Crafting, Playing Games Linked to Decreased Risk for Mild Cognitive Impairment

Deborah Brauser

February 09, 2017

Engaging in common, mentally stimulating activities in later years may decrease the risk for mild cognitive impairment (MCI), a new study suggests.

The findings, which were published online January 30 in JAMA Neurology, expand upon those presented ahead of last year's American Academy of Neurology meeting.

The cohort study of almost 2000 individuals with a mean age of 77 years and who were cognitively normal at baseline showed that those who participated in crafting and social activities, played games, and used the computer were 22% to 30% less likely than the nonparticipants to develop incident MCI up to 4 years later.

The associations between decreased MCI risk and computer use or being socially active were also significant in those who carried the apolipoprotein E (APOE) ε4 allele.

"I thought seeing these levels of significance in risk reduction based on activities was impressive, actually," senior author Yonas E. Geda, MD, professor at the Mayo Clinic School of Medicine in Scottsdale, Arizona, told Medscape Medical News.

Dr Yonas E. Geda

"I think the number one take-away is that it is never too late to engage in these simple activities that are right under our noses," he added.

"Natural" Activities

Dr Geda noted that although past research has looked at links between mentally stimulating activities and MCI risk, his group wanted to assess whether doing these during later life could have an effect.

"We really wanted to look at simple, accessible activities — not fancy, expensive, or complicated stuff, in older folks," he said. "Many people think they have to get expensive games, et cetera, but we wanted to look at activities that can happen in the natural environment of an elderly person."

The investigators evaluated a cohort of 1929 individuals (50.4% women) who were participating in the ongoing, population-based Mayo Clinic Study of Aging. All participants were at least 70 years of age and were followed up to their development of incident MCI (median follow-up, 4 years).

Questionnaires were used to measure the amount of mentally stimulating activities engaged in during the prior year. Regular participation was defined as engaging at least 1 to 2 times per week, whereas nonparticipation (reference group) was defined as engaging 2 to 3 times per month or less.

During the median follow-up, 456 members of the cohort developed new-onset MCI.

After adjustment for sex, age, and educational level, using vs not using the computer was significantly associated with decreased risk for MCI (hazard ratio [HR], 0.70; 95% confidence interval, 0.57 - 0.85; P < .001).

Dr Geda reiterated that computer use in this instance didn't mean for a specific type of program but for everyday use, such as email, web surfing, and shopping.

That said, he noted that computers should be used in moderation "and not for 2 to 3 hours in one sitting without taking a break every half hour."

Other activities associated with decreased MCI risk included the following:

  • Social/group activities, such as going to the movies (HR, 0.77; P = .009);

  • Playing games, such as cards, checkers, and bridge (HR, 0.78; P = .01); and

  • Crafts, such as knitting (HR, 0.72; P = .004).

"For crafting, I think it's about the psycho-motor coordination. The fingers' dexterity is coordinated by the basal ganglia," noted Dr Geda. "And I think knitting and quilting could be stimulating various parts of the brain, including the motor coordinating part."

Although reading books also showed a signal for decreased risk, the association was not significant (HR, 0.83; P = .06).

Further analysis after stratifying by cognitive impairment subtype showed that crafting, computer use, and social activities were associated with decreased risk for incident amnestic MCI (HRs, 0.76, 0.75, and 0.74, respectively).

But a decreased risk for incident nonamnestic MCI was found only for those participating in regular computer use (HR, 0.42).

APOE ε4 Status

When stratifying by APOE ε4 status, the researchers found that 26.7% of the total participants were carriers. In the subgroup of noncarriers, craft activities and computer use were significantly associated with decreased MCI risk (HRs, 0.65 and 0.73, respectively).

In the subgroup of APOE ε4 carriers, decreased risk associations were found for those who regularly participated in computer use (HR, 0.65) or social activities (HR, 0.62).

The investigators note that because of the study's observational nature, conclusions cannot be made about cause and effect and they "cannot exclude a 'reverse causality' explanation (ie, it is possible that participants who are at higher risk for MCI are less likely to engage in mentally stimulating activities)."

Still, considering the study's rigorous and large-scale design, along with similar results from past smaller studies, "we can concluded that the observed associations in our study are real," they write.

"Clinicians should keep in mind that it's never too late to advise their patients to participate in these types of simple activities that are available in everyday life," added Dr Geda.

The study was funded by grants from the National Institute on Aging and the National Institute of Mental Health and by the Robert Wood Johnson Foundation, the Robert H. and Clarice Smith and Abigail Van Buren Alzheimer's Disease Research Program, the European Regional Development Fund, the Arizona Alzheimer's Consortium, and the Edli Foundation in the Netherlands. Dr Geda has disclosed no relevant financial relationships. Disclosures for the coauthors are in the paper.

JAMA Neurol. Published online January 30, 2017. Abstract

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