Mental Exercise May Protect Against Dementia
All of us have moments when we forget where we put our keys or take a few extra minutes to remember someone’s name. Although these inevitable lapses of memory may increase with age, they are not a sign of ]]>dementia]]> , which is a far more serious condition characterized by progressive memory loss and confusion that is not a normal part of aging. Dementia affects about 1 in every 10 American age 65 and over.
Some causes of dementia can be treated and even reversed, but the most common forms, ]]>Alzheimer’s disease]]> and ]]>vascular dementia]]> , have no cure. Key in the fight against dementia, therefore, is research to determine ways to prevent it, or at the very least, to delay its onset. Several studies have shown that the more an elderly person participates in leisure activities, the lower is his or her risk of dementia. A new study published in the June 19, 2003 issue of The New England Journal of Medicine lends further support to this observation.
About the Study
Researchers at Albert Einstein College of Medicine and Syracuse University conducted a prospective cohort study (which follows a large group of people over a period of time) to examine whether participation by elders in leisure activities could reduce risk of dementia. From 1980 to 1983, the researchers enrolled 469 English-speaking subjects between the ages of 75 and 85 who resided in the community and did not have dementia.
Subjects underwent clinical and psychological evaluations at baseline and at follow-up visits every 12 to 18 months, through 2001 (for 21 years). Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders , Third Edition (DSM-III-R) criteria. The subjects were also asked how often they participated in 6 cognitive activities (reading books or newspapers, writing for pleasure, doing crossword puzzles, playing board games or cards, participating in organized group discussions, and playing musical instruments) and 11 physical activities (playing tennis or golf, swimming, bicycling, dancing, group exercises, team games such as bowling, walking for exercise, doing housework, and babysitting).
Dementia developed in 124 subjects (Alzheimer’s disease in 61 subjects, vascular dementia in 30, mixed dementia in 25, and other types of dementia in 8). Among cognitive activities, playing board games, reading, playing a musical instrument, and doing crossword puzzles were associated with a significantly reduced risk of dementia(even after the researchers took into account such differences as age, sex, educational level, and presence or absence of chronic disease. Dancing was the only physical activity associated with a significantly lowered risk of dementia.
The researchers also found that the more a subject participated in cognitive activities, the lower was his or her risk of dementia. Compared with the least active subjects, the most active subjects had a 63% lower risk of developing the disease.
Despite these compelling results, prospective cohort studies like this one are not capable of proving a cause and effect association. It might be that some other unrecognized factor, besides mentally engaging activities, actually led to improved cognitive performance. In addition, the findings may not apply to all older adults since study participants were 75 to 85 years old, middle class, mostly white (91%), and mostly female (64%).
How Does This Affect You?
This latest study adds strength to the view that participation in leisure activities is associated with lower risk of dementia. While elders who are in the early stages of dementia tend to participate less in leisure activities, studies like this one suggest that the reverse may be true: the more an elder participates in leisure activities, the less likely it is that he or she will get dementia in the first place.
With regard to the type of activities subjects participated in, the study found that cognitive activities in particular could make a significant difference. But that does not rule out the possibility that physical activities could have an impact, too. In fact, among the physical activities included in this study, positive (but not statistically significant) trends were seen for doing housework, swimming, walking, and babysitting. Plus, any number of other activities not considered could also be beneficial.
Even if their protective effect is small, these types of activities are essentially risk free and greatly enhance the quality of life. So pick up a crossword puzzle, read a book, play with your grandkids, or go for a walk—all are good for the body, soul, and mind.
The American Geriatrics Society
Verghese J, Lipton RB, Katz MJ, et al. Leisure Activities and the Risk of Dementia in the Elderly. NEJM . 2003;348(25):2508-16.
Coyle JT. Use it or Lose it(Do Effortful Mental Activities Protect Against Dementia? [Editorial]. NEJM . 2003;348(25):2489-90.
Forgetfulness: It's Not Always What You Think. NIH. Available at:
Accessed June 17, 2003.
Screening for Dementia in Primary Care Settings. Annals of Internal Medicine. Available at:
Accessed June 17, 2003.
Last reviewed June 19, 2003 by ]]>Richard Glickman-Simon, MD]]>
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