Cognitive Decline In Old Age Research Articles

Prevention of cognitive decline in old age : Selected primary preventive approaches

There are currently 1.8million people in Germany affected by dementia. Despite advances in research and new treatments, there is no cure for most cases of dementia. The evidence regarding the prevention of cognitive decline in old age is unclear. In addition to the optimized adjustment of drug treatment (e.g., arterial hypertension and diabetes mellitus), preventive measures that can be influenced by individuals themselves play an important role. These include areas such as physical and cognitive activity, remedying hearing loss, sleep, social contacts, abstaining from alcohol as well as tobacco consumption and nutrition. Multimodal concepts and digital approaches appear to be promising and an increase in evidence is expected in the coming years.

Grey matter ageing-related tau astrogliopathy: associations with brain pathologies and cognitive decline.

Grey matter ageing-related tau astrogliopathy (ARTAG) pathology is common in aged brains and detected in multiple brain regions. However, the associations of grey matter ARTAG with Alzheimer's disease and other common age-related proteinopathies, in addition to clinical phenotypes, including Alzheimer's dementia and cognitive decline, remain unclear. We examined 442 decedents (mean age at death = 90 years, males = 32%) from three longitudinal community-based clinical-pathological studies. Using AT8 immunohistochemistry, grey matter ARTAG pathology was counted in the superior frontal region, anterior temporal tip and amygdala and summarized as a severity score ranging from zero (none) to six (severe). Alzheimer's disease and other common age-related neuropathologies were also evaluated. The diagnosis of Alzheimer's dementia was based on clinical evaluations; annual tests of cognitive performance were summarized as global cognition and five cognitive domains. Multivariable logistic regression tested the associations of grey matter ARTAG pathology with an array of age-related neuropathologies. To evaluate associations of grey matter ARTAG pathology with Alzheimer's dementia and cognitive decline, we used logistic regression and linear mixed-effect models. Grey matter ARTAG pathology was seen in 324 (73%) participants, of which 303 (68%) participants had ARTAG in the amygdala, 246 (56%) in the anterior temporal tip and 137 (31%) in the superior frontal region. Grey matter ARTAG pathology from each of the three regions was associated with a pathological diagnosis of Alzheimer's disease and limbic-predominant age-related TAR DNA-binding protein 43 encephalopathy-neuropathological change but not with vascular pathology. In fully adjusted models that controlled for demographics, Alzheimer's disease and common age-related pathologies, an increase in severity of grey matter ARTAG pathology in the superior frontal cortex, but not in the amygdala or the anterior temporal tip, was associated with higher odds of Alzheimer's dementia and faster decline in global cognition, episodic memory and semantic memory. These results provide compelling evidence that grey matter ARTAG, specifically in the superior frontal cortex, contributes to Alzheimer's dementia and cognitive decline in old age.

Cardiometabolic disease, cognitive decline, and brain structure in middle and older age.

The presence of multiple cardiometabolic diseases (CMDs) has been linked to increased dementia risk, but the combined influence of CMDs on cognition and brain structure across the life course is unclear. In the UK Biobank, 46,562 dementia-free participants completed a cognitive test battery at baseline and a follow-up visit 9 years later, at which point 39,306 also underwent brain magnetic resonance imaging. CMDs (diabetes, heart disease, and stroke) were ascertained from medical records. Data were analyzed using age-stratified (middle age [<60] versus older [≥ 60]) mixed-effects models and linear regression. A higher number of CMDs was associated with significantly steeper global cognitive decline in older (β=-0.008; 95% confidence interval: -0.012, -0.005) but not middle age. Additionally, the presence of multiple CMDs was related to smaller total brain volume, gray matter volume, white matter volume, and hippocampal volume and larger white matter hyperintensity volume, even in middle age. CMDs are associated with cognitive decline in older age and poorer brain structural health beginning already in middle age. We explored the association of CMDs with cognitive decline and brain MRI measures.CMDs accelerated cognitive decline in older (≥60y) but not middle (<60) age.CMDs were associated with poorer brain MRI parameters in both middle and older age.Results highlight the connection between CMDs and cognitive/brain aging.

Effects of Bilingualism on Cognitive Processing

Purpose: The general purpose of the study was to examine the effects of bilingualism on cognitive processing.&#x0D; Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library.&#x0D; Findings: The findings reveal that there exists a contextual and methodological gap relating to the effects of bilingualism on cognitive processing. Preliminary empirical review revealed that bilingualism is associated with cognitive advantages, such as enhanced attentional control, executive function, and working memory capacity. Through a review of existing literature, it was found that bilingual individuals often outperform monolinguals in cognitive tasks, supporting the Bilingual Advantage Theory. Additionally, evidence suggested that bilingualism may contribute to a slower rate of cognitive decline in older age. These findings have implications for educators, policymakers, and healthcare professionals, highlighting the potential benefits of promoting bilingual education and language preservation efforts.&#x0D; Unique Contribution to Theory, Practice and Policy: The Bilingual Advantage theory, Neuroplasticity and Cognitive Reserve theory may be used to anchor future studies on bilingualism and cognitive processing. The study made significant contributions to theory, practice, and policy. It supported the Bilingual Advantage Theory by demonstrating enhanced cognitive processing abilities in bilingual individuals. Recommendations included further exploration of underlying mechanisms, tailored interventions in educational and clinical settings, and policies supporting bilingual education and language diversity. These findings and recommendations aimed to advance understanding of bilingualism's cognitive benefits, inform practice in education and healthcare, and influence policy development for promoting linguistic diversity and cognitive development.

Long-term exposure to transportation noise in relation to global cognitive decline and cognitive impairment: Results from a Swedish longitudinal cohort

Background and aimsTransportation noise is an environmental exposure with mounting evidence of adverse health effects. Besides the increased risk of cardiovascular and metabolic diseases, recent studies suggest that long-term noise exposure might accelerate cognitive decline in older age. We examined the association between transportation noise and cognitive function in a cohort of older adults. MethodsThe present study is based on 2594 dementia-free participants aged 60 + years from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). Global cognition score and CIND (cognitive impairment, no dementia) were assessed with a comprehensive neuropsychological battery at baseline and up to 16 years. Residential transportation noise resulting from road traffic, railway, and aircraft were estimated at the most exposed façade and the time-weighted average exposure was assessed. Linear mixed-effect models were used to assess the effect of long-term traffic noise exposure on the rate of change in global cognition score. Hazard ratios (HRs) and 95 % confidence intervals (CIs) of CIND by transportation noise exposure were obtained with Cox proportional hazard models. ResultsGlobal cognition score decreased at an average rate of −0.041 (95 %CI −0.043, −0.039) per year. Aircraft noise was associated with a 0.007 (per 10 dB Lden; 95 %CI −0.012, −0.001) faster annual rate of decline. Global cognition score seems to be not affected by road traffic and railway noise. During the follow-up, 422 (21 %) participants developed CIND. A 10-dB Lden difference in exposure to aircraft and railway noise was associated with a 16 % (HR 1.16, 95 %CI 0.91, 1.49) and 26 % (HR 1.26, 95 %CI 1.01, 1.56) increased hazard of CIND in the multi-pollutant model, respectively. No association was found for road traffic (HR 1.00, 95 %CI 0.83, 1.21). ConclusionsTransportation noise was linked to cognitive impairment and faster cognitive decline among older adults. Future studies are warranted to confirm our results.

Examining the consistency in bilingualism and white matter research: A meta-analysis

This study aimed to systematically investigate the relationship between bilingualism, age, L2 onset age of acquisition (AoA), and white matter integrity (operationalized as fractional anisotropy, FA), addressing inconsistencies in the literature. We conducted a meta-analysis of 23 studies and used meta-regression models to assess the influence of age and L2AoA on effect sizes in studies comparing monolinguals and bilinguals. Even though the overall between-group effect size across the whole brain was unreliable, bilingualism was associated with increased white matter integrity in specific tracts and in groups with a limited range of age and L2AoA. Age had a small, negative effect on white matter integrity, with differences between monolinguals and bilinguals more pronounced in younger adults, consistent with a view of an initial increase in white matter integrity, followed by remodeling for efficiency over time. In contrast, later L2AoA was associated with greater white matter integrity in bilinguals than monolinguals, again consistent with the remodeling for efficiency model. Our findings highlight the importance of considering age and L2AoA when examining the neural basis of bilingualism on white matter in the brain and how bilingualism contributes to structural changes that stave off cognitive decline in older age.

Effects of home-based interventions using exergames on physical and cognitive functions in community-dwelling older adults: a PRISMA-P-compliant protocol for a systematic review.

Physical activity and exercise are crucial to counteract physical and cognitive decline in old age. Home-based exergame training can be a solution to overcome physical inactivity. This systematic review aims to provide a comprehensive overview of home-based exergame interventions and evaluate their effectiveness in improving cognitive and physical functions through physical activity enhancement in older adults. We are conducting a systematic literature search including studies examining (1) community-dwelling older adults aged 60 years and older without any specific disease, (2) exergame-based exercise programs that take place at least partially in a home setting, and (3) intervention-related physical and/or cognitive outcomes. We will include randomized controlled trials and any other type of pre-post study published in English. There are no restrictions in terms of control group type and publication date. A search string was created and used in PubMed, Web of Science, Embase, Scopus and CINAHL. In addition, a hand search is carried out. This involves checking the references of the included studies and searching Google Scholar for further studies. The included studies will be summarized and, if homogeneity is sufficient, a random-effects meta-analysis will be performed. We will assess the risk of bias using RoB 2.0 and ROBINS-I. The findings of this systematic review will help to define the most suitable exergame programs to counteract cognitive and physical decline in older adults. Additionally, they will inform the development of effective home-based exergame systems and point to future pathways of digital rehabilitation in older adults. Prospero (ID: CRD42023374234).

Exercise and Protection from Age-Related Cognitive Decline.

In this chapter, we review the cross-sectional evidence in healthy human subjects for physical activity and cardiorespiratory fitness to offer neuroprotection and moderate cognitive decline in older age. The role of exercise training on cognition in healthy older adults and those diagnosed with mild cognitive impairment (MCI) is also discussed, including the evidence from neuroimaging studies that document changes to brain structure and function after a period of exercise training and improved fitness. Finally, in reference to animal models, the potential neurophysiological mechanisms for physical activity and exercise to impact human brain health are highlighted.

PHYSICAL ACTIVITY AS A MEDIATOR BETWEEN RACE/ETHNICITY AND CHANGES IN COGNITION

Abstract Racial/ethnic disparities in the rate of cognitive decline in older age have been established. Studies also report differences in physical activity across racial/ethnic groups. We investigated whether racial/ethnic differences in changes in cognition over a 12-year period (2006-2018) were mediated by physical activity using data from the Health and Retirement Study (N = 16,777, mean baseline age = 66.0 years). Structural equation modeling was used to estimate a latent growth curve model of changes in cognitive scores (27-item TICS) and investigate whether the relationship of race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White) to change in cognition was mediated by physical activity after controlling for age, sex, education, marital status, personal wealth, and insurance coverage. Results indicated that Blacks engaged in significantly lower levels of physical activity than Whites (b = -.176, ♌ = -.123, p &amp;lt; .001), but there were no differences between Hispanics and Whites (b = .028, ♌ = .017, ns). Physical activity significantly predicted higher initial cognitive scores (b = 5.205, ♌ = .610, p &amp;lt; .001) and less decline in cognitive scores over time (b = 1.063, ♌ = .796, p &amp;lt; .001). The indirect (mediational) effect for the Black vs. White comparison on changes in cognitive score was significant (b = .187, ♌ = .152, 95% CI [.135,.244]). These results provide important new information for understanding how physical activity, a modifiable lifestyle factor, may help explain racial/ethnic disparities in cognitive decline in middle and later life, suggesting greater need to reduce sedentary behavior and increase activity.

Predictors of Successful Brain Aging: An Autopsy Study

AbstractBackgroundThe neuropathological hallmarks of Alzheimer’s disease (AD), including amyloid plaques and neurofibrillary tangles, also accumulate in the brains of aging individuals. However, some individuals are able to age successfully without significant degenerative neuropathology or cognitive impairment, a phenomenon referred to as “successful aging”. The predictors of successful “neuropathologic” and “cognitive” aging are not fully understood, creating a critical knowledge gap. Factors such as resistance, resilience, and reserve are believed to play important roles. Furthermore, the relationship between neuropathological changes, such as tau pathology and amyloid pathology, and cognitive impairment in the oldest old population remains unclear, and the concept of amyloid plaques causing tau pathology may not be universally valid. The association between amyloid plaques and dementia also continues to be debated.MethodsIn this study, we utilized a collection of 414 post‐mortem brain tissues (171 female, 241 male) from aged individuals (average age 90, range 80‐108) with neuropathological and clinical data (215 without cognitive impairment and 161 with cognitive impairment) to perform a cross‐sectional analysis. Our cohort included subjects who had cognitive assessments available and included those with no amyloid plaque pathology or mild burden based on neuropathological criteria. Variables (including new traits derived from A.I. based feature extraction) associated with the cognitive measures were determined using multivariable logistic regression.ResultsOur results revealed that age of death and Braak neurofibrillary tangle stage were significant predictors of cognitive impairment (p&lt;0.05), while amyloid positivity was not. These findings suggest that tau pathology may have a stronger association with cognitive impairment in the oldest old population compared to amyloid plaques.ConclusionUnderstanding the neuropathological factors associated with successful brain and cognitive aging will contribute to our knowledge of the underlying mechanisms and may pave the way for the development of interventions to promote successful aging and prevent cognitive decline in old age. Further research in this area is warranted to elucidate the complex relationship between neuropathology, cognitive function, and aging in the oldest old population.

Association of Dietary Fat and the ApoE4 Allele with Cognitive Decline in a Biracial Population Sample

AbstractBackgroundIntake of dietary fat has been linked with cognition. Apolipoprotein E plays a critical role in lipid metabolism; however, the potential interaction between ApoE ε4 carrier and dietary fat on cognition is not fully understood. We aim to examine the association of types of dietary fat and their relation to cognitive decline among those with and without the ApoE ε4 allele.MethodThe study included 3,528 participants from the Chicago Health and Aging Project (62% African Americans, 63% female). Global cognition was assessed using a composite score of episodic memory, perceptual speed, MMSE; and diet using a 139‐item food frequency questionnaire. ApoE genotype was assessed by hME Sequenom mass‐array platform. Longitudinal mixed effect regression models were used to examine the association of dietary fat and the ApoE ε4 allele with cognitive decline, adjusting for age, sex, education, smoking status, and calorie intake.ResultAmong varying types of dietary fat, including saturated fat (SFA), monounsaturated fat, and polyunsaturated fat, we found that a higher intake of SFA was associated with faster cognitive decline (p for trend 0.0274). Per 5% increase in calorie from SFA was associated with a 15% faster cognitive decline (β = ‐0.0064, p = 0.04). Participants in the highest quintile of intakes of SFA had a 34% faster cognitive decline than those in the lowest quintile (β = ‐0.0125, p = 0.0095).In those with ApoE ε4 allele, per 5% increase in calorie from SFA was association with a 21% faster decline (β = ‐0.0197, p = 0.0038). Among participants with ApoE ε4 allele, individuals in the highest quintile of intakes of SFA had a 45% faster cognitive decline compared to those in the lowest quintile of intake (β = ‐0.0372, p = 0.0003). Higher SFA was not associated with cognitive decline among those without the ApoE ε4 allele nor other types of dietary fat.ConclusionOur study found a significant association of saturated fat with faster cognitive decline among those with the ApoE4 allele. Higher intake of saturated fat among the ApoE4 carriers might lead to significantly higher risk of cognitive decline in old age.

Dissociative Effects of Age on Neural Differentiation at the Category and Item Levels.

Increasing age is associated with age-related neural dedifferentiation, a reduction in the selectivity of neural representations, which has been proposed to contribute to cognitive decline in older age. Recent findings indicate that when operationalized in terms of selectivity for different perceptual categories, age-related neural dedifferentiation and the apparent age-invariant association of neural selectivity with cognitive performance are largely restricted to the cortical regions typically recruited during scene processing. It is currently unknown whether this category-level dissociation extends to metrics of neural selectivity defined at the level of individual stimulus items. Here, we examined neural selectivity at the category and item levels using multivoxel pattern similarity analysis (PSA) of fMRI data. Healthy young and older male and female adults viewed images of objects and scenes. Some items were presented singly, while others were either repeated or followed by a "similar lure." In agreement with recent findings, category-level PSA revealed robustly lower differentiation in older than in younger adults in scene-selective, but not object-selective, cortical regions. By contrast, at the item level, robust age-related declines in neural differentiation were evident for both stimulus categories. Additionally, we identified an age-invariant association between category-level scene selectivity in the parahippocampal place area and subsequent memory performance, but no such association was evident for item-level metrics. Lastly, category- and item-level neural metrics were uncorrelated. Thus, the present findings suggest that age-related category- and item-level dedifferentiation depend on distinct neural mechanisms.

Cognitive aging and experience of playing a musical instrument.

Musical instrument training has been found to be associated with higher cognitive performance in older age. However, it is not clear whether this association reflects a reduced rate of cognitive decline in older age (differential preservation), and/or the persistence of cognitive advantages associated with childhood musical training (preserved differentiation). It is also unclear whether this association is consistent across different cognitive domains. Our sample included 420 participants from the Lothian Birth Cohort 1936. Between ages 70 and 82, participants had completed the same 13 cognitive tests (every 3 years), measuring the cognitive domains of verbal ability, verbal memory, processing speed, and visuospatial ability. At age 82, participants reported their lifetime musical experiences; 40% had played a musical instrument, mostly in childhood and adolescence. In minimally adjusted models, participants with greater experience playing a musical instrument tended to perform better across each cognitive domain at age 70 and this association persisted at subsequent waves up to age 82. After controlling for additional covariates (childhood cognitive ability, years of education, socioeconomic status, and health variables), only associations with processing speed (β = 0.131, p = .044) and visuospatial ability (β = 0.154, p = .008) remained statistically significant. Participants with different amounts of experience playing a musical instrument showed similar rates of decline across each cognitive domain between ages 70 and 82. These results suggest a preserved differentiation effect: Cognitive advantages (in processing speed and visuospatial ability) associated with experience playing a musical instrument (mostly earlier in life) are preserved during older age. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

CALHM2 V136G polymorphism reduces astrocytic ATP release and is associated with depressive symptoms and Alzheimer's disease risk.

Depression is considered a prodromal state of Alzheimer's disease (AD), yet the underlying mechanism(s) by which depression increases the risk of AD are not known. Single-nucleotide polymorphism (SNP) analysis was used to determine the CALHM2 variants in AD patients. Cellular and molecular experiments were conducted to investigate the function of CALHM2 V136G mutation. We generated a new genetically engineered Calhm2 V136G mouse model and performed behavioral tests with these mice. CALHM2 V136G mutation (rs232660) is significantly associated with AD. V136G mutation resulted in loss of the CALHM2 ATP-release function in astrocytes and impaired synaptic plasticity. Mice homozygous for the Calhm2 V136G allele displayed depressive-like behaviors that were rescued by administration of exogenous ATP. Moreover, Calhm2 V136G mutation predisposed mice to cognitive decline in old age. CALHM2 dysfunction is a biologically relevant mechanism that may contribute to the observed clinical correlation between depression and AD.

Association between personality traits, leisure activities, and cognitive levels and decline across 12 years in older adults.

The engagement in cognitively stimulating activities has been found to be associated with slower rates of cognitive decline in old age. In which type of activities people engage in may depend on their personality traits, which thus might have an impact on later cognitive fitness. To study these potential links, we examined the associations between Neuroticism, Extraversion, and Openness; different types of leisure activities (e.g., social, mental, physical); and cognitive ability levels and decline in older adults. Analyses were based on a sample of young-old (60-72 years old; n = 1,609) and old-old (78 years or older; n = 1,085) adults from the Swedish National Study on Aging and Care in Kungsholmen, who participated in up to five repeated measurements of cognitive abilities spanning 12 years. We used latent growth curve models to estimate cognitive levels and decline, as well as the correlations with initial personality trait levels and leisure activity engagement. In both groups, lower Neuroticism, higher Extraversion, and higher Openness levels were moderately associated with stronger engagement in all types of activities. Lower Neuroticism, higher Extraversion, and a more activity lifestyle were weakly to moderately associated with slower cognitive decline in the old-old age group. There, personality traits and activities explained 9.3% of the variance in cognitive decline after controlling for age, sex, education, and chronic diseases (which explained 9.0%). Taken together, this study provides further evidence for the connection between personality traits, activity engagement, and later cognitive decline in old age. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The relationship between long-term blood pressure variability and cortical thickness in older adults

High blood pressure variability (BPV) is a risk factor for cognitive decline and dementia, but its association with cortical thickness is not well understood. Here we use a topographical approach, to assess links between long-term BPV and cortical thickness in 478 (54% men at baseline) community dwelling older adults (70–88 years) from the ASPirin in Reducing Events in the Elderly NEURO sub-study. BPV was measured as average real variability, based on annual visits across three years. Higher diastolic BPV was significantly associated with reduced cortical thickness in multiple areas, including temporal (banks of the superior temporal sulcus), parietal (supramarginal gyrus, post-central gyrus), and posterior frontal areas (pre-central gyrus, caudal middle frontal gyrus), while controlling for mean BP. Higher diastolic BPV was associated with faster progression of cortical thinning across the three years. Diastolic BPV is an important predictor of cortical thickness, and trajectory of cortical thickness, independent of mean blood pressure. This finding suggests an important biological link in the relationship between BPV and cognitive decline in older age.

The association between cannabis use and subjective memory complaints in older adults in the United States.

The U.S. population is aging and increasing numbers of older adults are using cannabis. Cognitive decline is common in older age and subjective memory complaints (SMC) have been associated with increased risk for dementia. While residual cognitive effects of cannabis use at younger ages are well understood, the links between cannabis use and cognition in older adults is less clear. The present study represents the first population-level analysis of cannabis use and SMC in older adults in the U.S. We used the National Survey of Drug Use and Health (NSDUH) dataset to evaluate SMC in respondents over age 50 (N = 26,399) according to past-year cannabis use. Results revealed that 13.2% (95%CI: 11.5%-15.0%) of those who reported cannabis use also reported SMC, compared to 6.4% (95%CI: 6.1%-6.8%) among individuals with no cannabis use. Logistic regression revealed a two-fold increase (OR = 2.21, 95%CI: 1.88-2.60) of reporting SMC in respondents who had used cannabis in the past year, which was attenuated (OR = 1.38, 95%CI: 1.10-1.72) when controlling for additional factors. Other covariates, including physical health conditions, misuse of other substances, and mental illness also significantly contributed to SMC outcomes. Cannabis use represents a modifiable lifestyle factor that has potential for both risk and protective properties that may impact the trajectory of cognitive decline in older age. These hypothesis generating results are important for characterizing and contextualizing population-level trends related to cannabis use and SMC in older adults.

Predictors of cognitive functioning trajectories among older Americans: A new investigation covering 20 years of age- and non-age-related cognitive change.

Despite the extensive study of predictors of cognitive decline in older age, a key uncertainty is how much these predictors explain both the intercept and age- and non-age-related change in cognitive functioning (CF). We examined the contribution of a broad range of life course determinants to CF trajectories. Data came from 7,068 participants in the 1996-2016 Health and Retirement Study. CF was measured as a summary score on a 27-point cognitive battery of items. We estimated multilevel growth curve models to examine the CF trajectories in individuals ages 54-85. We found that the variation in CF level at age 54 was three times as much as the variation in age slope. All the observed individual predictors explained 38% of the variation in CF at age 54. Personal education was the most important predictor (25%), followed by race, household wealth and income, parental education, occupation, and depression. The contributions of activity limitations, chronic diseases, health behaviors (obesity, smoking, vigorous activity), childhood conditions (childhood health, nutrition, financial situation), gender, marital status, and religion were rather small (<5%). Even though the age slope varied with many adulthood factors, they only explained 5.6% of the between-person variation in age slope. Moreover, age explained 23% of within-person variation in CF from age 54 to 85. The rest non-age-related within-person variation could not be explained by the observed time-varying factors. These findings suggest that future research is urgently needed to discover the main determinants of the slope of cognitive decline to slow down the progression of cognitive impairment and dementia.

EVALUATING POSITIVE EFFECTS OF LEISURE FROM A LIFE-COURSE PERSPECTIVE: A LITERATURE REVIEW

This article discusses the psychological impact of leisure across a lifetime using a life-course perspective, which assumes that people’s experiences at earlier life stages shape their following developmental trajectories. Since leisure activities are part of one’s lifestyle, adopting this perspective to leisure research is invaluable. By reviewing a variety of research, the article discusses 1) the progress of psychological leisure research and the impact of leisure on subjective well-being and cognitive functioning, 2) transitions in leisure and their relationship from a life-course perspective, and 3) the benefits related to the accumulation of leisure activities across the lifespan. The present review concludes that positive psychological achievement (e.g., self-worth, affirmation, and self-realization) and cognitive foundation (e.g., high levels of basic cognitive skills) shaped through leisure participation in early life stages help overcome challenges in later stages (i.e., successfully adapt to psychological vulnerability and cognitive decline in old age).

Physical Activity Is Associated with Slower Cognitive Decline in Older Adults with Type 2 Diabetes.

Physical activity is associated with slower cognitive decline in old age. Type 2 diabetes (T2d) is a risk factor for dementia and cognitive decline. Physical activity protects against several T2d complications. Yet, little is known about the contribution of physical activity to cognitive health among the elderly with T2d. To examine the association between physical activity and cognitive decline in older adults with T2d. This is a prospective longitudinal study using data from the Israel Diabetes and Cognitive Decline (IDCD) study. ICDC study (N=1,213), is a population-based cohort of adults over the age of 65, diagnosed with type 2 diabetes, who were cognitively normal at baseline and followed up every 18 months. Participants with at least one follow-up assessment who were in the same physical activity group consistently and had complete demographic data. Physical activity was measured using Minnesota Leisure Time Activity Questionnaire, cognitive functioning was measured using a broad neuropsychological assessment measuring Executive Functioning, Attention/Working Memory, Semantic Categorization and Episodic Memory. Participants were classified into physical activity groups based on self-reported physical activity at baseline and all follow ups: "active" - participation in recreational physical activity (n=286); "non-active"- the only physical activity was walking from place to place (n=93) and "sedentary" (n=19). Linear mixed effects models were applied to adjust for key demographic and cardiovascular risk factors. Participants were 72.4 (SD 4.6) years old, had 13.3 (SD 3.6) years of education, and 163 (41%) were female. In the fully adjusted model, compared to the non-active group the active group had significantly slower rate of decline in Global Cognition (p=0.005), Executive Functioning (p=.014), and Attention/Working Memory (p=.01). There were no significant group differences for Semantic Categorization (p=.17) and Episodic Memory (p=.88). Among initially cognitively normal and independent older adults with T2d, a physically active lifestyle was associated with a slower rate of cognitive decline. Future research should examine whether promoting physical activity may prevent or delay onset of dementia in this high-risk population.