The ‘use it or lose it’ hypothesis of cognitive aging predicts that engagement in intellectual, social, and physical activities offers protective benefits from age-related cognitive decline and lowers dementia risk. Although this hypothesis has not yet been supported conclusively, there is some empirical evidence in favor of the proposal. However, a number of questions surrounding the relationship between activity participation and cognitive ability in older adulthood are not yet well answered. This mini-review identifies seven key methodological and theoretical issues that are critical to our understanding and eventual possible promotion of activity participation as a way to maintain cognitive well-being. These include the mechanisms involved, the optimal ways of assessing activity engagement, which cognitive domains receive the most benefit from activity engagement, the temporal nature and the directionality of the relationship, the influence of demographic variables such as age, gender, or education, and whether one activity domain offers the most benefit to cognition. The current knowledge on each of these issues is critically evaluated, including describing what we already know about the issue, and identifying potential difficulties and opportunities that may exist in finding an answer. More studies need to take on the challenge of specifically targeting these issues, as each is essential to moving the field forward.
© 2009 S. Karger AG, Basel
- Lifestyle engagement
- Activity participation
- ‘Use it or lose it’ hypothesis
- Colcombe SJ, Kramer AF, Erickson KI, Scalf P, McAuley E, Cohen NJ, Webb A, Jerome GJ, Marquez DX, Elavsky S: Cardiovascular fitness, cortical plasticity, and aging. Proc Natl Acad Sci 2004;101:3316–3321.
- Seeman TE, McEwen BS: Impact of social environment characteristics on neuroendocrine regulation. Psychosom Med 1996;58:459–471.
- Craik FIM, Salthouse TA (eds): The Handbook of Aging and Cognition, ed 3. New York, Psychology Press, 2008.
- Dixon RA, Bäckman L, Nilsson LG (eds): New Frontiers in Cognitive Aging. New York, Oxford University Press, 2004.
- Salthouse TA: Theoretical Perspectives on Cognitive Aging. Hillsdale, Erlbaum, 1991.
- Fratiglioni L, Paillard-Borg S, Winblad B: An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol 2004;3:343–353.
- Small BJ, Hughes TF, Hultsch DF, Dixon RA: Lifestyle activities and late-life changes in cognitive performance; in Stern Y (ed): Cognitive Reserve: Theory and Applications. Philadelphia, Taylor & Francis, 2007, pp 173–186.
- Christensen H, Korten A, Jorm AF, Henderson AS, Scott R, Mackinnon AJ: Activity levels and cognitive functioning in an elderly community sample. Age Aging 1996;25:72–80.
- Holtzman RE, Rebok GW, Saczynski JS, Kouzis AC, Wilcox Doyle K, Eaton WW: Social network characteristics and cognition in middle-aged and older adults. J Gerontol Psychol Sci 2004;59B:P278–P284.
- Vance DE, Wadley VG, Ball KK, Roenker DL, Rizzo M: The effects of physical activity and sedentary behavior on cognitive health in older adults. J Aging Phys Act 2005;13:294–313.
- Hillman CH, Motl RW, Pontifex MB, Posthuma D, Stubbe JH, Boomsma DI, de Geus EJC: Physical activity and cognitive function in a cross-section of younger and older community-dwelling individuals. Health Psychol 2006;25:678–687.
- Bugg JM, DeLosh EL, Clegg BA: Physical activity moderates time-of-day differences in older adults’ working memory performance. Exp Aging Res 2006;32:431–446.
- Hultsch DF, Hammer M, Small BJ: Age differences in cognitive performance in later life: relationships to self-reported health and activity life style. J Gerontol Psychol Sci 1993;48:P1–P11.
- Karp A, Paillard-Borg S, Wang HX, Silverstein M, Winblad B, Fratiglioni L: Mental, physical and social components in leisure activities equally contribute to decrease dementia risk. Dement Geriatr Cogn Disord 2006;21:65–73.
- Newson RS, Kemps EB: Cardiorespiratory fitness as a predictor of successful cognitive aging. J Clin Exp Neuropsychol 2006;28:949–967.
- Newson RS, Kemps EB: The influence of physical and cognitive activities on simple and complex cognitive tasks in older adults. Exp Aging Res 2006;32:341–362.
- Parslow RA, Jorm AF, Christensen H, Mackinnon A: An instrument to measure engagement in life: factor analysis and associations with sociodemographic, health and cognition measures. Gerontology 2006;52:188–198.
- Roth DL, Goode KT, Clay OJ, Ball KK: Association of physical activity and visual attention in older adults. J Aging Health 2003;15:534–547.
- Salthouse TA, Berish DE, Miles JD: The role of cognitive stimulation on the relations between age and cognitive functioning. Psychol Aging 2002;17:548–557.
- Sturman MT, Morris MC, Mendes de Leon CF, Bienias JL, Wilson RS, Evans DA: Physical activity, cognitive activity, and cognitive decline in a biracial community population. Arch Neurol 2005;62:1750–1754.
- Hambrick DZ, Salthouse TA, Meinz EJ: Predictors of crossword puzzle proficiency and moderators of age-cognition relations. J Exp Psychol Gen 1999;128:131–164.
- Ghisletta P, Bickel JF, Lövdén M: Does activity engagement protect against cognitive decline in old age? Methodological and analytical considerations. J Gerontol Psychol Sci 2006;61B:P253–P261.
- Lindstrom HA, Fritsch T, Petot G, Smyth KA, Chen CH, Debanne SM, Lerner AJ, Friedland RP: The relationships between television viewing in midlife and the development of Alzheimer’s disease in a case-control study. Brain Cogn 2005;58:157–165.
- Zunzunegui MV, Alvarado BE, Del Ser T, Otero A: Social networks, social integration, and social engagement determine cognitive decline in community-dwelling Spanish older adults. J Gerontol Soc Sci 2003;58B:S93–S100.
- Albert MS, Jones K, Savage CR, Berkman L, Seeman T, Blazer D, Rowe JW: Predictors of cognitive change in older persons: Macarthur studies of successful aging. Psychol Aging 1995;10:578–589.
- Wang HX, Karp A, Winblad B, Fratiglioni L: Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. Am J Epidemiol 2002;155:1081–1087.
- Larson EB, Wang L, Bowen JD, McCormick WC, Teri L, Crane P, Kukull W: Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Ann Intern Med 2006;144:73–81.
- Abbott RD, White LR, Ross GW, Masaki KH, Curb JD, Petrovitch H: Walking and dementia in physically capable elderly men. JAMA 2004;292:1447–1453.
- Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K: Physical activity and risk of cognitive impairment and dementia in elderly persons. Arch Neurol 2001;58:498–504.
- Béland F, Zunzunegui MV, Alvarado B, Otero A, del Ser T: Trajectories of cognitive decline and social relations. J Gerontol Psychol Sci 2005;60B:P320–P330.
- Crowe M, Andel R, Pedersen NL, Johansson B, Gatz M: Does participation in leisure activities lead to reduced risk of Alzheimer’s disease? A prospective study of Swedish twins. J Gerontol Psychol Sci 2003;58B:P249–P255.
- Fratiglioni L, Wang HX, Ericsson K, Maytan M, Winblad B: Inluence of social network on occurrence of dementia: a community-based longitudinal study. Lancet 2000;355:1315–1319.
- Scarmeas N, Levy G, Tang MX, Manly J, Stern Y: Influence of leisure activity on the incidence of Alzheimer’s disease. Neurology 2001;57:2236–2242.
- Sumic A, Michael YL, Carlson NE, Howieson DB, Kaye JA: Physical activity and the risk of dementia in oldest old. J Aging Health 2007;19:242–259.
- Weuve J, Kang JH, Manson JE, Breteler MMB, Ware JH, Grodstein F: Physical activity, including walking, and cognitive function in older women. JAMA 2004;292:1454–1461.
- Wilson RS, Bennett DA, Bienias JL, Aggarwal NT, Mendes de Leon CF, Morris MC, Schneider JA, Evans DA: Cognitive activity and incident ad in a population-based sample of older persons. Neurology 2002;59:1910–1914.
- Aartsen MJ, Smits CHM, van Tilburg T, Knipscheer KCPM, Deeg DJH: Activity in older adults: cause or consequence of cognitive functioning? A longitudinal study on everyday activities and cognitive performance in older adults. J Gerontol Psychol Sci 2002;57B:P153–P162.
- Bielak AAM, Hughes TF, Small BJ, Dixon RA: It’s never too late to engage in lifestyle activities: significant concurrent but not change relationships between lifestyle activities and cognitive speed. J Gerontol Psychol Sci 2007;62B:P331–P339.
- Salthouse TA: Mental exercises and mental aging: evaluating the validity of the ‘use it or lose it’ hypothesis. Perspect Psychol Sci 2006;1:68–87.
- Salthouse TA: Reply to Schooler: consistent is not conclusive. Perspect Psychol Sci 2007;2:30–32.
- Schooler C: Use it – and keep it, longer, probably. A reply to Salthouse (2006). Perspect Psychol Sci 2007;2:24–29.
- Etnier J: Interrelationships of exercise, mediator variables, and cognition; in Poon LW, Spirduso WW, Chodzko-Zajko W (eds): Exercise and Its Mediating Effects on Cognition. Champaign, Human Kinetics, 2008, vol 2.
- Stern Y: What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc 2002;8:448–460.
- Kramer AF, Bherer L, Colcombe SJ, Dong W, Greenough WT: Environmental influences on cognitive and brain plasticity during aging. J Gerontol Med Sci 2004;59A:940–957.
- Schooler C: Psychological effects of complex environments during the life span: a review and theory. Intelligence 1984;8:259–281.
- Seeman TE, Lusignolo TM, Albert M, Berkman L: Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: Macarthur studies of successful aging. Health Psychol 2001;20:243–255.
- Hogan M: Physical and cognitive activity and exercise for older adults: a review. Int J Aging Hum Dev 2005;60:95–126.
- Colcombe SJ, Erickson KI, Raz N, Webb AG, Cohen NJ, McAuley E, Kramer AF: Aerobic fitness reduces brain tissue loss in aging humans. J Gerontol Med Sci 2003;58A:176–180.
- Morris MC, Evans DA, Tangney CC, Bienias JL, Wilson RS: Associations of vegetable and fruit consumption with age-related cognitive change. Neurology 2006;67:1370–1376.
- Netz Y, Wu M-J, Becker BJ, Tenenbaum G: Physical activity and psychological well-being in advanced age: a meta-analysis of intervention studies. Psychol Aging 2005;20:272–284.
- Anstey K, Christensen H: Education, activity, health, blood pressure and apolipoprotein e as predictors of cognitive change in old age: a review. Gerontology 2000;46:163–177.
- Berkman LF, Glass T, Brissete I, Seeman TE: From social integration to health: Durkheim in the new millennium. Soc Sci Med 2000;51:843–857.
- Hertzog C, Hultsch DF, Dixon RA: On the problem of detecting effects of lifestyle on cognitive change in adulthood: reply to Pushkar et al. (1999). Psychol Aging 1999;14:528–534.
- Lövdén M, Ghisletta P, Lindenberger U: Social participation attenuates decline in perceptual speed in old and very old age. Psychol Aging 2005;20:423–434.
- Hultsch DF, Hertzog C, Small BJ, Dixon RA: Use it or lose it: engaged lifestyle as a buffer of cognitive decline in aging? Psychol Aging 1999;14:245–263.
- Newson RS, Kemps EB: General lifestyle activities as a predictor of current cognition and cognitive change in older adults: a cross-sectional and longitudinal examination. J Gerontol Psychol Sci 2005;60B:P113–P120.
- Mackinnon A, Christensen H, Hofer SM, Korten AE, Jorm AF: Use it and still lose it? The association between activity and cognitive performance established using latent growth techniques in a community sample. Aging Neuropsychol Cogn 2003;10:215–229.
- Wilson RS, Mendes de Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, Bennett DA: Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA 2002;287:742–748.
- Heesch K, Van Uffelen J, Brown W: Are we accurately measuring physical activity in older adults? J Sci Med Sport 2009;12(suppl):S72.
- Dik MG, Deeg DJH, Visser M, Jonker C: Early life physical activity and cognition at old age. J Clin Exp Neuropsychol 2003;25:643–653.
- Fabrigoule C, Letenneur L, Dartigues JF, Zarrouk M, Commenges D, Barberger-Gateau P: Social and leisure activities and risk of dementia: a prospective longitudinal study. J Am Geriatr Soc 1995;43:485–490.
- Salthouse TA: Exercise and mental resources: methodological problems; in Spirduso WW, Poon LW, Chodzko-Zajko W (eds): Exercise and Its Mediating Effects on Cognition. Champaign, Human Kinetics, 2008, vol 2.
- Schinka JA, McBride A, Vanderploeg RD, Tennyson K, Borenstein AR, Mortimer JA: Florida Cognitive Activities Scale: initial development and validation. J Int Neuropsychol Soc 2005;11:108–116.
- Dotson VM, Schinka JA, Brown LM, Mortimer JA, Borenstein AR: Characteristics of the Florida Cognitive Activities Scale in older African Americans. Assessment 2008;15:72–77.
- Valenzuela MJ, Sachdev P: Assessment of complex mental activity across the lifespan: development of the lifetime of experiences questionnaire (LEQ). Psychol Med 2007;37:1015–1025.
- Ravaglia G, Forti P, Lucicesare A, Pisacane N, Rietti E, Bianchin M, Dalmonte E: Physical activity and dementia risk in the elderly: findings from a prospective Italian study. Neurology 2008;70:1786–1794.
- Niti M, Yap KB, Kua EH, Tan CH, Ng TP: Physical, social and productive leisure activities, cognitive decline and interaction with apoe-ε4 genotype in Chinese older adults. Int Psychogeriatr 2008;20:237–251.
- Dishman RK: Measurement of physical activity; in Poon LW, Chodzko-Zajko W, Tomporowski PD (eds): Active Living, Cognitive Functioning, and Aging. Champaign, Human Kinetics, 2006, pp 91–111.
- Andel R, Crowe M, Pedersen NL, Fratiglioni L, Johansson B, Gatz M: Physical exercise at midlife and risk of dementia three decades later: a population-based study of Swedish twins. J Gerontol Med Sci 2008;63A:62–66.
- Friedland RP, Fritsch T, Smyth KA, Koss E, Lerner AJ, Chen CH, Petot GJ, Debanne SM: Patients with Alzheimer’s disease have reduced activities in midlife compared with healthy control-group members. Proc Natl Acad Sci 2001;98:3440–3445.
- Wilson RS, Barnes LL, Bennett DA: Assessment of lifetime participation in cognitively stimulating activities. J Clin Exp Neuropsychol 2003;25:634–642.
- Wilson RS, Barnes LL, Krueger KR, Hoganson G, Bienias JL, Bennett DA: Early and late life cognitive activity and cognitive systems in old age. J Int Neuropsychol Soc 2005;11:400–407.
- Craik FIM: Age-related changes in human memory; in Park D, Schwarz N (eds): Cognitive Aging: A Primer. Philadelphia, Psychology Press, 2000, pp 75–92.
- Angevaren M, Vanhees L, Wendel-Vos W, Verhaar HJJ, Aufdemkampe G, Aleman A, Verschuren WMM: Intensity, but not duration, of physical activities is related to cognitive function. Eur Soc Cardiol 2007;14:825–830.
- Middleton L, Kirkland S, Rockwood K: Prevention of CIND by physical activity: different impact on VCI-ND compared with MCI. J Neurol Sci 2008;269:80–84.
- van Gelder BM, Tijhuis MAR, Kalmijn S, Giampaoli S, Nissinen A, Kromhout D: Physical activity in relation to cognitive decline in elderly men: The FINE Study. Neurology 2004;63:2316–2321.
- Wang JYJ, Zhou DHD, Li J, Zhang M, Deng J, Tang M, Gao C, Li J, Lian Y, Chen M: Leisure activity and risk of cognitive impairment: The Chongqing Aging Study. Neurology 2006;66:911–913.
- Fritsch T, McClendon MJ, Smyth KA, Lerner AJ, Friedland RP, Larsen JD: Cognitive functioning in healthy aging: the role of reserve and lifestyle factors early in life. Gerontologist 2007;47:307–322.
- Barnes DE, Yaffe K, Satariano WA, Tager IB: A longitudinal study of cardiorespiratory fitness and cognitive function in healthy older adults. J Am Geriatr Soc 2003;51:459–465.
- Colcombe S, Kramer AF: Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci 2003;14:125–130.
- Snowdon DA, Kemper SJ, Mortimer JA, Greiner LH, Wekstein DR, Markesbery WR: Linguistic ability in early life and cognitive function and Alzheimer’s disease in late life. Findings from the Nun Study. JAMA 1996;275:528–532.
- Calero-García MD, Navarro-González E, Muñoz-Manzano L: Influence of level of activity on cognitive performance and cognitive plasticity in elderly persons. Arch Gerontol Geriatr 2007;45:307–318.
- Richards M, Hardy R, Wadsworth MEJ: Does active leisure protect cognition? Evidence from a national birth cohort. Soc Sci Med 2003;56:785–792.
- Tranter LJ, Koutstaal W: Age and flexible thinking: an experimental demonstration of the beneficial effects of increased cognitively stimulating activity on fluid intelligence in healthy older adults. Aging Neuropsychol Cogn 2008;15:184–207.
- Colcombe SJ, Erickson KI, Scalf PE, Kim JS, Prakash R, McAuley E, Elavsky S, Marquez DX, Hu L, Kramer AF: Aerobic exercise training increases brain volume in aging humans. J Gerontol Med Sci 2006;61A:1166–1170.
- Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Mann Koepke K, Morris JN, Rebok GW, Unverzagt FW, Stoddard AM, Wright E: Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA 2006;296:2805–2814.
- Bialystok E, Craik FIM, Klein R, Viswanathan M: Bilingualism, aging, and cognitive control: evidence from the Simon Task. Psychol Aging 2004;19:290–303.
- Salthouse TA, Babcock RL, Skovronek E, Mitchell DRD, Palmon R: Age and experience effects in spatial visualization. Dev Psychol 1990;26:128–136.
- Schooler C, Mulatu MS: The reciprocal effects of leisure time activities and intellectual functioning in older people: a longitudinal analysis. Psychol Aging 2001;16:466– 482.
- Verghese J, Lipton RB, Katz MJ, Hall CB, Derby CA, Kuslansky G, Ambrose AF, Sliwinski M, Buschke H: Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003;348:2508–2516.
- Verghese J, LeValley A, Derby C, Kuslansky G, Katz M, Hall C, Buschke H, Lipton RB: Leisure activities and the risk of amnestic mild cognitive impairment in the elderly. Neurology 2006;66:821–827.
- Kondo K, Niino M, Shido K: A case-control study of Alzheimer’s disease in Japan – significance of life-styles. Dementia 1994;5:314–326.
- Park DC, Gutchess AH, Meade ML, Stine-Morrow EAL: Improving cognitive function in older adults: nontraditional approaches. J Gerontol Psychol Sci 2007;62B:45–52.
Allison A.M. Bielak, PhD
Ageing Research Unit, Centre for Mental Health Research
Australian National University
Building 63, Eggleston Road, Canberra, A.C.T. 0200 (Australia)
Tel. +61 2 6125 8413, Fax +61 2 6125 0733, E-Mail email@example.com
Received: March 13, 2009
Accepted: September 7, 2009
Published online: December 7, 2009
Number of Print Pages : 13
Number of Figures : 0, Number of Tables : 1, Number of References : 93
Gerontology (International Journal of Experimental, Clinical, Behavioural and Technological Gerontology)
Vol. 56, No. 5, Year 2010 (Cover Date: August 2010)
Journal Editor: Wick G. (Innsbruck)
ISSN: 0304-324X (Print), eISSN: 1423-0003 (Online)
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