title: Cognitive stimulation and cognitive and functional decline in Alzheimer's disease: the cache county dementia progression study.
abstract: OBJECTIVE
  To examine the association of engagement in cognitively stimulating activities with cognitive and functional decline in a population-based sample of incident Alzheimer's disease (AD).
  
  
  METHODS
  After diagnosis, 187 participants (65% females) were followed semiannually for a mean 2.7 (SD = 0.4) years. Mean age and education were 84.6 (SD = 5.8) and 13.2 (SD = 2.9) years. Caregivers enumerated cognitively stimulating leisure activities via the Lifestyle Activities Questionnaire. Cognition was assessed using the Mini-Mental State Examination and functional ability via the Clinical Dementia Rating sum of boxes. Linear mixed models tested the association between stimulating activities and change over time in each outcome. Covariates were demographic factors, estimated premorbid IQ, presence/absence of the APOE ε4 allele, duration of dementia, level of physical activity, and general health.
  
  
  RESULTS
  At initial assessment, 87% of participants were engaged in one or more stimulating activities, with mean (SD) activities = 4.0 (3.0). This number declined to 2.4 (2.0) at the final visit. There was a statistical interaction between dementia duration and number of activities in predicting rate of cognitive decline (p = .02) and overall functional ability (p = .006).
  
  
  CONCLUSIONS
  Active involvement in cognitively stimulating pursuits may be beneficial for persons with AD.
authors: Department of Psychology, Utah State University, Logan, UT 84322-4440, USA. joann.tschanz@usu.edu
authors: Katherine A
authors: KA
authors: Treiber
authors: Michelle C
authors: MC
authors: Carlson
authors: Chris
authors: C
authors: Corcoran
authors: Maria C
authors: MC
authors: Norton
authors: John C S
authors: JC
authors: Breitner
authors: Kathleen W
authors: KW
authors: Piercy
authors: Michael Scott
authors: MS
authors: Deberard
authors: David
authors: D
authors: Stein
authors: Beth
authors: B
authors: Foley
authors: Kathleen A
authors: KA
authors: Welsh-Bohmer
authors: Amber
authors: A
authors: Frye
authors: Constantine G
authors: CG
authors: Lyketsos
authors: Joann T
authors: JT
authors: Tschanz
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology*; D003071:Cognition; D018450:Disease Progression; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D011594:Psychometrics; D011795:Surveys and Questionnaires