Cognitive stimulation and cognitive and functional decline in alzheimer's disease: The cache county dementia progression study

Katherine A. Treiber, Michelle C. Carlson, Chris Corcoran, Maria C. Norton, John C.S. Breitner, Kathleen W. Piercy, Michael Scott DeBerard, David Stein, Beth Foley, Kathleen A. Welsh-Bohmer, Amber Frye, C. G. Lyketsos, J. T. Tschanz

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Objectives. To examine the association of engagement in cognitively stimulating activities with cognitive and functional decline in a population-based sample of incident Alzheimer's disease (AD). Method. After diagnosis, 187 participants (65% females) were followed semiannually for a mean 2.7 (SD = 0.4) years. Mean age and education were 84.6 (SD = 5.8) and 13.2 (SD = 2.9) years. Caregivers enumerated cognitively stimulating leisure activities via the Lifestyle Activities Questionnaire. Cognition was assessed using the Mini-Mental State Examination and functional ability via the Clinical Dementia Rating sum of boxes. Linear mixed models tested the association between stimulating activities and change over time in each outcome. Covariates were demographic factors, estimated premorbid IQ, presence/absence of the APOE e4 allele, duration of dementia, level of physical activity, and general health. Results. At initial assessment, 87% of participants were engaged in one or more stimulating activities, with mean (SD) activities = 4.0 (3.0). This number declined to 2.4 (2.0) at the final visit. There was a statistical interaction between dementia duration and number of activities in predicting rate of cognitive decline (p = .02) and overall functional ability (p = .006). Discussion. Active involvement in cognitively stimulating pursuits may be beneficial for persons with AD.

Original languageEnglish (US)
Pages (from-to)416-425
Number of pages10
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Volume66 B
Issue number4
StatePublished - Jul 2011


  • Alzheimer's disease
  • Cognitive activity
  • Cognitive decline
  • Dementia

ASJC Scopus subject areas

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies


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