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Engagement in social activities and progression from mild to severe cognitive impairment: the MYHAT study

Published online by Cambridge University Press:  21 December 2012

Tiffany F. Hughes ,
Jason D. Flatt ,
Bo Fu ,
Chung-Chou H. Chang  and
Mary Ganguli
Tiffany F. Hughes*
Affiliation:
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Jason D. Flatt
Affiliation:
Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Bo Fu
Affiliation:
Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Chung-Chou H. Chang
Affiliation:
Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Mary Ganguli
Affiliation:
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
*
Correspondence should be addressed to: Dr. Tiffany F. Hughes, PhD, MPH, Department of Psychiatry, University of Pittsburgh, 3600 Forbes Ave., Iroquois Bldg., Suite 205, Pittsburgh, PA 15213, USA. Phone: +412-647-6619; Fax: +412-647-6555. Email: [email protected].
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Abstract

Background: It is of considerable public health importance to prevent or delay the progression of mild cognitive impairment (MCI) to more severely impaired cognitive states. This study examines the risk of progression from mild to severe cognitive impairment in relation to engagement in social activities while mildly impaired and the concurrence of subsequent change in engagement with MCI progression.

Methods: Participants were 816 older adults with cognitively defined MCI (mean age 78.0 (standard deviation or SD = 7.4) years) from the Monongahela–Youghiogheny Healthy Aging Team (MYHAT) Study – a prospective cohort study of MCI in the community. Over three years of follow-up, 78 individuals progressed from MCI to severe cognitive impairment, while 738 did not progress. Risk of progression was estimated using discrete time survival analyses. The main predictors were standardized composite measures of the variety and frequency of engagement in social activities.

Results: Lower risk of progression from mild to severe cognitive impairment was associated with both a greater level of frequency of engagement in social activities while mildly impaired (OR = 0.72, 95% CI: 0.55–0.93, p = 0.01) and also with a slower rate of decline in the variety of activities over time (OR = 0.01, 95% CI: <0.001–0.38, p = 0.02).

Conclusions: Greater engagement in social activities may potentially be beneficial for preventing or delaying further cognitive decline among older adults with MCI. Alternatively, lesser engagement in social activities may be a marker of impending cognitive decline in MCI.

Keywords

MCIleisure activitiessocial engagementcognitive decline
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 4 , April 2013 , pp. 587 - 595
Copyright
Copyright © International Psychogeriatric Association 2012

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, 4th text revision edn.Washington, DC: American Psychiatric Association.Google Scholar
Andel, R.et al. (2005). Complexity of work and risk of Alzhemer's disease: a population-based study of Swedish twins. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60B, P251–P258.CrossRefGoogle Scholar
Bennett, D. A., Schneider, J. A., Tang, Y., Arnold, S. E. and Wilson, R. S. (2006). The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study. Lancet Neurology, 5, 406–412.CrossRefGoogle ScholarPubMed
Berkman, L. F., Glass, T., Brissette, I. and Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social Science and Medicine, 51, 843–857.CrossRefGoogle ScholarPubMed
Byers, A. L. and Yaffe, K. (2011). Depression and risk of developing dementia. Nature Reviews Neurology, 7, 323–331.CrossRefGoogle ScholarPubMed
Carlson, M. C.et al. (2009). Evidence for neurocognitive plasticity in at-risk older adults: the Experience Corps Program. Journals of Gerontology Series A: Biological and Medical Sciences, 64A, 1275–1282.CrossRefGoogle Scholar
Fillenbaum, G. G. (1988). Multidimensional Functional Assessment of Older Adults: The Duke Older Americans Resources and Services Procedures. Hillsdale, NY: Lawrence Erlbaum.Google Scholar
Fitzmaurice, G. M., Laird, N. M. and Ware, J. H. (2004). Applied Longitudinal Analysis. Hoboken, NJ: John Wiley.Google Scholar
Ganguli, M., Snitz, B., Vander Bilt, J. and Chang, C. C. (2009). How much do depressive symptoms affect cognition at the population level? The Monongahela–Youghiogheny Healthy Aging Team (MYHAT) study. International Journal of Geriatric Psychiatry, 24, 1277–1284.CrossRefGoogle ScholarPubMed
Ganguli, M., Chang, C.-C., Snitz, B., Saxton, J. A., Vanderbilt, J. and Lee, C.-W. (2010). Prevalence of mild cognitive impairment by multiple classifications: the Monongahela–Youghiogheny Healthy Aging Team (MYHAT) Project. American Journal of Geriatric Psychiatry, 18, 674–683.CrossRefGoogle ScholarPubMed
Ghisletta, P., Bickel, J. F. and Lövdén, M. (2006). Does activity engagement protect against cognitive decline in old age? Methodological and analytical considerations. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61, P253–P261.CrossRefGoogle ScholarPubMed
Hughes, T. F., Andel, R., Small, B. J., Borenstein, A. R. and Mortimer, J. A. (2008). The association between social resources and cognitive change in older adults: evidence from the Charlotte County Healthy Aging Study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 63, P241–P244.CrossRefGoogle ScholarPubMed
Hughes, T. F., Chang, C. C., Vander Bilt, J., Snitz, B. E. and Ganguli, M. (2012). Mild cognitive deficits and everyday functioning among older adults in the community: the Monongahela–Youghiogheny Healthy Aging Team Study. American Journal of Geriatric Psychiatry, 24, 836–844. doi:10.1097/JGP.0b013e3182423961.CrossRefGoogle Scholar
James, B. D., Wilson, R. S., Barnes, L. L. and Bennett, D. A. (2011). Late-life social activity and cognitive decline in old age. Journal of the International Neuropsychological Society, 17, 998–1005.CrossRefGoogle ScholarPubMed
Kaye, J.et al. (2012). Community life withdrawal and MCI progression. Presented at the Alzheimer's Association International Conference, Vancouver, BC, Canada.Google Scholar
Kukull, W. A. and Ganguli, M. (2012). Generalizability. The trees, the forest, and the low-hanging fruit. Neurology, 78, 1886–1891.CrossRefGoogle ScholarPubMed
Landau, S. M.et al. (2012). Association of lifetime cognitive engagement and low β-amyloid deposition. Archives of Neurology, doi:10.1001/archneurol.2011.2748.Google ScholarPubMed
Lövdén, M., Ghisletta, P. and Lindenberger, U. (2005). Social participation attenuates decline in perceptual speed in old and very old age. Psychology and Aging, 20, 423–434.CrossRefGoogle ScholarPubMed
Lupien, S. J., McEwen, B. S., Gunnar, M. R. and Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behavior and cognition. Nature Reviews Neuroscience, 10, 434–445.CrossRefGoogle Scholar
Mitchell, A. J. and Shiri-Feshki, M. (2009). Rate of progression of mild cognitive impairment to dementia–meta-analysis of 41 robust inception cohort studies. Acta Psychiatrica Scandinavica, 119, 252–265.CrossRefGoogle ScholarPubMed
Muangpaisan, W., Assantachai, P., Intalapaporn, S. and Pisansalakij, D. (2008). Quality of life of the community-based patients with mild cognitive impairment. Geriatrics and Gerontology International, 8, 80–85.CrossRefGoogle ScholarPubMed
Mungas, D., Marshall, S. C., Weldon, M., Haan, M. and Reed, B. R. (1996). Age and education correction of Mini-Mental State Examination for English and Spanish-speaking elderly. Neurology, 46, 700–706.CrossRefGoogle ScholarPubMed
Pressman, S. D.et al. (2009). Association of enjoyable leisure activities with psychological and physical well-being. Psychosomatic Medicine, 71, 725–732.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Singer, J. D. and Willett, J. B. (1993). It's about time: using discrete-time survival analysis to study duration and the timing of events. Journal of Educational and Behavioral Statistics, 18, 155–195.Google Scholar
Small, B. J., Dixon, R. A., McArdle, J. J. and Grimm, K. J. (2012). Do changes in lifestyle engagement moderate cognitive decline in normal aging? Evidence from the Victoria Longitudinal Study. Neuropsychology, 26, 144–155. doi:10.1037/a0026579.CrossRefGoogle ScholarPubMed
Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47, 2015–2028.CrossRefGoogle ScholarPubMed
Verghese, J.et al. (2006). Leisure activities and the risk of amnestic mild cognitive impairment in the elderly. Neurology, 66, 821–827.CrossRefGoogle ScholarPubMed
Wang, H. X., Karp, A., Winblad, B. and Fratiglioni, L. (2002). Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. American Journal of Epidemiology, 155, 1081–1087.CrossRefGoogle ScholarPubMed
Ward, A., Arrighi, H. M., Michels, S. and Cedarbaum, J. M. (2012). Mild cognitive impairment: disparity of incidence and prevalence estimates. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 8, 14–21.CrossRefGoogle ScholarPubMed