Reducing risk of mild cognitive impairment with mentally stimulating activities—when, what, how many and how much?

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In 2017, Krell-Roesch et al. found that cognitively unimpaired older adults (aged ≥ 70 years) who engaged in mentally stimulating activities reduced their risk of mild cognitive impairment (MCI). And, this month these researchers are back with more details!

Now they wanted to know whether engaging in mentally stimulating activities in midlife AND late life reduced risk of MCI when compared to adults who only engaged in these activities in midlife OR late life. So, timing of engagement was the first question. Then, they looked at how many of these mentally stimulating activities the participants needed to do. Do individuals need to engage in a variety of these activities to reduce their risk? Or, is one or two activities enough? Finally, how often should we recommend our clients complete these types of activities to see the benefit?

These are some big questions from a big study. Two thousand participants were tracked for a median time of five years, using self-reported data. The five mentally stimulating activities analyzed were:

  1. Reading books

  2. Computer use

  3. Social activities (hanging out with friends, going to the movies)

  4. Playing games (crossword puzzles, playing cards)

  5. Craft activities (pottery, quilting, or sewing) 

Before we get to the good stuff, what is the everyday application of this study? You could make the case that typically, SLPs do not see clients with MCI until they have a diagnosis.  However, ASHA defines our scope to include prevention of communication disorders. And this study does give us some concrete, modifiable lifestyle factors that we can encourage our aging clients to consider.

So, how about some specific results?  

First, the what and when questions:

Participants who engaged in computer use demonstrated decreased risk of MCI no matter when they started to participate—whether that be in midlife (50–65) or after the age of 70. Unfortunately, the study doesn’t provide details as to what this computer use entails.

Participants who engaged in craft activities in midlife did not reduce their risk of MCI, BUT those who engaged in craft activities AFTER the age of 70 years did decrease their risk.

Participants who engaged in social activities and games ONLY reduced their risk of MCI if they participated in midlife AND late-life.

Now, the how much and how often questions:

Overall, we don’t really know. There was no consistent “dose-response pattern” between the number of times per week or month the participant had to engage in the activity to see the reduced risk of MCI. It seems 2–3 times per month is enough for most activities; however, computer use needed to be completed at least 5–6 per week to decrease the risk of MCI. What we also don’t know from this study is how long each person should participate in each activity. For example, do you need to play cards for 15 minutes or 2 hours to get the benefits?

Broadly though, even late life engagement in mentally stimulating activities can reduce MCI risk for those who are cognitively unimpaired.  

Researchers caution that individuals who complete a variety of mentally stimulating activities may also engage in greater physical activity or eat a healthier diet. These habits have also been shown to be protective factors when it comes to MCI risk. Further, engaging in “leisure activities” may lend itself to better emotional health and this has been associated with improved cognitive function as well. We owe our older adults evidence-based solutions for the prevention of MCI—results of this study seem like a good place to start!

 

Krell-Roesch, J., Syrjanen, J.A., Vassilaki, M., Machulda, M.M., Mielke, M.M., Knopman, D.S., Kremers, W.K., Petersen, R.C., & Geda, Y.E. (2019). Quantity and quality of mental activities and the risk of incident mild cognitive impairment. Neurology. doi: 10.1212/WNL.0000000000007897.