Confined Living Tied to Cognitive Decline in Elderly

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D.on April 14, 2011

With findings that could have wide-ranging implications for elder care, an intriguing new study suggests our daily environment impacts our ability to think and recollect.

Researchers from Rush University Medical Center discovered the extent to which we move through our environments as we carry out our daily lives – from home to garden to workplace and beyond – has more significance than we might imagine; that our “life space” is intimately linked with cognitive function.

In the study, researchers found that seniors who had a constricted life space were almost twice as likely to develop Alzheimer’s disease as seniors whose life space extended well beyond the home.

“Life space may represent a new way to identify, out of a group of older persons displaying no memory or thinking problems, who is likely to go on to develop Alzheimer’s disease,” said Bryan James, Ph.D., the study’s lead investigator.

Participants in the study included 1,294 older adults living in the community taking part in two longitudinal studies: the Rush Memory and Aging Project, a study of chronic conditions of aging involving older persons from retirement communities and subsidized housing in Chicago, and the Minority Aging Research Study, which examines risk factors for cognitive decline in older African-Americans.

Study participants were followed for an average of four years and up to eight years. During this time frame, they received annual clinical assessments including detailed tests of cognitive function.

An individual’s life space was determined through interviews in which they reported whether their lives in the previous week extended beyond their town, outside their neighborhood, as far as their home’s parking lot or yard, or just to their porch or patio, or whether their lives remained confined to their bedroom or home.

When the study began, signs of clinical dementia were not present in any of the participants. During the follow-up, 180 developed Alzheimer’s disease.

A constricted life space was associated with an increased risk for developing Alzheimer’s disease as the effect of a life space confined to an individual’s immediate home environment demonstrated an almost twofold increased risk of AD.

Home confinement was associated with an increased risk of mild cognitive impairment, a condition that often precedes more rapid rate of cognitive decline, the hallmark of Alzheimer’s disease.

“The reasons why a constricted life space is associated with an increased risk of Alzheimer’s disease is not clear,” James said. “Underlying pathology may explain the result. Certain disease processes in the brain may affect how far we move through the world, years before they affect our memory and thinking.

“Or perhaps life space is an indicator of how much we are actively engaging and challenging our cognitive abilities. But at this point, we don’t have the answer.”

The article is posted online in the American Journal of Geriatric Psychiatry.

Source: Rush University Medical Center

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