. Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA. 2002 Feb 13;287(6):742-8. PubMed.


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  1. This is one of few studies that have longitudinally explored the relation between lifestyle and dementia. The authors carefully tested the hypothesis that engagement in cognitive activities is associated with both reduced risk for development of dementia and slower rates of cognitive decline. The results held even when many potential confounders were controlled for and even when subjects with low memory scores at baseline evaluation were excluded from the analyses. We have reported similar associations between intellectual (but also social and physical) engagements and risk for dementia in an ongoing cohort of 1,772 subjects in New York City.

    It is plausible that engagement in intellectually stimulating activities might affect subjects' cognitive reserve capacities and enable them to cope longer before the clinical manifestations of disease are apparent. However, the short interval between assessment of cognitive activities and disease outcome raises the possibility that they might reflect an early disease manifestation rather than a risk factor per se.

    Nevertheless, the hypothesis of lifestyle modifications affecting brain disease outcome becomes even more exciting in the face of increasing animal research literature about neuronal plasticity and its association with learning, and physically and socially enriched environment.

    View all comments by Nikolaos Scarmeas

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