Participation in cognitively-stimulating activities is associated with brain structure and cognitive function in preclinical Alzheimer's disease

Abstract

This study tested the hypothesis that frequent participation in cognitively-stimulating activities, specifically those related to playing games and puzzles, is beneficial to brain health and cognition among middle-aged adults at increased risk for Alzheimer's disease (AD). Three hundred twenty-nine cognitively normal, middle-aged adults (age range, 43.2-73.8 years) enrolled in the Wisconsin Registry for Alzheimer's Prevention (WRAP) participated in this study. They reported their current engagement in cognitive activities using a modified version of the Cognitive Activity Scale (CAS), underwent a structural MRI scan, and completed a comprehensive cognitive battery. FreeSurfer was used to derive gray matter (GM) volumes from AD-related regions of interest (ROIs), and composite measures of episodic memory and executive function were obtained from the cognitive tests. Covariate-adjusted least squares analyses were used to examine the association between the Games item on the CAS (CAS-Games) and both GM volumes and cognitive composites. Higher scores on CAS-Games were associated with greater GM volumes in several ROIs including the hippocampus, posterior cingulate, anterior cingulate, and middle frontal gyrus. Similarly, CAS-Games scores were positively associated with scores on the Immediate Memory, Verbal Learning & Memory, and Speed & Flexibility domains. These findings were not modified by known risk factors for AD. In addition, the Total score on the CAS was not as sensitive as CAS-Games to the examined brain and cognitive measures. For some individuals, participation in cognitive activities pertinent to game playing may help prevent AD by preserving brain structures and cognitive functions vulnerable to AD pathophysiology.

Keywords: AD prevention; Brain imaging; Cognition; Cognitive activity; Preclinical Alzheimer’s disease.

Conflict of interest statement

Disclosures: The authors indicate no potential conflicts of interest.

Figures

Figure 1. Volumetric regions of interest examined in the study

Figure 2. Relationship between CAS-Games and brain structure

Blue bars=Frequent gamers (i.e.,“5” on the original 5-point CAS scale), Red bars=Infrequent gamers (i.e., ≤4 on the original CAS scale). A–F=adjusted mean volumes (mm3) and standard errors for the (A) hippocampus, (B) posterior cingulate, (C) rostral middle frontal, (D) caudal middle frontal, (E) rostral anterior cingulate, (F) caudal anterior cingulate. Sample size was 316 (62 Frequent gamers and 254 Infrequent gamers).