adherence to the Nordic Prudent Dietary Pattern (NPDP) on MMSE decline to ≤24 over an average of 6 years (n = 1810).

Joint Exposure		n	Model 1 *	p-Value	Model 2 †	p-Value
Physical Activity	NPDP Adherence		HR (95% CI)		HR (95% CI)
Low	Low	165	Reference		Reference
Moderate/intense	Low	554	0.62 (0.38 to 1.02)	0.058	0.80 (0.48 to 1.33)	0.394
Low	Moderate/high	224	0.28 (0.12 to 0.63)	0.002	0.55 (0.24 to 1.27)	0.160
Moderate/intense	Moderate/high	1280	0.16 (0.09 to 0.27)	<0.001	0.39 (0.22 to 0.67)	0.001
p-value for trend			0.53 (0.45 to 0.62)	<0.001	0.72 (0.61 to 0.85)	<0.001
Mental Activity	NPDP Adherence
Low	Low	362	Reference		Reference
Moderate/intense	Low	357	0.73 (0.46 to 1.17)	0.189	1.04 (0.63 to 1.71)	0.884
Low	Moderate/high	452	0.37 (0.22 to 0.62)	<0.001	0.63 (0.37 to 1.09)	0.096
Moderate/intense	Moderate/high	1052	0.16 (0.09 to 0.27)	<0.001	0.40 (0.22 to 0.73)	0.003
p-value for trend			0.55 (0.47 to 0.64)	<0.001	0.74 (0.62 to 0.87)	<0.001
Social Activity	NPDP Adherence
Low	Low	467	Reference		Reference
Moderate/intense	Low	252	0.69 (0.41 to 1.17)	0.170	0.83 (0.49 to 1.41)	0.498
Low	Moderate/high	883	0.31 (0.21 to 0.48)	<0.001	0.57 (0.37 to 0.88)	0.011
Moderate/intense	Moderate/high	621	0.11 (0.06 to 0.22)	<0.001	0.28 (0.14 to 0.57)	<0.001
p-value for trend			0.52 (0.44 to 0.61)	<0.001	0.70 (0.59 to 0.83)	<0.001

Hazard ratios (95% CI) are from the parametric survival models. * Model 1: crude. ^† Model 2: adjusted for age, sex, education, civil status, total calorie intake, dietary vitamin/mineral supplement use, smoking status and duration (years), body mass index, vascular disorders, cancer, diabetes, depression, APOE ɛ4 allele carriage, and lifestyle factors other than the main exposure in each model.