January 15, 2008
Seniors who engage in reading books or newspapers, doing crossword puzzles, playing card games, or attending adult-education classes may be more likely to ward off Alzheimer's disease as they age. But once Alzheimer's is diagnosed, their mental abilities and memory may decline faster than those who were less likely to engage in such leisure activities. Those are the conclusions of an ongoing study of seniors with Alzheimer's living in New York.
Researchers at Columbia University's College of Physicians & Surgeons studied 283 elderly men and women living in the Washington Heights and Inwood neighborhoods of upper Manhattan. Their mean age was 79, and all had been diagnosed with Alzheimer's disease. They had been participating in the study for an average of four years before their disease was diagnosed, then followed after their diagnosis of dementia. Some had been participating in the study for more than 13 years.
All the participants were surveyed at the start of the study, before the diagnosis of dementia, about their participation in various leisure activities. Intellectual activities included reading books, newspapers or magazines; attending classes; and playing cards, games, or bingo. Social activities included doing volunteer work; attending a club or social center; going to movies or sports events; eating out at restaurants; paying social visits, or being visited by friends; or attending church or temple. Physical activities included walking or other exercise. And other activities the researchers asked about included knitting, listening to music, or watching television.
The researchers found that participation in intellectual and social activities was associated with fewer cases of Alzheimer's disease. But once Alzheimer's disease took hold, those who were active participants in activities such as reading or paying social visits declined faster than those who were less engaged in intellectual or social pursuits.
The researchers did not find a link between physical activity and mental capacity, although other studies suggest that exercise may help to keep the brain young. The findings appeared in the Archives of Neurology, a medical journal from the American Medical Association.
Building Brain Reserve
How might intellectual and social activity protect the brain? The scientists who conducted this study suggest that intellectual and social pursuits act to build up so-called cognitive reserve, the ability of the brain to function well despite the loss of nerve cells and other problems caused by Alzheimer's disease. According to this theory, intellectual activities cause brain cells to establish rich and complex connections that may protect them from damage. It is also possible that mental stimulation causes new brain cells to grow. If some cells die, due to Alzheimer's or another disease, enough other cells may remain to keep the person healthy and mentally alert, thereby delaying the onset of symptoms.
Earlier research has found that participating in leisure activities are associated with a reduced risk of Alzheimer's. Population studies suggest, for example, that men and women who slack off on leisure-time activities in their midlife years are more likely to develop Alzheimer's when they are old. Similarly, seniors who maintain a rich social network and remain active throughout old age are less likely to develop the illness than those who participate in fewer activities.
There are other interpretations of this study, as well.
Scientists aren't sure whether the activities themselves provide direct benefits, or whether people who forego participation are showing subtle, early symptoms of dementia. People with Alzheimer's often give up on favorite hobbies like crossword puzzles, and such lack of interest and apathy may develop years before they are actually diagnosed with the disease.
Another conclusion is that more intellectually and socially active people decline faster once they have been diagnosed with Alzheimer's disease. Yet another possibility is that intellectually active people appear more normal at very early stages of the disease and by the time they are diagnosed, they may be farther along than people who have been less intellectually and socially active. So they may appear to decline faster.
Still, seniors -- and everyone else -- should be encouraged to read, play bridge, and stay mentally and physically active, experts advise. The current results support earlier findings on the "use it or lose it" theory that staying mentally and physically active and engaged in your younger years helps keep the mind sharp.
To learn more about preventing Alzheimer's and keeping the mind sharp, visit www.ALZinfo.org.