@article {178,
	title = {Leisure activity and cognitive decline in incident Alzheimer disease.},
	journal = {Arch Neurol},
	volume = {64},
	year = {2007},
	month = {2007 Dec},
	pages = {1749-54},
	abstract = {BACKGROUND: High rates of leisure activity have been associated with reduced risk of Alzheimer disease (AD).

OBJECTIVE: To determine whether prediagnosis leisure activity modifies the rate of cognitive decline in patients with AD.

DESIGN: Inception cohort followed up longitudinally for a mean of 5.3 years (up to 13.9 years).

SETTING: Urban community.

PARTICIPANTS: A total of 283 patients with incident AD (mean age, 79 years; 56.2\% Hispanic and 31.1\% African American).

MAIN OUTCOME MEASURES: Change in a composite cognitive score from diagnosis on and during the entire study follow-up.

RESULTS: In multivariate-adjusted generalized estimating equation models of postdiagnosis change (n = 133), each leisure activity was associated with an additional yearly decline of 0.005 of a z-score unit in cognitive score (P = .17). In models expanded to include cognitive change during study follow-up, including evaluations before and after diagnosis (n = 283), each activity was associated with an additional yearly decline of 0.005 of a z-score unit in cognitive score (P = .03). The association was strongest for intellectual activities.

CONCLUSIONS: Greater participation in prediagnosis leisure activities, especially intellectual activities, was associated with faster cognitive decline, supporting the hypothesis that the disease course in AD may vary as a function of cognitive reserve.},
	keywords = {Aged, Alzheimer Disease, Cognition, Cohort Studies, Disease Progression, Female, Follow-Up Studies, Humans, Leisure Activities, Male, Models, Neurological, Prognosis},
	issn = {0003-9942},
	doi = {10.1001/archneur.64.12.1749},
	author = {Helzner, Elizabeth P and Scarmeas, Nikolaos and Cosentino, Stephanie and Portet, Florence and Stern, Yaakov}
}
