Wilson R S, Scherr P A, Schneider J A, Tang Y, Bennett D A
Rush Alzheimer's Disease Center, Rush University Medical Center, 600 South Paulina, Suite 1038, Chicago, IL 60612, USA.
Neurology. 2007 Nov 13;69(20):1911-20. doi: 10.1212/01.wnl.0000271087.67782.cb. Epub 2007 Jun 27.
Frequent cognitive activity in old age has been associated with reduced risk of Alzheimer disease (AD), but the basis of the association is uncertain.
More than 700 old people underwent annual clinical evaluations for up to 5 years. At baseline, they rated current and past frequency of cognitive activity with the current activity measure administered annually thereafter. Those who died underwent a uniform postmortem examination of the brain. Amyloid burden, density of tangles, and presence of Lewy bodies were assessed in eight brain regions and the number of chronic cerebral infarctions was noted.
During follow-up, 90 people developed AD. More frequent participation in cognitive activity was associated with reduced incidence of AD (HR = 0.58; 95% CI: 0.44, 0.77); a cognitively inactive person (score = 2.2, 10th percentile) was 2.6 times more likely to develop AD than a cognitively active person (score = 4.0, 90th percentile). The association remained after controlling for past cognitive activity, lifespan socioeconomic status, current social and physical activity, and low baseline cognitive function. Frequent cognitive activity was also associated with reduced incidence of mild cognitive impairment and less rapid decline in cognitive function. Among 102 persons who died and had a brain autopsy, neither global nor regionally specific measures of neuropathology were related to level of cognitive activity before the study, at study onset, or during the course of the study.
Level of cognitively stimulating activity in old age is related to risk of developing dementia.
老年时期频繁进行认知活动与阿尔茨海默病（AD）风险降低有关，但这种关联的基础尚不确定。
700多名老年人接受了长达5年的年度临床评估。在基线时，他们对当前和过去的认知活动频率进行评分，此后每年进行当前活动测量。死亡者均接受统一的脑尸检。评估了八个脑区的淀粉样蛋白负荷、缠结密度和路易小体的存在情况，并记录了慢性脑梗死的数量。
随访期间，90人患上了AD。更频繁地参与认知活动与AD发病率降低有关（HR = 0.58；95% CI：0.44，0.77）；认知不活跃的人（得分 = 2.2，第10百分位数）患AD的可能性是认知活跃的人（得分 = 4.0，第90百分位数）的2.6倍。在控制了过去的认知活动、终生社会经济地位、当前的社会和身体活动以及低基线认知功能后，这种关联仍然存在。频繁的认知活动还与轻度认知障碍发病率降低和认知功能下降速度减缓有关。在102名死亡并接受脑尸检的人中，无论是整体还是区域特异性的神经病理学测量都与研究前、研究开始时或研究过程中的认知活动水平无关。
老年时期认知刺激活动的水平与患痴呆症的风险有关。
