HONOLULU—The benefits of leisure activity in reducing the risk of Alzheimer’s disease may be affected by the apolipoprotein (APOE) e4 allele. Thomas Fritsch, PhD, and colleagues found that novelty-seeking activities, such as learning a new skill, were protective against the disease, as expected, as were activities involving integration of ideas. “However, these patterns varied by APOE epsilon 4 status,” Dr. Fritsch reported. “Novelty-seeking activities provided protection only among noncarriers of the epsilon 4 allele, and integrative activities provided protection only among epsilon 4 carriers.”

Previous studies have found that an active lifestyle may help protect against cognitive decline and that participation in mentally stimulating activities may reduce the risk of Alzheimer’s disease.

Dr. Fritsch and colleagues theorized that seeking novel activities may offer protection against the disease, because these activities require active mental processing that could increase cognitive reserve. Therefore, the investigators examined the association between participation in novelty-seeking leisure activities and Alzheimer’s disease status. Dr. Fritsch is a Research Associate with the University Memory and Aging Center, Case Western Reserve University and University Hospitals of Cleveland. He presented his team’s findings at the 55th Annual Meeting of the American Academy of Neurology.

AN ACTIVE ATTITUDE AGAINST ALZHEIMER'S DISEASE

The researchers based their findings on a case-control study of 180 patients with Alzheimer’s disease and 360 controls. All cases and controls underwent the same medical and neurologic examinations and comprehensive battery of neuropsychologic testing. Blood samples were collected for APOE genotyping, and study participants completed a Life History Questionnaire that requested medical, occupational, dietary, activity, and smoking histories. In addition, each case was required to have a reliable informant who had a close personal relationship with the case. Surrogates responded for the cases, and the controls responded for themselves. The respondents reported how frequently the subjects had looked for opportunities to complete each of 16 activities from age 20 to the present (for controls) or from age 20 to five years before disease onset (for cases).

Logistic regression analysis was used to model the risk of Alzheimer’s disease as a function of participation in activities, controlling for year of birth, education, and sex. According to Dr. Fritsch, patients with Alzheimer’s disease and controls did not differ in terms of sex. However, patients were, on average, significantly older and less educated and had lower Mini-Mental State Examination scores compared with controls.

The investigators identified four types of activities and labeled them as novelty-seeking, integrative, social, and passive. Novelty-seeking activities included learning a new skill, starting a new hobby, learning a new subject, doing things that are challenging mentally, solving a problem, and engaging in a new experience. Integrative activities included discussing politics and ideas. Social activities consisted of visiting either a place the subject had been before or somewhere new, as well as spending time with friends. Passive activities included resting or taking a nap and spending time alone. Because passive activity items had poor internal consistency reliability, they were excluded from subsequent analyses.

LEISURE ACTIVITIES AND APOE