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Self-reported Lifestyle Activities in Relation to Longitudinal Cognitive Trajectories

Pettigrew, Corinne, PhD*; Shao, Yi, BS*; Zhu, Yuxin, BS; Grega, Maura, MSN*; Brichko, Rostislav, BA*; Wang, Mei-Cheng, PhD; Carlson, Michelle C., PhD; Albert, Marilyn, PhD*; Soldan, Anja, PhD*

Alzheimer Disease & Associated Disorders: January-March 2019 - Volume 33 - Issue 1 - p 21–28
doi: 10.1097/WAD.0000000000000281
Original Articles

Background: Few studies have examined the relationship between lifestyle activity engagement and cognitive trajectories among individuals who were cognitively normal at baseline.

Objective: To examine the relationship of current engagement in lifestyle activities to previous cognitive performance among individuals who were cognitively normal at baseline, and whether this relationship differed for individuals who subsequently developed mild cognitive impairment (MCI), or by APOE-4 genotype, age, and level of cognitive reserve.

Methods: Participants (N=189) were primarily middle-aged (M=56.6 y) at baseline and have been prospectively followed with annual assessments (M follow-up=14.3 y). Engagement in physical, cognitive, and social activities was measured by the CHAMPS activity questionnaire. Longitudinal cognitive performance was measured by a global composite score.

Results: Among individuals who progressed to MCI (n=27), higher lifestyle activity engagement was associated with less decline in prior cognitive performance. In contrast, among individuals who remained cognitively normal, lifestyle activity engagement was not associated with prior cognitive trajectories. These effects were largely independent of APOE-4 genotype, age, and cognitive reserve.

Conclusions: Greater engagement in lifestyle activities may modify the rate of cognitive decline among those who develop symptoms of MCI, but these findings need to be confirmed in prospective studies.

*Department of Neurology, Johns Hopkins University School of Medicine

Departments of Biostatistics

Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD

Supported by the National Institutes of Health (grant numbers U19-AG033655, P50-AG005146).

M.A. is an advisor to Eli Lilly. The remaining authors declare no conflicts of interest.

Reprints: Corinne Pettigrew, PhD, Division of Cognitive Neuroscience, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD 21205 (e-mail:

Received April 5, 2018

Accepted October 3, 2018

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