SEATTLE, Feb. 18 -- Middle-age and older adults who prefer a mental workout to passive activities, such as watching TV, may be less likely to develop memory loss as they age, researchers said.

Mentally stimulating social activity and reading in middle age reduced the likelihood of mild cognitive impairment in old age by more than 40%, found Yonas E. Geda, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues.

After age 65, reading, making crafts, using the computer, playing games, and watching less TV were associated with 30% to 50% lower risk of mild cognitive impairment, Dr. Geda's group reported in a case-control study to be presented at the American Academy of Neurology meeting here.

Dr. Geda said these findings provide concrete evidence for the "use it or lose it" axiom. "This means perhaps aging does not have to be a simple passive process."

In the multivariate analysis adjusted for age, sex, and education, the researchers found the following activities done over the prior year late in life protective against mild cognitive impairment:

• Reading books (odds ratio 0.67, 95% confidence interval 0.49 to 0.94)
• Playing games (OR 0.65, 95% CI 0.47 to 0.90)
• Crafting activities, such as quilting or pottery (OR 0.66, 95% CI 0.47 to 0.93)
• Computer activities (OR 0.50, 95% CI 0.36 to 0.71)
• Watching television less (OR 0.48 for fewer than seven hours per day versus more, 95% CI 0.27 to 0.86)

Dr. Geda cautioned that the findings were based on patients' memories of activities and need to be confirmed in prospective studies.

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IOWA CITY, Iowa, Feb. 11 -- The difficult judgment call on whether Alzheimer's patients are safe to drive can be helped by a battery of cognitive tests, researchers here said.

"By measuring driver performance through off-road tests of memory, visual, and motor abilities, we may be able to develop a standardized assessment of a person's fitness to drive," Dr. Dawson said.

To determine whether performance on tests of cognition, visual perception, and motor function could predict the level of safety in licensed drivers with early Alzheimer's, the researchers conducted a controlled trial of 40 patients with mild disease and 115 patients without dementia.

"Given that driving puts demands on diverse cognitive functions, it is unlikely that a test of any single cognitive ability will be an accurate predictor of driving safety," the researchers said.

The study may have been limited by a lack of investigation of other environmental factors, such as having family members in the vehicle and time of day, as well as a possible lack of generalizability because only seven of the 40 patients in the experimental group were women.

Still, the researchers concluded that for predicting safety errors within the Alzheimer's disease group, "off-road neuropsychological tests of cognition, vision, and motor abilities gave additional information above and beyond diagnosis alone. Hence, performance on these tests can be helpful when predicting whether a patient with Alzheimer's disease can safely drive a vehicle."
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Kapil D. Sethi, MD, Professor of Neurology; Director, Movement Disorders Program, Medical College of Georgia, Augusta
Medscape Today