Stimulating Leisure Activities Research Articles

Association between a combination of cognitively stimulating leisure activities and long-chain polyunsaturated fatty acid intake on cognitive decline among community-dwelling older Japanese individuals.

Multifactorial lifestyle approaches could be more effective than a single factor for maintaining cognitive function. This study investigated the association of combining cognitively stimulating leisure activities (CSLAs), including puzzles, quizzes, and cognitive training games, with intake of long-chain polyunsaturated fatty acids (LCPUFAs), including docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (ARA), on cognitive function in the older Japanese individuals without dementia. Participants were community-dwelling Japanese individuals without a self-reported history of dementia (n = 906, aged 60-88 years) from datasets of a 2-year longitudinal study (baseline: 2006-2008 and follow-up: 2008-2010). CSLA engagement and LCPUFA intake were divided into high and low groups according to frequency (≥once/week and <once/week) for CSLA engagement and median intake level for LCPUFA intake according to sex, then categorized into four groups. The associations of multivariate-adjusted odds ratio (OR) for a cognitive decline, shown as a decrease in the Mini-Mental State Examination score by 2 or more points, and the combination of CSLA engagement with LCPUFA intake were assessed using a multiple logistic regression model. Subgroup analysis involved participants with low DHA and EPA intakes (n = 303; median intake, 325 mg/day), mirroring those in North America. The HIGH-CSLA/HIGH-ARA group cumulatively yielded a lower OR for cognitive decline (0.41; 95% confidence interval, 0.25-0.70) than did the LOW-CSLA/LOW-ARA group (p for trend = 0.001). In the subgroup analysis, the OR for the HIGH-CSLA/HIGH-DHA group was notably reduced (0.31; 95% confidence interval, 0.11-0.87; p for trend = 0.025) compared with the LOW-CSLA/LOW-DHA group. High CSLA engagement frequency combined with high ARA intake may cumulatively reduce the risk of cognitive decline among older Japanese individuals. Furthermore, combining CSLA engagement frequency with DHA intake could have a positive association with maintaining cognitive function among older individuals, particularly those with low DHA and EPA intakes.

A Longitudinal Analysis of the Relationship Between Different Levels of Cognitively Stimulating Leisure Activity and Cognitive Function Among Older Adults with MCI

A Longitudinal Analysis of the Relationship Between Different Levels of Cognitively Stimulating Leisure Activity and Cognitive Function Among Older Adults with MCI

The longitudinal relationship between levels of cognitively stimulating leisure activity and positive and negative affect among older adults with MCI.

The purpose of this study was to investigate the longitudinal relationship between different levels of cognitively stimulating leisure activity (CSLA) participation and different levels of positive and negative affect among older adults with mild cognitive impairment (MCI). Using a repeated-measured multivariate analysis of covariance (RM-MANCOVA), this study analyzed the Health and Retirement Study (HRS) data from 2012 to 2020 (N = 5932). The results presented the following. (a) The high CSLA group showed higher positive affect and lower negative affect than the mid and low groups. Also, the mid-CSLA group presented higher positive affect and lower negative affect than the low CSLA group. (b) Both positive and negative affect showed significant differences between years and indicated a continuously declining slope year by year without exceptions. (c) The high CSLA group not only presented higher positive affect and lower negative affect during the period but also solely showed a rebounding feature in the declining slope on both emotions. The findings of this study provide valuable support for the design and implementation of CSLA participation programs and clinical guidelines for older adults with MCI. The results highlight the importance of determining the optimal level of CSLA engagement that is required to promote emotional health and cognitive function in this population. Healthcare professionals and clinical practitioners can leverage the insights gained from this study to develop and deliver effective CSLA interventions tailored to the specific needs and capacities of older adults with MCI.

Lifestyle activities contribute to cognitive reserve in mid‐life, independently of education, in cognitively healthy middle‐aged individuals at risk for late‐life Alzheimer’s disease

AbstractBackgroundIt is now acknowledged that Alzheimer’s Disease (AD) processes are present decades before the onset of clinical symptoms, but it remains unknown whether lifestyle factors can protect against these early AD processes in mid‐life. Intellectually, physically, and socially stimulating lifestyle activities are associated with maintenance of late‐life cognitive abilities (Chan et al., 2018), and lower cognitive impairment in AD (Livingston et al., 2020). We asked whether such activities contribute to cognitive reserve (CR) from mid‐life, in cognitively healthy individuals who are at risk for late‐life AD.MethodMiddle‐aged individuals (aged 40‐59 years, mean = 52 years) from the PREVENT Dementia study (www.preventdementia.co.uk) were assessed at baseline (N = 210, 62/148 male/female) and two‐year follow‐up (N = 188, 55/133 male/female), with cognitive ability (multidomain battery) and brain health (total grey matter volume, functional brain network segregation) measures. Mid‐life activities were measured using the Lifetime of Experiences Questionnaire, which comprises occupational as well as intellectually, physically, and socially stimulating leisure activities. Dementia risk was assessed with the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) score.ResultMultivariable linear regression showed that intellectual, physical, and social activities undertaken in mid‐life made a unique contribution to episodic and relational memory in mid‐life, independent of occupation and CAIDE at baseline (β (se) = 0.04 (0.02), p = 0.02, Figure 1a) and follow‐up (β (se) = 0.07 (0.02), p = 0.002, Figure 1b). Furthermore, these activities moderated the relationship between cognitive ability and brain health at follow‐up (β (se) = 3.47 (1.40), p = 0.01), with verbal and visuospatial functions, and short‐term (conjunctive) memory of people with higher activity levels less dependent on their brain functional integrity (Figure 2), consistent with the concept of CR (Brayne et al., 2010). Such a moderation by these mid‐life activities was more prominent in individuals with higher CAIDE scores (β (se) = 4.28 (1.83), p = 0.02, Figure 3).ConclusionThese findings suggest that modifiable lifestyle activities contribute uniquely to CR and may offset cognitive decrements due to AD risk in mid‐life. They support the targeting of modifiable lifestyle activities for the prevention of Alzheimer’s disease.

Modifiable Factors Associated with Mortality among the Oldest Old with Cognitive Impairment: A Longitudinal Study in China

AbstractBackgroundThe oldest old (aged above 80 years) have the highest death rate, and CI (Cognitive Impairment) significantly increases risk of mortality. Studies investigating mortality associated with dementia mostly identified non‐modifiable factors, providing limited practical implications. This study aims to investigating factors associated with mortality among the oldest old with dementia, with particular focus on modifiable factors.MethodOur study included 6,997 older adults aged 80 years above who were diagnosed with CI. Data were from the Chinese Longitudinal Healthy Longevity Study (CLHLS). CI was measured by the Mini‐mental State Examination (MMSE). Cox proportional hazard regression combined with Least Absolute Shrinkage and Selection Operator (LASSO) was applied to select factors and evaluate their association with mortality of the oldest adults with CI.ResultOf the 6,997 participants, 6,451 died with median survival time of 2.2 years. 21 out of the 56 variables were selected from the LASSO‐penalized Cox regression model. Consistent with previous studies, the hazard of mortality increases by 19% with every incremental 10 years of age (95% CI: 12‐27%). The hazard of morality among women was 23% lower than that of men (95% CI: 18%‐29%). History of diabetes also increases the hazard of mortality. In terms of modifiable factors, daily outdoor activities, daily watching TV or listening to the radio, being married, good chewing ability are associated with lower mortality, while smoking and high systolic blood pressure increases the risk of mortality in a dose‐response manner.ConclusionSeveral modifiable factors are associated with mortality among the oldest adults with CI. Analysis suggests that healthy diet, cognitive stimulating leisure activities, marriage, and good chewing ability may contribute to lowering the risk of mortality among this population.

The Associations Between Personality Traits, Leisure Activities, and Memory Performance in Older Adulthood

The present study examines the links between personality traits, leisure activities, and memory in older adults after controlling for leisure activities and demographic factors. The research sample consisted of 24,930 individuals aged 65 to 101 years from 27 European countries (43.2% men and 56.8% women). Data from the 7th Wave of the Survey of Health, Ageing, and Retirement in Europe was analyzed. Memory was assessed using a modified version of Rey’s Auditory Verbal Learning Test (RAVLT). Personality traits were assessed using the BFI-10 Personality Traits Questionnaire. Data analysis revealed that personality traits such as openness to experience and neuroticism allow for the prediction of memory capacity in older adulthood. These relationships remained significant even after controlling for cognitively stimulating leisure activities and age. These results show that personality traits such as neuroticism and openness to experience might be valuable in predicting memory functioning among older adults.

Cognitive reserve and dementia risk management in people with an intellectual disability.

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HEALTHY LEISURE: ADVANCING UNDERSTANDING OF LEISURE DECISIONS, ACTIVITIES, AND HEALTH CONSEQUENCES

Abstract Leisure activities promote healthy aging, yet aging poses new challenges to engagement in active, meaningful, health-promoting leisure. This stalemate wherein people need to but struggle to engage in healthy leisure as they age calls for further research describing what healthy leisure entails, decision processes predicting it, and long-term consequences over the lifespan. This symposium brings together five rigorous studies aimed at understanding diverse aspects of leisure – how adults make daily leisure decisions, the health-promoting or demoting consequences of specific leisure activities as a person ages, and unique challenges faced by vulnerable populations. Paper 1 describes how daily energy and affect conjointly influence the types and variety of leisure activities midlife adults choose. Paper 2 identifies specific leisure activities that protect against cognitive decline in older adults, with consideration of vulnerable subgroups (illiterate, rural residents). Paper 3 investigates how seven leisure activities longitudinally predict cognitive impairment in older adults and differences by life course SES. Paper 4 identifies social interactions with friends as a key aspect of healthy leisure that longitudinally associates with cognitive function in older adults. Paper 5 focuses on a vulnerable population, older breast cancer survivors, and examines whether participating in cognitively stimulating leisure activities is associated with cognitive function (vs. non-cancer controls). These papers use different samples and datasets to describe the nature, causes, and consequences healthy leisure by specific population groups. The discussant, Dr. Allison Bielak will integrate key findings from these studies, discuss their theoretical and methodological contributions, and consider opportunities for future research.

Mahjong Playing and Leisure Physical Activity Alleviate Cognitive Symptoms in Older Community Residents.

Leisure activities, particularly physically and cognitively stimulating leisure activities, mitigate cognitive decline. The present study aimed to examine the relationship between mahjong playing, leisure physical activity, and mild cognitive impairment (MCI). Older adults with and without MCI were recruited (n = 489, healthy group; and n = 187, MCI group). The regression results showed that years of mahjong playing (odds ratio = 0.595, 95% confidence interval [0.376, 0.961], p = .032) and physical activity (odds ratio = 0.572, 95% confidence interval [0.381, 0.849], p = .012) were associated with reduced odds of having MCI after adjusting for a series of covariates. Leisure physical activity and mahjong playing interacted with each other and produced combined effects on the odds of having MCI. Combined cognitive and physical interventions may produce larger benefits on cognition than either intervention alone.

The relationship between cognitive engagement and better memory in midlife

IntroductionEngagement in cognitively stimulating work and activities may slow cognitive decline and dementia. We examined the individual and combined associations of four cognitive engagement indices (educational attainment, occupational complexity, social engagement, and cognitively stimulating leisure activities) with objective and subjective cognition.MethodsMiddle‐aged adults (n = 1864) enrolled in the Healthy Brain Project completed the Cogstate Brief Battery, the Cognitive Function Instrument, and self‐report questionnaires of cognitive engagement.ResultsEducational attainment and leisure activity engagement were individually associated with memory performance. Participants were classified based on whether they rated highly in zero to four cognitive engagement indices. Compared to participants with no indices, participants with two or more indices performed moderately better on memory.DiscussionResults suggest that greater variety of cognitive engagement across different areas of life is related to better memory in midlife. Possible explanation for this relationship may be increased opportunity for enhancing cognitive reserve, but further investigations are required.

The cumulative effect of cognitive engagement on cognitive function in middle‐aged adults

AbstractBackgroundEngagement in cognitively stimulating work and activities is proposed to slow cognitive decline and delay dementia. Few studies have considered the cumulative effect of multiple cognitively engaging factors on cognitive function. In middle‐aged adults, this study aimed to determine the individual and combined associations of four cognitive engagement factors (i.e., educational attainment, occupational complexity, social engagement and cognitively stimulating leisure activities) with objectively measured cognitive performance and subjective ratings of cognitive function.MethodA total of 1864 cognitively normal middle‐aged adults (aged 40‐70) enrolled in the Healthy Brain Project, a study with an online remote assessment platform seeking to understand midlife risk factors for dementia. Cognitive engagement factors were measured by online self‐report questionnaires. The Cogstate Brief Battery was used to measure cognitive domains of attention and memory. Subjective ratings of cognitive function were measured using the Cognitive Function Instrument.ResultAfter controlling for age, sex, ethnicity and mood symptomatology, participants with high educational attainment or high occupational complexity performed significantly better on attention and memory tasks and reported less subjective ratings of cognitive concern. Higher participation in cognitively engaging leisure activities was significantly associated with better attention and memory performance, but not with subjective ratings of cognitive function. Social engagement was not associated with any outcome. The magnitude of these effects was small and trivial (Cohen’s d ranging from 0‐0.17). Participants were then classified into five groups based on whether they rated highly in 0‐4 cognitive engagement factors. Compared to participants with no factors, participants scoring highly in 2 or more factors performed significantly better on the memory tasks, with the magnitude of difference moderate (Cohen’s d ranging from 0.30‐0.49).ConclusionThese results suggest a cumulative relationship between high cognitive engagement across several domains of life and better memory performance in cognitively normal middle‐aged adults.

Can engagement in socially and cognitively stimulating leisure activities compensate for other dementia risk factors? A prospective cohort study

AbstractBackgroundWith the projected surge in global dementia cases, research is increasingly focusing on lifestyle factors as preventive measure. Social and cognitive leisure activities are promising targets, but have thus far received relatively little attention. This study investigates whether cognitive and social activities contribute to dementia risk, and whether engagement in these activities moderates the association between other known risk factors (education, wealth &amp; lifestyle factors).MethodWe used data of the English Longitudinal Study of Ageing (ELSA) on engagement in social and cognitive activities in 6346 participants, followed up from 2008/2009 until 2014/2015. Dementia prevalence was assessed until up to 7 years after baseline. Self‐reported cognitive (e.g. “reading the newspaper”) and social (e.g. being a member of a social club) activities and social participation (e.g. “going to the cinema”) were clustered into high and low based on a median split. We then assessed their individual contribution to dementia‐risk as well as their interaction with the other risk factors, using Cox regression models, controlling for age, sex, education, wealth and lifestyle risk factorsResultWe found that higher engagement in cognitive (HR=0.476; 95% CI=0.27‐0.84) and social activities (HR=0.60; 95% CI=0.42‐0.87) as well as social participation (HR=0.59; 95% CI=0.38‐0.90) were associated with lower dementia risk, independently of the other risk‐factors in the model. We also found an interaction between the level of engagement in social activities and level of education with regard to dementia risk, but not with other risk factors.ConclusionCognitive and social leisure activities and social participation may be beneficial for overall dementia risk. The benefits of social activities may be larger for people with low education. Both should be taken into account when designing dementia prevention measures.

Effects of Work Demand and Changes in Leisure Activity on Postretirement Memory

Abstract. This study evaluated the interactions between prior cognitive work demands and changes in cognitively stimulating leisure activities during the retirement transition and their relationship to changes in postretirement memory. We drew data ( N = 631) from five waves of repeated annual measurements as part of the HEalth, Ageing and Retirement Transitions in Sweden study. We modeled memory trajectories using piecewise growth-curve models. Findings revealed that increased cognitive stimulation from leisure activities had beneficial effects on postretirement memory development among individuals reporting previously low cognitive work demands. Our findings provide partial evidence supporting public health recommendations, stating that retirees from less intellectually demanding occupations will gain from increases in cognitive leisure following retirement.

Cognitive reserve may outperform age, mood and psychiatric comorbidities as a predictor of executive functioning in bipolar disorder and healthy adults

ABSTRACT Introduction Cognitive reserve plays a protective role against executive dysfunction in healthy adults and individuals with psychiatric illnesses such as bipolar disorder. However, the magnitude of the influence of cognitive reserve on specific executive functions (EFs), and its impact relative to variables such as depressive symptoms, age and psychiatric comorbidities, is unexplored. This study aimed to quantify the influence of cognitive reserve on specific EFs, and compare its impact with that of depressive symptoms, age and psychiatric comorbidities, in separate models for patients with bipolar disorder and healthy adults. Method This was a cross-sectional study of 121 adults with no mood disorders and 109 with bipolar disorder, all of whom underwent a comprehensive psychiatric assessment and evaluation of the EFs. Cognitive reserve was measured using years of education, IQ and reading and writing habits. The association between EFs and predictors (cognitive reserve, depressive symptoms, age and psychiatric comorbidities) was evaluated through structural equation modeling. Four models were constructed for each group independently (bipolar disorder and control), one each for working memory, verbal fluency, inhibition and flexibility, due to group differences in age and cognitive reserve. Results Working memory, inhibition and flexibility were most significantly predicted by cognitive reserve and age. Verbal fluency was only predicted by cognitive reserve. Comorbidities and depressive symptoms were not significant in any of the models. Cognitive reserve had a positive influence on all EFs in models for patients with bipolar disorder and models for control participants. Age had a negative impact on three of the four EFs tested. Conclusion Fostering cognitive reserve through continued education and cognitively stimulating leisure activities may be an effective intervention for executive dysfunction in patients and non-patients alike. In some cases, the effects of these interventions may outweigh the negative cognitive impact of aging, depressive symptoms and psychiatric conditions.

Associations of cognitive reserve and psychological resilience with cognitive functioning in subjects with cerebral white matter hyperintensities.

Cerebral small vessel disease is characterized by progressive white matter hyperintensities (WMH) and cognitive decline. However, variability exists in how individuals maintain cognitive capabilities despite significant neuropathology. The relationships between individual cognitive reserve, psychological resilience and cognitive functioning were examined in subjects with varying degrees of WMH. In the Helsinki Small Vessel Disease Study, 152 subjects (aged 65-75 years) underwent a comprehensive neuropsychological assessment, evaluation of subjective cognitive complaints and brain magnetic resonance imaging with volumetric WMH evaluation. Cognitive reserve was determined by education (years) and the modified Cognitive Reserve Scale (mCRS). Psychological resilience was evaluated with the Resilience Scale 14. The mCRS total score correlated significantly with years of education (r=0.23, p<0.01), but it was not related to age, sex or WMH volume. Together, mCRS score and education were associated with performance in a wide range of cognitive domains including processing speed, executive functions, working memory, verbal memory, visuospatial perception and verbal reasoning. Independently of education, the mCRS score had incremental predictive value on delayed verbal recall and subjective cognitive complaints. Psychological resilience was not significantly related to age, education, sex, WMH severity or cognitive test scores, but it was associated with subjective cognitive complaints. Cognitive reserve has strong and consistent associations with cognitive functioning in subjects with WMH. Education is widely associated with objective cognitive functioning, whereas lifetime engagement in cognitively stimulating leisure activities (mCRS) has independent predictive value on memory performance and subjective cognitive complaints. Psychological resilience is strongly associated with subjective, but not objective, cognitive functioning.

Foreign Language Learning as Cognitive Training to Prevent Old Age Disorders? Protocol of a Randomized Controlled Trial of Language Training vs. Musical Training and Social Interaction in Elderly With Subjective Cognitive Decline.

Introduction: With aging comes a reduction of cognitive flexibility, which has been related to the development of late-life depression and progression of general cognitive decline. Several factors have been linked to attenuating such decline in cognitive flexibility, such as education, physical exercise and stimulating leisure activities. Speaking two or more languages has recently received abundant attention as another factor that may build up cognitive reserve, thereby limiting the functional implications of compromised cognition that accompany old age. With the number of older adults reaching record levels, it is important to attenuate the development of old-age disorders. Learning to speak a foreign language might offer a powerful tool in promoting healthy aging, but up to date effect studies are sparse. Here, the protocol that forms the foundation of the current study is presented. The present study aims to: (1) examine the effects of a foreign language training on cognitive flexibility and its neural underpinnings, and on mental health; and (2) assess the unique role of foreign language training vs. other cognitive or social programs.Method: One-hundred and ninety-eight Dutch elderly participants reporting subjective cognitive decline are included and randomized to either a language intervention, a music intervention, or a social control intervention. During 3 to 6 months, the language group learns English, the music group learns to play the guitar and the social group participates in social meetings where art workshops are offered. At baseline, at a 3-month follow-up, and at 6 months after termination of the training program, clinical, cognitive and brain activity measurements (combined EEG and fNIRS methods) are taken to assess cognitive flexibility and mental health.Discussion: This is the first trial addressing combined effects of language learning in elderly on cognition, language proficiency, socio-affective measures, and brain activity in the context of a randomized controlled trial. If successful, this study can provide insights into how foreign language training can contribute to more cognitively and mentally healthy years in older adulthood.Clinical Trial Registration: The trial is registered at the Netherlands Trial Register, July 2, 2018, trial number NL7137. https://www.trialregister.nl/trial/7137.

Active lifestyle as a reflection of cognitive reserve: The Modified Cognitive Reserve Scale

Cognitive reserve (CR) refers to individual differences in cognitive processing that can protect from and compensate for functional decline related to ageing or brain pathology. The CR theory postulates that attaining an active and cognitively stimulating lifestyle can accumulate CR. The Cognitive Reserve Scale (CRS) is a questionnaire that measures lifelong attainment in leisure activities. This cross-sectional study aimed to examine the usefulness, validity and reliability of a modified Finnish translation of the CRS, the Modified Cognitive Reserve Scale (mCRS). The mCRS consists of 20 questions concerning studying and information seeking, hobbies and social relationships during three age phases: young adulthood (18–35 years), adulthood (36–64 years) and late adulthood (≥65 years). A group of 69 neurologically healthy adults aged 26–78 filled the mCRS and completed a neuropsychological test battery. We examined the internal consistency of the mCRS and associations between the mCRS, demographical variables and cognitive performance. The mCRS was normally distributed and showed satisfactory internal consistency (Cronbach’s alpha 0.81). It was significantly associated with occupation (ԑ2 = 0.14) and education (rho = 0.51) but not with age or gender. There were significant associations between the mCRS and verbal reasoning (rho = .306), visual reasoning (r = .319), learning (r = .293) and inhibition (rho = -.368). Our study suggests that the mCRS is a reliable and valid method to assess lifelong leisure activity. The mCRS is related to other factors that enhance CR, occupation and education, and associated with cognitive performance of healthy adults. It provides an easily administrable means to assess lifelong attainment in stimulating leisure activities.

Pathway Analysis of Leisure Activity and Cognitive Function in the Long Life Family Study

Familial longevity and greater involvement in activities purported to build cognitive reserve (e.g. education, cognitively stimulating leisure activity) have both been associated with better cognitive function in later life, yet little is known about how these protective factors relate with one another. In this work, we modeled the associations among familial longevity, proxies of cognitive reserve, and cognitive function in the Long Life Family Study (LLFS). We assessed cognitive function using a comprehensive battery of neuropsychological tests (i.e. Digit-Spans, California Verbal Learning Test, Rey-Osterrieth Complex Figure, phonemic fluency, category fluency, Word Generation, DKEFS Sorting Test, and logical memory) in a subset of LLFS family members and a referent cohort (N=314, mean age 75.7±14.6 years). To model these associations, we used a series of Bayesian hierarchical regression pathways that incorporate a random effect for family relatedness, adjusted by age and sex. All continuous variables were rescaled and bounded to be approximately between (0,1) in order to standardize regression coefficients and to allow for an asymmetrical beta-distribution. Controlling for education level, age, and sex, referents had greater engagement in late-life cognitive activities compared to LLFS family members, β=0.38 (95% CI: 0.18 to 0.57). In turn, those with higher markers of cognitive reserve exhibited better neuropsychological performance. Despite LLFS family members having lower participation in cognitively stimulating leisure activities, there were no differences between LLFS family members and referents on cognitive test performance. These results suggest long-lived family members may have more unique pathways (i.e. genetic/environmental) that preserve cognition later in life.

Validation of composite proxy measures of cognitive reserve

AbstractBackgroundCognitive reserve (CR) enables individuals to maintain cognitive function despite the presence of brain pathology or atrophy [1]. CR is typically measured via proxy variables that reflect exposure to lifetime experiences, such as education [2]. Composite measures of multiple proxies combine contributions from several experiences and display consistent positive relationships with cognitive function [3]. However, the optimal set of proxies for inclusion in composite measures remains to be determined [2]. Here, we aimed to identify a combination of proxies that best reflects the ability to maintain cognitive function despite cortical thinning.MethodAs part of a larger analysis, 277 healthy adult participants provided data for this study (mean age = 69.18, SD age = 6.66, 141 females). Global cognition was defined as average of z‐scores from the Animal Naming task, Colour Trails Test 1 and 2, Immediate and Delayed Recall. Mean cortical thickness was calculated using FreeSurfer using a previously reported method [4]. CR proxies were: educational attainment, occupational complexity, premorbid intelligence, social engagement, cognitively stimulating activity, leisure activity, and physical activity. For each composite, a three‐step hierarchical‐multiple regression was performed to predict global cognition. Independent variables in Step 1 were age, gender, cortical thickness, CR composite was added in Step 2, and an interaction term (cortical thickness*composite) was further added in Step 3. Positive associations between CR composites and global cognition – independent of age, gender and cortical thickness – were ranked on significant R‐squared change values from Step 1 to Step 2. Moderation effects were identified by significant R‐squared change values from Step 2 to Step 3.ResultMost CR composites had positive associations with global cognition, independent of age, gender, and cortical thickness (see Figure 1). A CR composite measuring cognitively stimulating activity, leisure activity, and physical activity had the biggest negative moderation effect (R2 change = 0.013, p = 0.0276) on the cortical thickness‐global cognition relationship.ConclusionA composite measure of cognitively stimulating‐, leisure‐, and physical‐activity, displays construct validity as a measure of CR in addition to a wide range of composites which display positive, independent, associations with cognitive function.

Intelligence trajectories in adolescents and adults with down syndrome: Cognitively stimulating leisure activities mitigate health and ADL problems.

This study examined: (a) crystallized/fluid intelligence trajectories of adolescents and adults with Down syndrome; and (b) the contribution of endogenous (health, activities of daily living-ADL) and exogenous (cognitively stimulating leisure activities) factors on adults' intelligence with age. Four cohorts (N=80) with Down syndrome participated: adolescents (ages 16-21) and adults (ages 30-45, 46-60 and 61+). All completed Vocabulary and Similarities (crystallized) and Block Design and Raven (fluid) intelligence tests (WAIS-IIIHEB , Wechsler, 2001). The 30-45 cohort significantly outperformed the 16-21 cohort. Except for Vocabulary, which remained stable, onset of decline was at 40-50. Age-related declining health and ADL correlated with participants' lower fluid intelligence, but cognitive leisure activities mitigated this influence. Intelligence development into adulthood supported the continuous trajectory and compensation age theory, rather than accelerated or stable trajectories. Not only endogenous factors but also exogenous factors determined intelligence levels in adults with Down syndrome, supporting cognitive activity theory.