HIGH INTENSITY COGNITIVE ACTIVITY IS SELECTIVELY ASSOCIATED WITH MAINTAINED COGNITION





M.C. Carlson PhD *, Q. Xue PhD, K. Bandeen-Roche PhD, & L.P. Fried MD, The Johns Hopkins Medical Institutions

Michelle Carlson, Ph.D.
Center on Aging and Health
2024 E. Monument St., Suite 2-700
Baltimore, MD 21205
e-mail: mcarlson@jhsph.edu




High Intensity Cognitive Activity is Selectively Associated with Maintained Cognition
This study sought to characterize the range of activities that a representative cohort of cognitively and physically intact older women regularly participated in and to determine whether participation in high relative to moderate and low cognitive intensity activities was associated with better maintenance of cognitive and physical functions over a 3-year interval. For these purposes, we developed the Cognitive Activities Questionnaire (CAQ) to easily obtain comprehensive information regarding the types and frequencies of participation in 20 everyday activities. We split the 20 activities into three groups, High, Moderate and Low Intensity activities, based on geriatric psychologists’ ratings. For each intensity level, two summary measures of cognitive activity were derived: 1) frequency of participation in an activity, which ranged from “seldom or not at all” to “every day”, and number or breadth of activity, which equaled the sum of a given set of activities endorsed. The latter measure was used to assess whether any participation, regardless of frequency, was associated with better cognition. The three frequency measures for each intensity level showed nominal collinearity (Pearson r’s= 0.18- 0.26). Intensity-specific measures of breadth were moderately correlated (r’s= 0.38- 0.44). Survey results showed that participants reported doing low intensity activities often, such as watching television (approximately 4 hours/day). Among high intensity activities, most read the newspaper daily. However, less than half participated once a month or more in other stimulating activities, such as volunteering, going to church or civic organizations, playing cards and games, and doing crossword puzzles.
We next used Generalized Estimating Equations (GEE’s) to determine whether participation in moderate and particularly, high, cognitive intensity activities were selectively associated with better cognitive functioning over a 3-year interval. To do so, we divided participants into four activity groups by using the median frequency within each intensity level as the cut score for high vs. low frequency (or number) activity. Individuals were divided into one of four groups:
1. Low intensity activity reference group = 9HI+ 9MI
2. Moderate intensity activity group = 9HI+8MI
3. High intensity activity group = 8HI + 9MI
4. High & Moderate activity group = 8HI +8MI.
Those in the HI activity groups (3 & 4) had more formal education than the other 2 groups. No other group differences were observed in baseline age, Mini-Mental State Exam, Geriatric Depression Scale, and chronic disease burden. GEE’s, adjusted for these demographic, mental and medical health factors, revealed that Group 4 showed the greatest maintenance of psychomotor speed (Trail Making Test, Part A), executive attention (Trail Making Test, Part B), and delayed verbal recall (Hopkins Verbal Learning Test) relative to Group 1. Group 3 showed a similar, although slightly attenuated, maintenance relative to Group 1. This study demonstrates the utility of cognitive intensity as a parameter in the assessment of cognitive activity. This parameter may be a sensitive metric in assessing relationships between cognitively stimulating activity and a variety of important health outcomes, such as physical function.




Key words: cognition, cognitive activity, aging, everyday activity







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