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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.7 no.2 São Paulo Apr./June 2013 


Education, leisure activities and cognitive and functional ability of Alzheimer's disease patients: A follow-up study

Escolaridade, actividades de lazer e capacidade cognitiva e funcional de doentes com a Demência tipo Alzheimer: um estudo de follow up

Margarida Sobral1  2 

Constança Paúl2 

1MSc, Psychogeriatrics Service, Hospital Magalhães Lemos, Porto, Portugal

2PhD, Research and Education Unit Aging, UNIFAI, Institute of Biomedical Sciences Abel Salazar, University of Porto, Portugal


Education and participation in leisure activities appear to be highly relevant variables in Alzheimer's disease (AD) and usually form the basis of the Cognitive Reserve construct. Objective: [A] To determine the association between education, cognitive and functional ability of AD patients; [B] To determine the association between participation in leisure activities and cognitive and functional ability of AD patients; [C] To evaluate the association of education and participation in leisure activities in the course of AD. Methods: Functional and neuropsychological abilities of 120 outpatients with probable AD were evaluated at baseline, at 36 and 54 months. Data collected at baseline included socio-demographics, clinical variables, education and frequency of participation in leisure activities throughout life. All participants and/or caregivers answered the questionnaire, "Participation in leisure activities throughout life" while patients completed the MMSE, the Clinical Dementia Rating scale, neuropsychological tests from the Lisbon Screening for Dementia Assessment, Barthel Index and Lawton and Brody's Index. Results: AD patients with higher levels of education achieved better results on cognitive tests. The participants with higher participation in leisure activities exhibited better results on cognitive and functional tests than those with lower participation. The disease progression was linear and progressed similarly regardless of the level of education of participants. However, the results suggest a slower disease progression in patients with a higher level of participation in leisure activities throughout their lives. Conclusion: AD patients with high education and high participation in leisure activities may benefit from a slower cognitive and functional decline after diagnosis of AD.

Key words: aging; Alzheimer's disease; education; leisure activities


Escolaridade e participação em actividades de lazer parecem ser variáveis muito relevantes na doença de Alzheimer (DA) e normalmente usadas no construto Reserva Cognitiva. Objetivo: [A] Conhecer a associação entre escolaridade, capacidades cognitivas e funcionais de doentes com DA; [B] Conhecer a associação entre participação em actividades de lazer e capacidades cogntivas e funcionais de doentes com DA; [C] Avaliar a associação da escolaridade e participação em actividades de lazer no curso da DA. Métodos: Foram avaliadas competências funcionais e neurospsicológicas de 120 doentes com provável DA na baseline, após 36 e 54 meses. Dados recolhidos na baseline incluíram variáveis socio-demográficas, clínicas, escolaridade e frequência da participação em actividades de lazer. Participantes ou/e cuidadores responderam ao questionário, "Participação em actividade de lazer ao longo da vida" e completaram o MMSE, CDR, provas da Bateria de Lisboa para Avaliação das Demências, índice de Barthel e índice Lawton e Brody. Resultados: Doentes com DA com níveis mais elevados de escolaridade obtiveram melhores resultados nas provas cognitivas. Participantes com níveis mais elevados de participação em actividades de lazer exibiram melhores resultados nos testes cognitivos e funcionais do que aqueles com níveis mais baixos de participação. A progressão da doença foi linear e progrediu de forma semelhante relativamente ao nível de escolaridade. No entanto, resultados sugerem uma mais lenta progressão da doença relativamente aos doentes com níveis mais elevados de participação em actividades de lazer. Conclusão: Doentes com DA com elevada escolaridade e alta participação em actividade de lazer podem beneficiar de um mais lento declínio cognitivo e funcional após o diagnóstico da DA.

Palavras-chave: envelhecimento; doença de Alzheimer; escolaridade; actividades de lazer

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Received: December 28, 2012; Accepted: April 18, 2013

Margarida Sobral. Hospital de Magalhães Lemos. Rua do Professor Álvaro Rodrigues 4149 - 003 Porto Portugal. E-mail:

Disclosure: The authors report no conflicts of interest

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