Self-reported Lifestyle Activities in Relation to Longitudinal Cognitive Trajectories

Abstract

Background: Few studies have examined the relationship between lifestyle activity engagement and cognitive trajectories among individuals who were cognitively normal at baseline.

Objective: To examine the relationship of current engagement in lifestyle activities to previous cognitive performance among individuals who were cognitively normal at baseline, and whether this relationship differed for individuals who subsequently developed mild cognitive impairment (MCI), or by APOE-4 genotype, age, and level of cognitive reserve.

Methods: Participants (N=189) were primarily middle-aged (M=56.6 y) at baseline and have been prospectively followed with annual assessments (M follow-up=14.3 y). Engagement in physical, cognitive, and social activities was measured by the CHAMPS activity questionnaire. Longitudinal cognitive performance was measured by a global composite score.

Results: Among individuals who progressed to MCI (n=27), higher lifestyle activity engagement was associated with less decline in prior cognitive performance. In contrast, among individuals who remained cognitively normal, lifestyle activity engagement was not associated with prior cognitive trajectories. These effects were largely independent of APOE-4 genotype, age, and cognitive reserve.

Conclusions: Greater engagement in lifestyle activities may modify the rate of cognitive decline among those who develop symptoms of MCI, but these findings need to be confirmed in prospective studies.

Figure 1.

Timeline showing the design of the BIOCARD study, and types of data collected each year from 1995–2017. Abbreviations: CSF, cerebrospinal fluid; MRI, magnetic resonance imaging; PET, positron emission tomography; NIH, National Institutes of Health

Figure 2.

Relationship of engagement in lifestyle activities to prior cognitive trajectories, shown separately by low and high activity levels (median split) and diagnosis (remained cognitively normal; progressed to MCI). Figures depict frequency of engagement in (a) high intensity physical, (b) cognitive, and (c) social activities, and (e) total engagement in all activities (number). Level of activity engagement was modeled as a continuous variable; it was dichotomized for illustration purposes only.

Figure 2.

Relationship of engagement in lifestyle activities to prior cognitive trajectories, shown separately by low and high activity levels (median split) and diagnosis (remained cognitively normal; progressed to MCI). Figures depict frequency of engagement in (a) high intensity physical, (b) cognitive, and (c) social activities, and (e) total engagement in all activities (number). Level of activity engagement was modeled as a continuous variable; it was dichotomized for illustration purposes only.