With The Mind in Old Age -
It's Use It or Lose It!

Reuters Health
By Alison McCook
SOURCE: The New England Journal of Medicine 2003;348:2508-2516, 2489-249

NEW YORK (Reuters Health) - Keeping up leisure activities such as reading, playing board games and dancing may help the elderly stay mentally sharp into their later years, researchers said Wednesday.

In a New England Journal of Medicine report, U.S. investigators found that people over 75 who engaged in leisure activities were less likely to show signs of dementia than others.

But not all activities appeared equally effective in reducing dementia risk. For instance, people who reported frequently playing board games, reading, playing a musical instrument or doing crossword puzzles were less likely to develop dementia than those who said they engaged in those activities only rarely.

However, frequently joining group discussions and writing appeared to offer no protection against memory-robbing diseases like Alzheimer's.

Elderly people who reported often taking a turn on the dance floor were less likely to show signs of dementia, but no other form of physical activity appeared to have any effect on dementia risk, the report indicates.

In an interview with Reuters Health, study author Dr. Joe Verghese of the Albert Einstein College of Medicine in New York said that mind-bending activities may stave off dementia by increasing a person's "cognitive reserve."

For instance, engaging in mental exercise may increase the connections between brain cells or promote new networks between cells, Verghese said. So while people who perform these activities may get dementia as often as others, mentally active people can perhaps afford to lose more brain cells before symptoms appear, he noted.

Based on these findings, Verghese said he believed that people who work with the elderly should "definitely" encourage them to take part in mental exercise, similar to the activities featured in the current study.

He added that people engage in leisure activities because they enjoyed them, and had likely done so before the study began, suggesting that mind exercises may help your brain long before old age.

"A cognitive reserve takes a long time to develop," Verghese said.

He and his colleagues obtained their findings by following 469 dementia-free people older than 75, noting their activities of choice and whether they developed dementia. Participants were followed for up to 21 years, with more than half of the study participants followed for at least five years.

Verghese explained that researchers have shown that people who develop dementia tend to halt their activities as a result. Consequently, experts have debated whether people who do less mental exercise and later develop dementia were inclined to abandon their earlier activities because they had an early, undetected form of the disease.

To address this concern, in their analysis, Verghese said he and his team excluded people who developed dementia within the study's first seven years, who may have had an early form of the disease when the study began.

Although dancing was the only physical activity that appeared to influence mental acuity in old age, Verghese said that it makes sense that exercising your body, which improves general health, may still help your mind.

Similarly, although writing and group discussions appeared to offer no benefit, Verghese noted that more mind-challenging forms of those activities -- such as book clubs or autobiographical writing -- may help stave off mental decline.

In an accompanying perspective, Dr. Joseph T. Coyle of Harvard Medical School in Boston agrees that promoting leisure activities among the elderly couldn't hurt.

While researchers investigate further the relative contributions of genes and environment to dementia risk, "seniors should be encouraged to read, play board games, and go ballroom dancing, because these activities, at the very least, enhance their quality of life, and they just might do more than that."