A Decade Later on How to “Use It” So We Don’t “Lose It”: An Update on the Unanswered Questions about the Influence of Activity Participation on Cognitive Performance in Older Age

Abstract

Activity engagement is a modifiable factor that has been widely-cited as being good for the aging brain and cognition and represents a valuable target for reducing dementia risk. However, specific issues about activity engagement (mental, social, and physical) and cognition in older adulthood remain, and Bielak [Gerontology 2010;56: 507-519] reviewed seven major methodological and theoretical questions about this relationship. We present an updated reflection on these key questions, focusing on research published in the last 10 years. For some questions, a significant amount of work has been done and conclusions have become clearer; for others, there have been few additions to the literature and our knowledge remains much the same as it was a decade ago. We review the issues identified in the 2010 paper including the directionality and temporal nature of the relationship; whether specific activity domains offer different benefits to cognition and what domain(s) of cognition are affected; variation in the relation by age, gender, or education; potential mechanisms involved; and how activity engagement is assessed. For each, we present the most up-to-date research, discuss remaining challenges and possible future directions. This formal unifying of the information in the field is intended as a guide to support continued progress by spurring on studies addressing specific questions while reminding researchers of critical issues. We conclude with recommendations that future studies investigating the link between activity engagement and cognitive performance in adulthood should consider.

The short-term effects of activity engagement on working memory performance in older age.

“…In her scoping review on activity engagement and cognitive aging, Bielak (2010) outlined the lack of research on concrete guidance for engagement in everyday activities and commented that if we do not know how to “use it”, how then could we aim to not “lose it” (Bielak, 2010, p. 507). The comment referred to the “use it or lose it” hypothesis, which proposes that cognitive abilities can be maintained through repeated use and degrade when not used (Hertzog, 2009; Schooler, 2007; Bielak & Gow, 2022). It emphasizes the importance of continuous cognitive activation, which implies that effects of activity engagement on cognitive functioning are rather short-term (Hertzog, 2009; Schooler, 2007).…”

Association of leisure activity changes and reversion from mild cognitive impairment to normal cognitive function among older adults: A prospective cohort study

“…This finding may indicate that there appears to be something unique about how cognitive-based LAE and perceptual speed ability change over time for nonagenarian individuals compared with young–old individuals. Later-life LAE among older adults with MCI may predict later cognitive status, but individuals might respond differently to such effects ( 45 ). In addition, older adults with younger age tend to participate in more challenging activities than those in later older years.…”

Effect of leisure activities on cognitive aging in older adults: A systematic review and meta-analysis

“…Future studies should further explore the substantial differences and reasons for the differences in the effects of leisure activities on the cognitive function of the elderly across countries. Identifying differences may lead to improved health care recommendations influence the effect of leisure activities on cognitive function in older adults (Krell-Roesch et al, 2019;Bielak and Gow, 2022). The effect of leisure activities on cognitive function in older adults is more pronounced for the low education level than for the high education level (Ihle et al, 2015), but the evidence is inconsistent (Kishimoto et al, 2016;Stenling et al, 2021).…”

“…In addition, previous studies have reported that factors including frequency and intensity of activity, specific type of activity, age of engagement in activity, gender, and education level may influence the effect of leisure activities on cognitive function in older adults ( Krell-Roesch et al, 2019 ; Bielak and Gow, 2022 ). The effect of leisure activities on cognitive function in older adults is more pronounced for the low education level than for the high education level ( Ihle et al, 2015 ), but the evidence is inconsistent ( Kishimoto et al, 2016 ; Stenling et al, 2021 ).…”