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July 14, 2021
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Frequently engaging in 'cognitively stimulating activities' may delay dementia onset

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Individuals with a “cognitively active lifestyle” delayed dementia onset up to 5 years compared with individuals who engaged in low levels of cognitive activity, according to findings from a longitudinal cohort study published in Neurology.

“The good news is that it’s never too late to start doing the kinds of inexpensive, accessible activities we looked at in our study,” Robert S. Wilson, PhD, professor in the department of neurological sciences at Rush Medical College and neuropsychologist at Rush University Alzheimer’s Disease Center, said in a press release. “Our findings suggest it may be beneficial to start doing these things, even in your 80s, to delay the onset of Alzheimer’s dementia.”

Wilson RS, et al. Neurology. 2021;doi:10.1212/WNL.0000000000012388.

Wilson RS, et al. Neurology. 2021;doi:10.1212/WNL.0000000000012388.

Wilson and colleagues aimed to determine whether increased levels of cognitive activity predicted older age at the time of dementia onset in Alzheimer’s disease dementia among older individuals without dementia. The 1,903 older individuals included in the analysis reported how often they engaged in “cognitively stimulating activities” such as reading and underwent annual clinical exams to diagnose dementia as well as AD. The researchers performed neuropathological analyses on individuals who died. They also examined the link between baseline cognitive activity and age at diagnosis of incident AD dementia and to postmortem markers of AD and other dementias.

Over a mean follow-up period of 6.8 years, the researchers reported incident AD diagnoses in 457 individuals (mean age at diagnosis, 88.6 years; range, 64.1-106.5 years). An “extended accelerated failure time model” demonstrated that an increased level of baseline cognitive activity (mean, 3.2) correlated with older age at AD dementia onset (estimate = 0.026; 95% CI, 0.013-0.039). The researchers found that decreased cognitive activity (score = 2.1; 10th percentile) was linked to a mean age at disease onset of 88.6 years compared with a mean age at disease onset of 93.6 years in relation to more cognitive activity (score = 4; 90th percentile). Subsequent analyses that adjusted for potential confounding factors demonstrated similar results.

The researchers also conducted neuropathologic exams on 695 patients who died, according to the study results. Those exams showed that cognitive activity was “unrelated” to postmortem markers of AD and other dementias, such as amyloid and tau protein deposits.

Wilson and colleagues noted that the study results were based on a group of primarily white individuals with higher levels of education, limiting their findings, according to the press release. As a result, future research should examine whether the findings apply to the general population.

“Our study shows that people who engage in more cognitively stimulating activities may be delaying the age at which they develop dementia,” Wilson said in the press release. “It is important to note, after we accounted for late life level of cognitive activity, neither education nor early life cognitive activity were associated with the age at which a person developed [AD] dementia. Our research suggests that the link between cognitive activity and the age at which a person developed dementia is mainly driven by the activities you do later in life.”

Reference:

American Academy of Neurology. Think about this: Keeping your brain active may delay Alzheimer’s dementia 5 years. Available at: https://www.aan.com/PressRoom/Home/PressRelease/4909. Accessed July 13, 2021.