Here's what you need to know about living a "cognitively active" lifestyle.

By Karla Walsh; Reviewed by Victoria Seaver, M.S., RD
July 21, 2021
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As the classic idiom goes, prevention is better than cure, and this is exactly what much of the recent scope of dementia research has focused on.

We know that a sizable portion of Alzheimer's risk lies in our DNA, but a lot of the determinants of dementia are triggered by lifestyle habits. There's no proven, surefire way to prevent or cure dementia, but scientists are discovering that individuals who tend to follow certain habit patterns tend to have less brain decline with age.

Adding to a mountain of research that suggests an overall healthy lifestyle can drastically lower risk for cognitive decline, we've learned that walking three times weekly, not smoking, playing music and following a generally heart-smart lifestyle can majorly move the needle and decrease the chances of receiving a dementia diagnosis.

As many as one in five seniors 65 and older will experience some type of mild cognitive impairment (MCI), which can impact memory, decision-making and/or reasoning skills. In many cases, MCI progresses to dementia, including Alzheimer's disease.

The latest lifestyle-related research on this topic might just be one of the most fun yet: According to a brand-new study published July 14 in the journal Neurology, a "cognitively active lifestyle" including writing letters, reading and playing games in old age may delay the onset of Alzheimer's by five years.

Earlier studies have found that reading can lower risk for cognitive decline, which caused scientists to hypothesize that brain-stimulating activities might slow the onset of dementia by boosting the "cognitive reserve," or our ability to think, which varies by individual and throughout the lifespan.

"You might say that the cognitive activity through life delays the symptoms but does not stop the underlying disease. In other words, the activity gives you a 'reserve' that makes you 'resilient' to the presence of the Alzheimer's pathology in the brain, enabling you to function better for longer," James Rowe, professor of cognitive neurology at the University of Cambridge, United Kingdom, adds in the Medical News Today story about the research. (Rowe was not involved in the study, by the way, he's just chiming in with some overall expert context.)

To determine this, the scientists studied data from 1,903 people with an average age of about 80 years who were enrolled in the Rush Memory and Aging Project. None of these individuals had received a dementia diagnosis at the start of the study.

At the beginning, each participant answered seven questions to assess their levels of cognitive activity. Queries addressed how much time they spent reading each day, how often they wrote letters and how frequently they played games (like cards, puzzles or board games). The seniors also shared details about their early-life cognitive activity, current loneliness levels and how social they tend to be (say, by visiting family or friends).

Each person also took annual clinical evaluations, which covered medical history, a neurological examination and a set of 19 cognitive tests. They also agreed to a brain autopsy after death.

By the conclusion of the 7-year study, 695 participants had died and 457 had developed Alzheimer's (the latter group included both living and deceased individuals). Those who were most cognitively active as seniors developed Alzheimer's disease, on average, at age 93.6. Those who reported the least cognitive challenges in old age developed Alzheimer's disease around an average age of 88.6 years.

It's worth noting that this could be a chicken and egg scenario, the scientists write: "it is possible that a low level of cognitive activity is an early sign of underlying disease rather than a true risk factor."

Still, the researchers believe that a more likely explanation is that cognitively-stimulating habits actually change the way the brain is structured and how it functions to enhance that aforementioned cognitive reserve.

"I was confident that higher cognitive activity would be associated with later age of dementia onset, but I was unsure of the size of the association," Dr. Robert Wilson, lead author of the paper, tells Medical News Today. "The study suggests that a cognitively active lifestyle can stave off the cognitive symptoms of Alzheimer's disease and related disorders by several years and thereby greatly reduce how much of one's lifespan is spent in a cognitively disabled state. We asked about everyday cognitively stimulating activities, such as reading a newspaper or book or visiting a library; it was cognitive activity in old age that was most protective."

This research shows "clearly that cognitive activity is good for you and your wellbeing in later life, and that is an important message to get out. It is not about what to do after you get memory symptoms or dementia, but how to prevent the dementia by being active earlier in life—part of a bigger shift away from merely treating dementia to looking after brain health," Rowe summarizes. "Although cognitive activity does not change the presence or severity of the brain changes of Alzheimer's, your brain manages better to cope with the pathology" and the diagnosis and severity is delayed.

While this study was fairly long-term and extensive, it was performed on mostly white, well-educated participants. Future research should focus on larger cohorts of diverse adults, the scientists recommend.

In addition to reading, playing and writing notes daily, check out how to exercise for better brain health and the best foods to limit to reduce risk for Alzheimer's.

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