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Do Cognitive Activities Protect Against Dementia?

Cognitively challenging activities protected elders who exhibited no baseline dementia.

Elderly people who participate in cognitively challenging activities appear to have lower risk for dementia than do those who don't participate in such activities. However, to ensure that reduced participation in such activities is not a result of early subtle dementia, we need long-term observational studies. In this analysis from the Bronx Aging Study, researchers identified 469 people (age range, 75 to 85) with no evidence of dementia and followed them for as long as 21 years (median follow-up, 5 years).

Dementia developed in 124 subjects. Elders who participated at least twice weekly in cognitive activities such as reading, playing board games, and playing musical instruments had significantly reduced risks for dementia. Three observations support the conclusion that regular participation in cognitive activities protected against dementia:

• Reduced risk persisted even after adjusting for baseline differences in the results of neuropsychological tests.
  
• Reduced risk persisted even after excluding subjects in whom dementia was diagnosed during the first 7 years of follow-up.
  
• Participation in another type of activity -- physical activity -- was not associated with reduced risk for dementia.
  

Comment: The findings support the theory that participation in cognitively challenging activities increases cognitive reserve and delays or prevents the onset of dementia. However, although this study was designed to minimize confounding, it remains possible that reduced participation in these pastimes resulted from subtle effects of an early, otherwise unrecognizable, dementing process.

— Allan S. Brett, MD

Published in Journal Watch General Medicine July 8, 2003

Citation(s):

Verghese J et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003 Jun 19; 348:2508-16.

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