BACKGROUND: High rates of leisure activity have been associated with reduced risk of Alzheimer disease (AD). OBJECTIVE: To determine whether prediagnosis leisure activity modifies the rate of cognitive decline in patients with AD. DESIGN: Inception cohort followed up longitudinally for a mean of 5.3 years (up to 13.9 years). SETTING: Urban community. PARTICIPANTS: A total of 283 patients with incident AD (mean age, 79 years; 56.2% Hispanic and 31.1% African American). MAIN OUTCOME MEASURES: Change in a composite cognitive score from diagnosis on and during the entire study follow-up. RESULTS: In multivariate-adjusted generalized estimating equation models of postdiagnosis change (n = 133), each leisure activity was associated with an additional yearly decline of 0.005 of a z-score unit in cognitive score (P = .17). In models expanded to include cognitive change during study follow-up, including evaluations before and after diagnosis (n = 283), each activity was associated with an additional yearly decline of 0.005 of a z-score unit in cognitive score (P = .03). The association was strongest for intellectual activities. CONCLUSIONS: Greater participation in prediagnosis leisure activities, especially intellectual activities, was associated with faster cognitive decline, supporting the hypothesis that the disease course in AD may vary as a function of cognitive reserve.
BACKGROUND: High rates of leisure activity have been associated with reduced risk of Alzheimer disease (AD). OBJECTIVE: To determine whether prediagnosis leisure activity modifies the rate of cognitive decline in patients with AD. DESIGN: Inception cohort followed up longitudinally for a mean of 5.3 years (up to 13.9 years). SETTING: Urban community. PARTICIPANTS: A total of 283 patients with incident AD (mean age, 79 years; 56.2% Hispanic and 31.1% African American). MAIN OUTCOME MEASURES: Change in a composite cognitive score from diagnosis on and during the entire study follow-up. RESULTS: In multivariate-adjusted generalized estimating equation models of postdiagnosis change (n = 133), each leisure activity was associated with an additional yearly decline of 0.005 of a z-score unit in cognitive score (P = .17). In models expanded to include cognitive change during study follow-up, including evaluations before and after diagnosis (n = 283), each activity was associated with an additional yearly decline of 0.005 of a z-score unit in cognitive score (P = .03). The association was strongest for intellectual activities. CONCLUSIONS: Greater participation in prediagnosis leisure activities, especially intellectual activities, was associated with faster cognitive decline, supporting the hypothesis that the disease course in AD may vary as a function of cognitive reserve.
Authors: Christopher M Gidicsin; Jacqueline E Maye; Joseph J Locascio; Lesley C Pepin; Marlie Philiossaint; J Alex Becker; Alayna P Younger; Maria Dekhtyar; Aaron P Schultz; Rebecca E Amariglio; Gad A Marshall; Dorene M Rentz; Trey Hedden; Reisa A Sperling; Keith A Johnson Journal: Neurology Date: 2015-06-10 Impact factor: 9.910
Authors: Katherine A Treiber; Michelle C Carlson; Chris Corcoran; Maria C Norton; John C S Breitner; Kathleen W Piercy; Michael Scott Deberard; David Stein; Beth Foley; Kathleen A Welsh-Bohmer; Amber Frye; Constantine G Lyketsos; Joann T Tschanz Journal: J Gerontol B Psychol Sci Soc Sci Date: 2011-03-25 Impact factor: 4.077
Authors: R S Wilson; L L Barnes; N T Aggarwal; P A Boyle; L E Hebert; C F Mendes de Leon; D A Evans Journal: Neurology Date: 2010-09-01 Impact factor: 9.910
Authors: Elizabeth M Lane; Robert H Paul; David J Moser; Thomas D Fletcher; Ronald A Cohen Journal: J Int Neuropsychol Soc Date: 2011-05 Impact factor: 2.892