Premorbid reading activity and patterns of cognitive decline in Alzheimer disease

Background: Educational and occupational attainment have been associated wi th progression of Alzheimer disease in some studies. One hypothesis about t his association is that education and occupation are markers for lifelong p articipation in cognitively stimulating activities like reading. Objective: To assess the relation of premorbid reading activity with patter ns of cognitive decline in Alzheimer disease. Methods: During a 4-year period, 410 persons with Alzheimer disease had ann ual clinical evaluations, which included administration of 17 cognitive fun ction tests from which global, verbal, and nonverbal summary measures were derived. At baseline, a knowledgeable informant was questioned about the af fected person's reading frequency and access to reading materials before de mentia onset. Results: A composite measure of premorbid reading activity was developed. I t had moderately high interval consistency and was positively correlated wi th education and baseline level of cognitive function. In analyses that con trolled for baseline cognitive function, education, and other demographic v ariables, higher level of premorbid reading activity was associated with mo re rapid decline on the global cognitive and verbal measures but not on the nonverbal measure. Conclusions: These results suggest that both the extent and nature of premo rbid cognitive experiences may affect how Alzheimer disease pathology is cl inically expressed.