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Participation in cognitively stimulating activities and risk of incident Alzheimer disease
Wilson RS, Mendes De Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, Bennett DA.. JAMA, 2002-02-01
Topic: Amyloid, tau and blood-test diagnosis
Context Frequent participation in cognitively stimulating activities has been hypothesized to reduce risk of Alzheimer disease (AD), but prospective data regarding an association are lacking. Objective To test the hypothesis that frequent participation in cognitive activities is associated with a reduced risk of AD. Design Longitudinal cohort study with baseline evaluations performed between January 1994 and July 2001 and mean follow-up of 4.5 years. Participants and setting A total of 801 older Catholic nuns, priests, and brothers without dementia at enrollment, recruited from 40 groups across the United States. At baseline, they rated frequency of participation in common cognitive activities (eg, reading a newspaper), from which a previously validated composite measure of cognitive activity frequency was derived. Main outcome measures Clinical diagnosis of AD by a board-certified neurologist using National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria and change in global and specific measures of cognitive function, compared by cognitive activity score at baseline. Results Baseline scores on the composite measure of cognitive activity ranged from 1.57 to 4.71 (mean, 3.57; SD, 0.55), with higher scores indicating more frequent activity. During an average of 4.5 years of follow-up, 111 persons developed AD. In a proportional hazards model that controlled for age, sex, and education, a 1-point increase in cognitive activity score was associated with a 33% reduction in risk of AD (hazard ratio, 0.67; 95% confidence interval, 0.49-0.92). Results were comparable when persons with memory impairment at baseline were excluded and when terms for the apolipoprotein E epsilon4 allele and other medical conditions were added. In random-effects models that controlled for age, sex, education, and baseline level of cognitive function, a 1-point increase in cognitive activity was associated with reduced decline in global cognition (by 47%), working memory (by 60%), and perceptual speed (by 30%). Conclusion These results suggest that frequent participation in cognitively stimulating activities is associated with reduced risk of AD.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Wilson, R. S., Mendes De Leon, C. F., Barnes, L. L., Schneider, J. A., Bienias, J. L., Evans, D. A., et al. (2002). Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA. https://doi.org/10.1001/jama.287.6.742
Vancouver
Wilson RS, Mendes De Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, et al. Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA. 2002. doi:10.1001/jama.287.6.742. PMID: 11851541.
BibTeX
@article{wilson2002-11851541,
author = {Wilson, R. S. and Mendes De Leon, C. F. and Barnes, L. L. and Schneider, J. A. and Bienias, J. L. and Evans, D. A. and Bennett, D. A.},
title = {{Participation in cognitively stimulating activities and risk of incident Alzheimer disease}},
journal = {JAMA},
year = {2002},
doi = {10.1001/jama.287.6.742},
pmid = {11851541},
url = {https://doi.org/10.1001/jama.287.6.742}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Objective To test the hypothesis that frequent participation in cognitive activities is associated with a reduced risk of AD.
- Results Baseline scores on the composite measure of cognitive activity ranged from 1.57 to 4.71 (mean, 3.57; SD, 0.55), with higher scores indicating more frequent activity.
- In a proportional hazards model that controlled for age, sex, and education, a 1-point increase in cognitive activity score was associated with a 33% reduction in risk of AD (hazard ratio, 0.67; 95% confidence interval, 0.49-0.92).
- Results were comparable when persons with memory impairment at baseline were excluded and when terms for the apolipoprotein E epsilon4 allele and other medical conditions were added.
- In random-effects models that controlled for age, sex, education, and baseline level of cognitive function, a 1-point increase in cognitive activity was associated with reduced decline in global cognition (by 47%), working memory (by 60%), and perceptual speed (by 30%).
Why it matters
In 801 older Catholic nuns, priests and brothers without dementia, followed for an average of 4.5 years, 111 developed Alzheimer's disease; those who reported doing mentally stimulating activities (such as reading a newspaper) more often at the start were less likely to be among them — each 1-point higher score on a composite activity scale was linked to a 33% lower risk (hazard ratio 0.67, 95% CI 0.49–0.92) after accounting for age, sex and education. The authors report similar results when people with early memory problems were excluded or APOE ε4 was taken into account, and higher activity was also linked to slower decline in thinking skills. This is an observational study in an unusual group of people, so it shows an association, not that more mental activity prevents Alzheimer's.
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Study details
- Study designcohort study
- Participants111
- Evidence strengthModerate
How this study scored 70/100
Published in a top-tier journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2002 — older than 20 years, still counted |
| Sample size | 2 / 4 | 111 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,331 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 51.2 citations a year over 26 year(s) since 2002 |
| Impact for its field and year | 5 / 6 | Cited 32.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 72 other studies in this library |
| Still being cited | 3 / 4 | Cited 100 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Robert Smith Wilson: h-index 56 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Rush University Medical Center: institution h-index 670 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 11851541) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 70 / 100 | — |
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