title: Activity loss is associated with cognitive decline in age-related macular degeneration.
abstract: METHODS
  The objective of this study was to determine whether relinquishing cognitive, physical, and social activities is associated with an increased risk of cognitive decline in patients with age-related macular degeneration (AMD). We conducted a 3-year longitudinal study of 206 nondemented patients with AMD.
  
  
  RESULTS
  Twenty-three subjects (14.4%) declined cognitively. Age, sex, education, decline in visual acuity, and number of dropped activities were associated with cognitive decline; each additional dropped activity increased the risk by 58%. Subjects who relinquished three activities were 3.87 times (95% confidence interval, 1.95-7.76) more likely to become demented than subjects who relinquished no activities; those who relinquished five activities were 9.54 times (95% confidence interval, 3.05-30.43) more likely. A multivariate model demonstrated that number of dropped activities was a powerful predictor of cognitive decline after controlling for relevant risk factors, particularly for subjects younger than 80 years of age.
  
  
  CONCLUSIONS
  Relinquishing valued activities is associated with an increased risk of cognitive decline in older patients with vision loss caused by AMD. These data suggest the importance of promoting optimal cognitive and physical health in patients with AMD and perhaps other chronic diseases.
authors.affiliation: Department of Psychiatry, Jefferson Medical College, Philadelphia, PA, USA. barry.rovner@jefferson.edu
authors.forename: Barry W
authors.initials: BW
authors.lastname: Rovner
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Casten
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Leiby
authors.forename: William S
authors.initials: WS
authors.lastname: Tasman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001521:Behavior Therapy; D003072:Cognition Disorders / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008268:Macular Degeneration / Q000453:epidemiology*; D008297:Male; D009043:Motor Activity; D012307:Risk Factors; D012919:Social Behavior; D015354:Vision, Low / Q000453:epidemiology