Association of intellectual activities with cognitive function: the Emory Healthy Aging Study Open Access

Abstract

Background: In aging societies, cognitive impairment and dementia are becoming a big burden for both individuals and families. As no drugs have been proved to be effective enough for treatment, prevention becomes vital. Though increasing evidence indicates that lifestyles and certain intellectual activities can affect cognitive function in the elderly, few studies have explored that relationship in diverse samples in the U.S. Our goal is to test this association in a U.S. population and try to determine what specific intellectual activities may offer particular protection.

Methods: Participants in the Emory Healthy Aging Study, a community-based cohort study in the U.S. with online recruitment and follow-up, were selected. Self-reported frequency of engagement in multiple intellectual activities was obtained and combined in a total activity score. Cognitive function was evaluated with the Cognitive Function Instrument (CFI), a validated test. The cross-sectional association between intellectual activities and cognitive function was assessed with multiple linear regression, while logistic regression was used to explore associations of intellectual activities with cognitive function change during the follow-up.

Result: 14031 participants (mean age 63.2, 72.4% female) were included in the cross-sectional analysis. Mean (SD) CFI score at baseline was 2.31 (2.35). Total intellectual activity score was strongly associated with better cognitive function (-0.65, 95% CI -0.71, -0.59), with reading books, reading newspapers, writing letters, playing games and playing instruments showing statistically significant associations. The longitudinal analysis included 6716 participants, with 4297 (64.0%) participants reporting better or stable cognitive function while 2419 (36.0%) reported worse cognitive function. Intellectual activities, overall or individually, did not show significant association with cognitive change.

Conclusion: Cognitive function is related to intellectual activity frequency, with more frequently engaging in intellectual activities resulting in lower likelihood of severe cognitive impairment. Despite no evidence showing intellectual activities being related to cognitive function change in this cohort, engaging in more intellectual activities in daily life might be recommended to prevent cognitive impairment.

Table of Contents

1. Introduction 1

2. Methods 2

2.1 The Emory Healthy Aging Study (EHAS) 2

2.2 Study population 2

2.3 Cognitive Function Assessment 2

2.4 Intellectual activities 3

2.5 Education Background 3

2.6 Statistical Analysis 3

2.6.1 Cross-sectional analysis 4

2.6.2 Longitudinal analysis 4

3. Results 5

3.1 Study population characteristics 5

3.2 Cognitive function 6

3.3 Intellectual Activities 6

3.4 Covariates: 6

3.5 Intellectual activity frequency and cognitive function 7

3.5.1 Cross-sectional analysis 7

3.5.2 Longitudinal analysis 7

4. Discussion 8

4.1.Cross-sectional analysis 8

4.2.Longitudinal analysis 10

4.3. Strengths and limitations 10

5. Conclusion 11

5. References: 12

6. Figures and Tables 14

Figure 1. Flow chart showing how the participants were chosen for two study sections 14

Figure 2. Cognitive Function Instrument questions. 14

Table 1 A. Baseline characteristics of study participants in cross-sectional study, Emory Healthy Aging Study 15

Table 1 B. Baseline characteristics of study participants in longitudinal study, Emory Healthy Aging Study 16

Table 2. Association of global intellectual activity score and demographic variables with cognitive function (CFI) score. Linear regression model simultaneously adjusted for all variables in the table (model 1). 17

Table 3. Association of individual intellectual activities score and demographic variables with cognitive function (CFI) score. Linear regression model simultaneously adjusted for all variables in the table (model 2). 18

Table 4. Association of global intellectual activity score and demographic variables with cognitive loss over follow-up. Logistic regression model simultaneously adjusted for all variables in the table (model 3). 19

Table 5. Association of individual intellectual activities score and demographic variables with cognitive loss over follow-up. Logistic regression model simultaneously adjusted for all variables in the table (model 4) 20

R Code 21

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Psychology, Cognitive Psychology, Behavioral
Keyword	behavior intellectual activity longitudinal analysis cross-sectional analysis cognitive function
Committee Chair / Thesis Advisor	Alonso, Alvaro, Emory University

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