title: White matter lesions and cognitive performance: the role of cognitively complex leisure activity.
abstract: BACKGROUND
  Among persons with white matter lesions (WMLs), there is a range of cognitive function. We examine whether participation in leisure activities modifies the effect of WML load on cognitive function.
  
  
  METHODS
  Data are from 2300 men and women (aged 66-92 years) participating in the population-based Age Gene/Environment Susceptibility-Reykjavik Study. Subcortical WML load was calculated as a weighted sum, based on size of lesions in the four lobes. Periventricular WML load was calculated as the sum of lesion scores, based on size, for the frontal caps, occipitoparietal caps and bands. The upper quartile of lesion load in either area was compared to the lower three quartiles. Composite scores of memory (MEM), speed of processing (SP), and executive function (EF) were constructed from a battery of neuropsychological tests. Frequency of participation in nine cognitively stimulating leisure activities was assessed via questionnaire; the upper quartile was compared to the lower three quartiles. Multiple regression, controlling for demographic and health factors and brain infarcts, was used to test the main effects and interaction of WMLs and leisure activity on cognitive function.
  
  
  RESULTS
  High leisure activity was associated with higher performance in all three cognitive abilities: MEM beta = 0.20, 95% confidence interval [CI], 0.11-0.29; SP beta = 0.37, 95% CI, 0.29-0.45; and EF beta = 0.23, 95% CI, 0.15-0.29. High WML load was associated with significantly lower performance in SP (beta = -0.06, 95% CI, -0.13 to -0.01). The effect of WMLs on SP performance was modified by high leisure activity (p for interaction <.05).
  
  
  CONCLUSIONS
  Participation in cognitively stimulating leisure activity may attenuate the effect of WML pathology on cognitive performance.
authors.affiliation: Division of Geriatric Medicine, University of Massachusetts Medical School, Biotech Four, 377 Plantation Street, Worcester, MA 01605, USA. jane.saczynski@umassmed.edu
authors.forename: Jane S
authors.initials: JS
authors.lastname: Saczynski
authors.forename: Maria K
authors.initials: MK
authors.lastname: Jonsdottir
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Sigurdsson
authors.forename: Gudny
authors.initials: G
authors.lastname: Eiriksdottir
authors.forename: Palmi V
authors.initials: PV
authors.lastname: Jonsson
authors.forename: Melisa E
authors.initials: ME
authors.lastname: Garcia
authors.forename: Olafur
authors.initials: O
authors.lastname: Kjartansson
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.forename: Vlimundur
authors.initials: V
authors.lastname: Gudnason
authors.forename: Lenore J
authors.initials: LJ
authors.lastname: Launer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001927:Brain Diseases / Q000503:physiopathology*; D002552:Cerebral Ventricles / Q000473:pathology; D003072:Cognition Disorders / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D009929:Organ Size; D013647:Task Performance and Analysis
references.citation: Neuroepidemiology. 2006;26(1):23-9
references.pmid: 16254450
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Neurology. 2003 Apr 8;60(7):1082-8
references.pmid: 12682310
references.citation: Eur J Neurosci. 2003 May;17(10):2042-6
references.pmid: 12786970
references.citation: Neurology. 2002 Aug 13;59(3):383-91
references.pmid: 12177372
references.citation: Brain Res. 1998 Nov 23;812(1-2):38-49
references.pmid: 9813233
references.citation: Atherosclerosis. 2007 Jan;190(1):143-9
references.pmid: 16488420
references.citation: J Am Coll Cardiol. 1990 Mar 15;15(4):827-32
references.pmid: 2407762
references.citation: J Int Neuropsychol Soc. 2002 Mar;8(3):448-60
references.pmid: 11939702
references.citation: Arch Gen Psychiatry. 2006 Mar;63(3):273-9
references.pmid: 16520432
references.citation: J Neurol Neurosurg Psychiatry. 2004 Oct;75(10):1467-9
references.pmid: 15377698
references.citation: Neuron Glia Biol. 2004 Nov;1(4):351-63
references.pmid: 16921405
references.citation: Nat Neurosci. 2005 Sep;8(9):1148-50
references.pmid: 16116456
references.citation: Neurosci Lett. 1987 Dec 29;83(3):351-5
references.pmid: 2450317
references.citation: Cerebrovasc Dis. 2002;13 Suppl 2:21-30
references.pmid: 11901239
references.citation: Neuroimage. 2002 Nov;17(3):1394-402
references.pmid: 12414279
references.citation: Brain Res. 2004 Aug 20;1018(1):130-5
references.pmid: 15262214
references.citation: Atherosclerosis. 2006 May;186(1):222-4
references.pmid: 16445917
references.citation: N Engl J Med. 2004 Apr 1;350(14):1387-97
references.pmid: 15070788
references.citation: Int Psychogeriatr. 2003;15 Suppl 1:99-103
references.pmid: 16191224
references.citation: Ann Neurol. 1989 Apr;25(4):317-24
references.pmid: 2712531
references.citation: Nat Rev Neurosci. 2005 Jun;6(6):463-75
references.pmid: 15891777
references.citation: Arch Gen Psychiatry. 2000 Nov;57(11):1071-6
references.pmid: 11074873
references.citation: Ann Neurol. 2000 Feb;47(2):145-51
references.pmid: 10665484
references.citation: Neurobiol Aging. 1998 Nov-Dec;19(6):589-97
references.pmid: 10192219
references.citation: Dementia. 1994 Sep-Oct;5(5):266-81
references.pmid: 7951684
references.citation: Am J Epidemiol. 2007 May 1;165(9):1076-87
references.pmid: 17351290
references.citation: Stroke. 2005 Jan;36(1):50-5
references.pmid: 15576652
references.citation: Nature. 1997 Apr 3;386(6624):493-5
references.pmid: 9087407
references.citation: Diabetes Care. 2004 Jan;27 Suppl 1:S5-S10
references.pmid: 14693921
references.citation: J Am Coll Radiol. 2006 Sep;3(9):665-76
references.pmid: 17412147
references.citation: JAMA. 2002 Feb 13;287(6):742-8
references.pmid: 11851541