Tuesday, December 11, 2018

Can Intellectual Engagement Stem Cognitive Decline?

Well shit, that was going to be one of my main prevention ideas. I may now have to up my coffee intake even more. Or become even more socially engaged. Instead of dating 3 people at a time as specified in 'The Tao of Dating: The Smart Womens's Guide to Being Absolutely Irresistible', maybe I should up that to 7, one for each day of the week.

Can Intellectual Engagement Stem Cognitive Decline?

It may boost mental ability in old age, but won't affect the trajectory of decline, study suggests

  • by Contributing Writer, MedPage Today
Self-reported intellectual engagement throughout life, including problem-solving, was not associated with a more favorable cognitive trajectory beyond age 65, according to a longitudinal study from Scotland.
While intellectual stimulation on a regular basis was significantly associated with higher levels of mental ability in old age, it did not influence the course of age-related cognitive decline over 15 years, reported Roger Staff, PhD, of the University of Aberdeen, and colleagues in The BMJ.
"Engagement in problem-solving is associated with a cognitive advantage in late life, after adjusting for life course differences," said Staff. But, contrary to the widely held use-it-or-lose-it belief, "intellectual engagement is not associated with the trajectory of decline," he told MedPage Today.
This finding contrasts a number of observational studies reporting that cognitively stimulating activities reduce the risk of cognitive decline, noted Joe Verghese, MBBS, of the Albert Einstein College of Medicine in New York.
"The current study used a subjective assessment of the engagement in intellectual activities, rather than direct measures of intensity and frequency of participation, and there was major attrition in the cohort over time that might in part explain the different finding," Verghese, who was not involved in the study, told MedPage Today.
These results are not the final word on the role of intellectual activities in preventing cognitive decline, Verghese added. "Clearly, more work needs to be done in defining the role of cognitive activities in preventing cognitive decline."
Staff and colleagues studied records of 498 people from the archives of the Scottish Council for Research in Education, which had maintained population-based records of the Scottish Mental Surveys of 1947. All participants were born in 1936, and all took part in a group intelligence test at age 11.
Participants were about age 64 at baseline, and each person's education history and National Adult Reading Test Score were recorded at the start of the study. Over a 15-year period, participants were tested for memory and mental processing speed up to five times with the Digit Symbol Substitution Test, a test of matching symbols with digits, and the Auditory-Verbal Learning Test, a verbal memory test.
The researchers used a version of the Typical Intellectual Engagement questionnaire that assessed four areas of intellectual engagement: abstract reasoning, reading, problem-solving, and intellectual curiosity. They adjusted for possible confounders from early life, including scores of childhood intelligence and length of formal education, and controlled for practice effects that may have been associated with repeated testing.
They found that while overall intellectual engagement had no influence on the trajectory of decline of memory and processing speed, it was significantly associated with the level of cognitive performance in later life, with each point on a 24-point scale tied to 0.97 standardized cognitive performance score for processing speed and 0.71 points for memory (both P<0.05).
Engaging in problem-solving activities had the largest association with life course cognitive gains, with each point accounting for 0.43 standardized cognitive performance score for processing speed and 0.36 points for memory (both P<0.05).
The results "support the life course importance of engagement in complex problem-solving activities for boosting cognitive ability throughout life," observed George Rebok, PhD, of Johns Hopkins University in Baltimore, who was not involved with the study.
"They also bolster support for the idea that such activities may boost one to a higher cognitive performance level, thereby possibly maintaining cognitive abilities over a longer period of time, even though the trajectory of mental decline, once it occurs, may not be altered," he told MedPage Today.
Studies that track intellectual activities and cognitive decline have two main problems, noted Deborah Blacker, MD, ScD, of Massachusetts General Hospital in Boston, who was not involved in the study.
"The first is that the results may be an artifact of the baseline cognitive status and the things that come along with that, like education and cognitive reserve," she told MedPage Today. "The second is reverse causation: in a study that spans only 5 years, for example, people may have already cut back on something that once was fun because it's not as pleasurable."
This study, by including childhood cognitive scores and testing people over 15 years, attempts to address both of these issues, she said.
But it has limitations, Blacker pointed out. It tended to be biased toward people with higher levels of education, as evidenced by assessing items like abstract reasoning. And better educated people are more likely to participate in studies like these, Staff and colleagues noted. Details of early life experiences were retrospective and could not be corroborated, and participant dropout may have influenced results, they added. And Scots born in 1936 may not be representative of other populations.
The study was funded by the University of Aberdeen. Staff and co-authors disclosed no relevant relationships with industry.
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