Share this to:

Support & Insight for the Autumn of Life

An Active Brain in Later Life Delays Alzheimer’s

Researchers say reading, writing letters, doing puzzles or playing card games in later life could delay the onset of Alzheimer’s by as much as five years.

Keeping your brain active in old age has always been a smart idea, but a study supported by the National Institute on Aging suggests that reading, writing letters and playing card games or puzzles in later life may delay the onset of Alzheimer’s dementia by up to five years.

The research was published in the July 14, 2021, online issue of Neurology, the medical journal of the American Academy of Neurology.

“The good news is that it’s never too late to start doing the kinds of inexpensive, accessible activities we looked at in our study,” said study author Robert S. Wilson, PhD, of Rush University Medical Center in Chicago.

“Our findings suggest it may be beneficial to start doing these things, even in your 80s, to delay the onset of Alzheimer’s dementia.”


The study looked at 1,978 people with an average age of 80 who did not have dementia at the start of the study. The people were followed for an average of seven years.

To determine if they had developed dementia, participants were given annual examinations, which included a number of cognitive tests.

When the study began, people rated their participation in seven activities on a five-point scale. The questions included: “During the past year, how often did you read books?” and “During the past year, how often did you play games like checkers, board games, cards or puzzles?”

Participants also answered questions about cognitive activity in childhood, adulthood and middle age.


Researchers then averaged each person’s responses, with a score of one meaning once a year or less and score of five meaning every day or almost every day.

People in the group with high cognitive activity scored an average of 4.0 which meant activities several times per week, compared to an average score of 2.1 for those with low cognitive activity, which meant activities several times per year.

During the study follow-up period, 457 people with an average age of 89 were diagnosed with Alzheimer’s dementia. People with the highest levels of activity, on average, developed dementia at age 94.

The people with the lowest cognitive activity, on average, developed dementia at age 89, a difference of five years.

The results were similar when researchers adjusted for other factors that could affect dementia risk, such as education level and sex.


To test the idea that low cognitive activity may be an early sign of dementia, not the other way around, researchers also looked at the brains of 695 people who died during the study. Brain tissue was examined for markers of Alzheimer’s like amyloid and tau protein deposits.

Researchers found no association between how active they were cognitively and markers of Alzheimer’s disease and related disorders in their brains.

“Our study shows that people who engage in more cognitively stimulating activities may be delaying the age at which they develop dementia,” Wilson said.

“It is important to note that after we accounted for late life level of cognitive activity, neither education nor early life cognitive activity were associated with the age at which a person developed Alzheimer’s dementia.

“Our research suggests that the link between cognitive activity and the age at which a person developed dementia is mainly driven by the activities you do later in life.”

A limitation of the study is that it was based on a group of mainly white people who had high levels of education. Further research will be needed to determine if the findings apply to the general population.



  • Robert S. Wilson, Tianhao Wang, Lei Yu, Francine Grodstein, David A. Bennett, Patricia A. Boyle; Cognitive Activity and Onset Age of Incident Alzheimer Disease DementiaNeurology Jul 2021, 10.1212/WNL.0000000000012388; DOI: 10.1212/WNL.0000000000012388
Notify of

Inline Feedbacks
View all comments
B. Berger

B. Berger

Visit Our Pages On:


This site was inspired by my Mom’s autoimmune dementia.

It is a place where we separate out the wheat from the chaffe, the important articles & videos from each week’s river of news. With a new post on Alzheimer’s or dementia appearing on the internet every 7 minutes, the site’s focus on the best information has been a help to many over the past 15 years. Thanks to our many subscribers for your supportive feedback.

The site is dedicated to all those preserving the dignity of the community of people living with dementia.

Peter Berger, Editor


hearing aid, hearing, ears
Hearings Aids Offer Dementia Prevention
Studies have found an association between hearing loss and the development of dementia in older adults. Research also...
Fish, Omega-3, Dementia
Dr. Michael Gregger, Director of the authoritative NutritionFacts site, asks, "Why has fish consumption been associat...
man and woman sitting on bench facing sea
Is Sitting Bad for the Brain? Maybe Not.
Is keeping seated and sedentary, while intellectually stimulated, part of the best way to care for your brain?
Would love your thoughts, please comment.x
News, Treatments, Care Tips

Subscribe To The Weekly Newsletter

videos & articles on Research & Prevention
News to Get at the Truth

Subscribe To Our Weekly Newsletter