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Alzheimer's, Dementia & Mental Health

Intellectual Enrichment Again Proven to Delay Cognitive Decline in Seniors

Latest study from Mayo Clinic published in JAMA Neurology suggests even those with high risk gene can delay decline for years

June 23, 2014 - The evidence continues to mount that the way to protect against the common cognitive decline seen in too many senior citizens is to maintain a lifestyle of intellectual enrichment throughout life. A new study from the Mayo Clinic Study of Aging confirms it again in a report appearing in today’s edition of JAMA Neurology, and add that it may delay dementia as long as nine years, even in high risk seniors.

Previous research has linked intellectual enrichment with possible protection against cognitive decline.

The purpose of this study was to investigate the association of lifetime intellectual enrichment with baseline cognitive performance and rate of cognitive decline in an older population without dementia and to estimate the years of protection provided against cognitive impairment by these factors.

The researchers found that higher scores that gauged education (years of school completed) and occupation (based on attributes, complexities of a job), as well as higher levels of mid/late-life cognitive activity (e.g., reading books, participating in social activities and doing computer activities at least three times per week) were linked to better cognition in older patients.

 

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They examined lifetime intellectual enrichment with baseline performance and the rate of cognitive decline in older patients without dementia and estimated the protection provided against cognitive decline, according to author Prashanthi Vemuri, Ph.D., of the Mayo Clinic and Foundation, Rochester, Minn.

They did prospective analysis of individuals enrolled from October 1, 2004, and in 2008 and 2009 in the Mayo Clinic Study of Aging, a longitudinal, population-based study of cognitive aging in Olmsted County, Minnesota.

“We studied 1995 individuals without dementia (1718 cognitively normal individuals and 277 individuals with mild cognitive impairment) who completed intellectual lifestyle enrichment measures at baseline and underwent at least 1 follow-up visit,” writes Dr. Vemuri and colleagues.

The 1,995 seniors studies were ages 70 to 89 years and did not have dementia (1,718 were cognitively normal and 277 individuals had mild cognitive impairment) in Olmsted County, Minnesota. They analyzed education/occupation scores and mid/late-life cognitive activity based on self-reports.

There results confirmed that better education/occupation scores and mid/late-life cognitive activity were associated with better cognitive performance.

Higher education/occupation scores were associated with higher levels of cognition. Higher levels of mid/late-life cognitive activity were also associated with higher levels of cognition, but the slope of this association slightly increased over time. Lifetime intellectual enrichment might delay the onset of cognitive impairment and be used as a successful preventive intervention to reduce the impending dementia epidemic.

The authors suggest high lifetime intellectual enrichment may delay the onset of cognitive impairment by almost nine years in carriers of the APOE4 genotype, a risk factor for Alzheimer disease, compared with low lifetime intellectual enrichment.

Only baseline age, mid/late-life cognitive activity, and APOE4 genotype were significantly associated with longitudinal change in cognitive performance from baseline (P < .05).

For APOE4 carriers with high lifetime intellectual enrichment (75th percentile of education/occupation score and midlife to late-life cognitive activity), the onset of cognitive impairment was approximately 8.7 years later compared with low lifetime intellectual enrichment (25th percentile of education/ occupation score and mid/late-life cognitive activity).

“Lifetime intellectual enrichment might delay the onset of cognitive impairment and be used as a successful preventive intervention to reduce the impending dementia epidemic,” the authors write.

Funding for the study came from the National Institutes of Health, the Alexander Family Alzheimer’s Disease Research Professorship of the Mayo Foundation, and grant from the National Institutes of Health for the Opus Building.

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