Midlife engagement in cognitive activities and cognitive function in middle aged individuals at high risk for AD

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AbstractBackgroundWe examined the cross‐sectional relationship of engagement in cognitive activities with cognitive function in cognitively normal middle‐aged (40‐65y) individuals enriched for high risk for Alzheimer’s disease (AD) due to a parental family history (FH+), and matched controls (FH‐), participants of the Israel Registry for Alzheimer’s Prevention (IRAP) study.MethodEngagement in cognitive activities by type and intensity was evaluated via the Florida Cognitive Activities Scale (FCAS) (score range 0–100), resulting in three scores: 1) FCAS‐Total, 2) FCAS‐Higher Cognitive (HC), capturing activities more cognitively demanding (e.g. playing chess) and 3) FCAS‐Frequent Activity (FA), capturing frequent activities (e.g. watching TV). A comprehensive neuropsychological battery yielded scores for four cognitive domains; executive functions, language, working memory and episodic memory. Global cognition was the mean of the four cognitive domains. Regression analysis adjusting for age, sex and education examined the relationship of each one‐point increase in the FCAS scores on cognitive function for the total sample.ResultThe study included 473 participants (FH+ = 374; FH‐ = 99) (Table 1). Participants' mean age was 54.9 (SD = 6.7) years (64.4% women) with 16.5 (SD = 3.1) years of education. The groups did not differ in sociodemographic, cognitive or FCAS characteristics. The FCAS‐Total score was associated with better global cognition (slope = 0.0150; p = 0.001), executive functions (slope = 0.0147; p = 0.005), language (slope = 0.0095; p = 0.0052) and working memory (slope = 0.0117; p = 0.0142). Higher FCAS‐HC score was associated with better global cognition (slope = 0.0221; p = 0.010), executive functions (slope = 0.0315; p = 0.001), language (slope = 0.0214; p = 0.0008) and working memory (slope = 0.0244; p = 0.006). FCAS‐FA was not associated with function in any of the cognitive domains. There were no associations between total cognitive activity nor its sub‐types with episodic memory.ConclusionHigher engagement in cognitive activities, specifically those requiring higher cognitive effort, is associated with better cognitive function already in midlife. This relationship was not detected for episodic memory, which is the domain most typically affected in the first stages of AD. The longitudinal phase of the IRAP study will reveal the underlying mechanisms and whether reduced engagement in cognitive activity is a risk factor or a very early indicator of incipient cognitive decline high AD risk adults.