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Mentally Stimulating Activities and Cognitive Impairment

— Can certain late-life activities help the aging brain?

Ƶ MedicalToday
A senior woman and her friends play cards.

The number of mentally stimulating activities adults participated in -- and their timing -- was tied to their risk of age-related memory loss, a prospective study of 2,000 older adults showed.

Engaging in two or more cognitively stimulating activities -- such as reading books, computer use, crafts, social activities, and playing games -- in late life was tied to a lower risk of incident mild cognitive impairment (MCI), reported Yonas Geda, MD, of the Mayo Clinic in Scottsdale, Arizona, and colleagues.

Engaging in any two activities in late life decreased MCI risk by 28%; three activities dropped the risk by 45%, and four activities lowered the risk by 56%, they wrote in .

"It is never too late," Geda told Ƶ. "If I am 84, I can still engage in mental activities and have good reason to assume I will have a better chance of reducing my risk of mild cognitive impairment."

The analysis builds on the authors' previous work that showed stimulating activities may diminish the risk of MCI in older people, even APOE4 carriers.

The earlier study generated a number of questions, noted co-author Janina Krell-Roesch, PhD, formerly of the Mayo Clinic and currently with the Karlsruhe Institute of Technology in Germany. In response, "this new research looked at two different things," she told Ƶ. "Does the timing of the activities matter? And does the number of activities matter?"

The current research followed 2,000 cognitively unimpaired people who were ages ≥70 in the , monitoring them for clinical progression to MCI over a median of 5 years. Participants completed a self-reported survey at baseline about the timing, number, and frequency of engaging in five mentally stimulating activities: reading books, computer use, social activities, playing games, and craft activities.

At baseline, participants had a median age of about 78 and education level of 14 years. Half of the group (49.9%) was male. Over the follow-up period, 532 people developed new onset MCI.

The number of mentally stimulating activities participants engaged in at midlife (from the ages of 50 through 65) showed no significant association with the risk of new onset of MCI. But in late life (ages ≥66), engaging in more activities was tied to a significantly reduced risk of incident MCI.

Engaging in any two activities in late life showed an HR for MCI of 0.72 (95% CI 0.53-0.99). Engaging in any three late-life activities had an HR of 0.55 (95% CI 0.40-0.77), four activities showed an HR of 0.44 (95% 0.30-0.65), and five had an HR of 0.57 (95% CI 0.34-0.96).

Computer use in midlife, computer use and craft activities in late life, and social activities, game playing, and computer use in combined late-life and midlife stages all were linked to a decreased incidence of MCI. In late life, a decreased risk of MCI was tied to reading books, playing games, or engaging in craft or social activities at least 2 to 3 times a month, or using a computer at least 5 to 6 times a week.

This analysis provides "evidence that there is an association between quality and quantity of mentally stimulating activities, which include both cognitive and social leisure activities, and reduced risk or slowing of the emergence of mild cognitive impairment," noted Rebecca Amariglio, PhD, of Brigham and Women's Hospital in Boston, and colleagues, in an .

"The findings of this report could be of value to clinicians attempting to counsel midlife and older adults about how to stave off or delay the onset of mild cognitive impairment," they added. While mentally stimulating activities may be low-cost interventions that could decrease the risk of cognitive decline," important questions remain about why mentally stimulating activities remain primarily more protective in late life compared with midlife."

The study has several limitations: it was observational and did not provide evidence that cognitively stimulating activities reduce incident cognitive impairment. Low engagement in activities may be the result of incipient MCI; other unmeasured variables also may account for the associations found in the study. Activities were self-reported and participants were asked to remember how often they engaged in activities as far back as middle-age, up to 2 decades before the study began.

Disclosures

The study was supported by the NIH, the National Institute on Aging, the National Institute of Mental Health, the Robert Wood Johnson Foundation, the Robert H. and Clarice Smith and Abigail Van Buren Alzheimer's Disease Research Program, the GHR Foundation, the Mayo Foundation for Medical Education and Research, the Edli Foundation, and the Arizona Alzheimer's Consortium.

Researchers disclosed relevant relationships with Eli Lilly, Lysosomal Therapeutics, Biogen, Lundbeck, the Alzheimer's Treatment and Research Institute, AstraZeneca, Roche, Merck, Genentech, and Janssen Alzheimer Immunotherapy.

The editorialists disclosed no relevant relationships with industry.

Primary Source

Neurology

Krell-Roesch J, et al "Quantity and quality of mental activities and the risk of incident mild cognitive impairment" Neurology 2019; DOI: 10.1212/WNL.0000000000007897.

Secondary Source

Neurology

Skylar-Scott I, et al "Frequency, number, and timing of mental activity and risk of mild cognitive impairment" Neurology 2019; DOI: 10.1212/WNL.0000000000007890.