Original Contributions |

Association of Lifetime Cognitive Engagement and Low β-Amyloid Deposition

Susan M. Landau, PhD; Shawn M. Marks, BS; Elizabeth C. Mormino, PhD; Gil D. Rabinovici, MD; Hwamee Oh, PhD; James P. O’Neil, PhD; Robert S. Wilson, PhD; William J. Jagust, MD
Arch Neurol. 2012;69(5):623-629. doi:10.1001/archneurol.2011.2748.
Text Size: A A A
Published online

Objective To assess the association between lifestyle practices (cognitive and physical activity) and β-amyloid deposition, measured with positron emission tomography using carbon 11–labeled Pittsburgh Compound B ([11C]PiB), in healthy older individuals.

Design Cross-sectional clinical study.

Setting Berkeley, California.

Participants Volunteer sample of 65 healthy older individuals (mean age, 76.1 years), 10 patients with Alzheimer disease (AD) (mean age, 74.8 years), and 11 young controls (mean age, 24.5 years) were studied from October 31, 2005, to February 22, 2011.

Main Outcome Measures Cortical [11C]PiB average (frontal, parietal, lateral temporal, and cingulate regions) and retrospective, self-report scales assessing participation in cognitive activities (eg, reading, writing, and playing games) and physical exercise.

Results Greater participation in cognitively stimulating activities across the lifespan, but particularly in early and middle life, was associated with reduced [11C]PiB uptake (P < .001, accounting for age, sex, and years of education). Older participants in the highest cognitive activity tertile had [11C]PiB uptake comparable to young controls, whereas those in the lowest cognitive activity tertile had [11C]PiB uptake comparable to patients with AD. Although greater cognitive activity was associated with greater physical exercise, exercise was not associated with [11C]PiB uptake.

Conclusions Individuals with greater early- and middle- life cognitive activity had lower [11C]PiB uptake. The tendency to participate in cognitively stimulating activities is likely related to engagement in a variety of lifestyle practices that have been implicated in other studies showing reduced risk of AD-related pathology. We report a direct association between cognitive activity and [11C]PiB uptake, suggesting that lifestyle factors found in individuals with high cognitive engagement may prevent or slow deposition of β-amyloid, perhaps influencing the onset and progression of AD.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours


Place holder to copy figure label and caption
Graphic Jump Location

Figure 1. Individuals with greater cognitive engagement show reduced amyloid burden. Carbon 11–labeled Pittsburgh Compound B ([11C]PiB) in cognitively normal older participants (x-axis) is inversely associated with past cognitive activity (y-axis) (linear regression, β = −1.73 ± 0.47; P < .001). Both variables are residual values after correcting for age, sex, and years of education.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. Cognitively normal older individuals with the lowest cognitive activity have amyloid burden that resembles that of patients with Alzheimer disease (AD). A, Carbon 11–labeled Pittsburgh Compound B ([11C]PiB) indices, reflecting amyloid deposition, in 10 patients with AD and 11 young controls were compared with older controls, who were subdivided into tertiles based on past cognitive activity scores. Within older controls, the cognitive activity tertiles differed from one another (P = .001 by the Kruskal-Wallis test) such that the lowest tertile had higher [11C]PiB uptake than the middle tertile (P = .04 by the Mann-Whitney test) and the top tertile (P = .001 by the Mann-Whitney test). The middle and highest tertiles were marginally different (P = .06). Patients with AD had higher [11C]PiB levels compared with older controls overall (P < .001) and young controls (P < .001). Young controls had lower [11C]PiB levels than older controls overall (P = .04). B, Regions in which past cognitive activity is inversely associated with [11C]PiB (blue; P = .001, cluster size = 100 voxels; controlling for age, sex, and years of education) overlaid, for comparison, on the set of regions used to calculate the mean cortical [11C]PiB indices for each study participant (cyan), which are plotted in A and listed in Table 2.




July 1, 2012
Hui-Xin Wang, PhD
Arch Neurol. 2012;69(7):940-941. doi:10.1001/archneurol.2012.507.
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles