Interactional Effects Between Relational and Cognitive Reserves on Decline in Executive Functioning.

OBJECTIVES: The present study set out to investigate associations of cognitive reserve (as indicated by education) and relational reserve (as indicated by the family network size and indices of emotional support) to decline in executive functioning over 6 years as measured by changes in Trail Making Test (TMT) completion time in older adults and whether education and network size interacted with age and sex as covariates with respect to this longitudinal association. METHOD: We analyzed data from 897 participants tested on TMT parts A and B in two waves 6 years apart. The mean age in the first wave was 74.33 years. Participants reported information on their family networks and their level of education. RESULTS: Latent change score modeling testing for moderation effects revealed a significant interaction of network size in the first wave of data assessment with education. Specifically, for lower levels of cognitive reserve (-1 SD of education), the longitudinal association between relational reserve in the first wave and subsequent changes in executive functioning was not significant. In contrast, for higher levels of cognitive reserve (+1 SD of education), a higher relational reserve in the first wave significantly predicted a smaller subsequent increase in TMT completion time from the first to the second wave (i.e., a smaller decline in executive functioning). DISCUSSION: The present longitudinal study provides evidence for the interaction between cognitive and relational reserves. This confirms the hypothesis that reserves from different domains are intertwined and their combined effects contribute to less cognitive decline in old age.

Distinct effects of cognitive versus somatic anxiety on cognitive performance in old age: the role of working memory capacity.

Objective: The adverse effects of anxiety on cognition are widely recognized. According to Attentional Control Theory, worry (i.e. facet of cognitive anxiety) is the component that is responsible for these effects, and working memory capacity (WMC) plays an important role in regulating them. Despite the increasing importance of this problem with aging, little is known about how these mechanisms interact in old age. In this study, we explored the distinct contributions of the somatic and cognitive components of anxiety to neuropsychological performance, and the potential moderating role of WMC.Method: We administered cognitive tasks testing processing speed, cognitive flexibility and working memory to 605 older adults, who also underwent depression and test anxiety assessments (data from VLV study).Results: Multiple regression analyses showed that cognitive (but not somatic) aspects of anxiety affected cognitive flexibility. The effect of cognitive anxiety on processing speed was moderated by WMC: the anxiety-performance association was lower for participants with greater WMC.Conclusion: Results confirmed the specific role of worry in the anxiety-performance relationship in old age and supported the hypothesis that working memory resources regulates its deleterious effect on cognition. The absence of a moderation effect in the more costly switching task may reflect a limitation of resources with aging.

Motivation as a Mediator of the Relation Between Cognitive Reserve and Cognitive Performance.

OBJECTIVES: Interindividual differences in cognitive aging may be explained by differences in cognitive reserve (CR) that are built up across the life span. A plausible but underresearched mechanism for these differences is that CR helps compensating cognitive decline by enhancing motivation to cope with challenging cognitive situations. Theories of motivation on cognition suggest that perceived capacity and intrinsic motivation may be key mediators in this respect. METHOD: In 506 older adults, we assessed CR proxies (education, occupation, leisure activities), motivation (perceived capacity, intrinsic motivation), and a global measure of cognitive functioning. RESULTS: Perceived capacity, but not intrinsic motivation, significantly mediated the relation between CR and cognitive performance. DISCUSSION: Complementary with neurobiological and cognitive processes, our results suggest a more comprehensive view of the role of motivational aspects built up across the life span in determining differences in cognitive performance in old age.

The impact of physical activity and sex differences on intraindividual variability in inhibitory performance in older adults.

It is well-known that processing speed and executive functions decline with advancing age. However, physical activity (PA) has a positive impact on cognitive performances in aging, specifically for inhibition. Less is known concerning intraindividual variability (iiV) in reaction times. This study aims to investigate the influence of PA and sex differences on iiV in inhibitory performance during aging. Healthy adults were divided into active and sedentary groups according to PA level. To analyse iiV in reaction times, individual mean, standard deviation and the ex-Gaussian parameters were considered. An interaction between activity level and sex was revealed, sedentary females being slower and more variable than sedentary men. No sex differences were found in the active groups. These results indicate that the negative impact of sedentariness on cognitive performance in older age is stronger for females. The present findings underline the need to consider sex differences in active aging approaches.

Cross-lagged relation of leisure activity participation to Trail Making Test performance 6 years later: Differential patterns in old age and very old age.

OBJECTIVE: We investigated cross-lagged relations between leisure activity participation and Trail Making Test (TMT) performance over 6 years and whether those reciprocal associations differed between individuals. METHOD: We analyzed data from 232 participants tested on performance in TMT Parts A and B as well as interviewed on leisure activity participation in 2 waves 6 years apart. Mean age in the Wave 1 was 73.42 years. Participants were also tested on vocabulary (Mill Hill scale) as a proxy indicator of crystallized intelligence and reported information on early and midlife cognitive reserve markers (education and occupation). Latent cross-lagged models were applied to investigate potential reciprocal activity-TMT relationships. RESULTS: The relation of leisure activity participation predicting TMT performance 6 years later was significantly larger than was the relation of TMT performance predicting later leisure activity participation. Statistically comparing different moderator groups revealed that this pattern was evident both in individuals with low education and in those with high education but, notably, emerged in only young-old adults (but not in old-old adults), in individuals with a low cognitive level of job in midlife (but not in those with a high cognitive level of job in midlife), and in individuals with high scores in vocabulary (but not in those with low scores in vocabulary). CONCLUSIONS: Late-life leisure activity participation may predict later cognitive status in terms of TMT performance, but individuals may markedly differ with respect to such effects. Implications for current cognitive reserve and neuropsychological aging research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Frailty in aging and its influence on perceived stress exposure and stress-related symptoms: evidence from the Swiss Vivre/Leben/Vivere study.

Frailty is a core concept in understanding vulnerability and adjustment to stress in older adults. Adopting the perspective provided by the transactional model of stress and coping (Lazarus and Folkman in Stress, appraisal, and coping, Springer, New York, 1984), the present study examined three aspects of frailty in older adults: (1) the link between frailty and perceived stress exposure (PSE); (2) the link between frailty and stress-related symptoms (SRS); and (3) the role of frailty in the link between PSE and SRS. Participants were 2711 adults aged between 64 and 101 years who were taking part in the Swiss Vivre/Leben/Vivere study. As well as assessing frailty, we measured PSE and SRS during the 4 weeks preceding the administration of the questionnaires, together with the covariates age, sex, educational attainment, language of the canton, and type of canton (urban vs. rural). Regression analyses revealed higher levels of PSE in frail older adults than in non-frail older adults. In addition, frail older adults reported more SRS than non-frail older adults. As expected, the association between PSE and SRS differed as a function of the frailty status: The positive relation between PSE and SRS being stronger for frail older adults than for non-frail older adults. These results suggest that frailty is related to perceived discrepancy between resources and demands, and to ability to cope with PSE. Our findings have implications for interventions to help frail older adults manage stress.

The role of cognitive reserve accumulated in midlife for the relation between chronic diseases and cognitive decline in old age: A longitudinal follow-up across six years.

OBJECTIVES: The present study set out to investigate relations of the number of chronic diseases (as a global indicator of individuals' multimorbidity) to cognitive status and cognitive decline over six years as measured by changes in Trail Making Test (TMT) completion time in old adults and whether those relations differed by key life course markers of cognitive reserve (education, occupation, and cognitively stimulating leisure activities). METHOD: We analyzed data from 897 participants tested on TMT parts A and B in two waves six years apart. Mean age in the first wave was 74.33 years. Participants reported information on chronic diseases, education, occupation, and cognitively stimulating leisure activities. RESULTS: Latent change score modeling testing for moderation effects revealed that a larger number of chronic diseases significantly predicted stronger increase in TMT completion time (i.e., steeper cognitive performance decline). Notably, the detrimental relation of the number of chronic diseases to stronger increase in TMT completion time (i.e., cognitive performance decline) was significantly stronger in individuals with less engagement in cognitively stimulating leisure activities in midlife. DISCUSSION: Present data suggest that disease-related cognitive decline may be steeper in individuals who have accumulated less cognitive reserve in midlife. However, greater midlife activity engagement seemed to be associated with steeper cognitive decline in any case. Implications for current cognitive reserve and neuropsychological aging research are discussed.

Individual Differences in Developmental Change: Quantifying the Amplitude and Heterogeneity in Cognitive Change across Old Age.

It is well known that cognitive decline in older adults is of smaller amplitude in longitudinal than in cross-sectional studies. Yet, the measure of interest rests generally with aggregated group data. A focus on individual developmental trajectories is rare, mainly because it is difficult to assess intraindividual change reliably. Individual differences in developmental trajectories may differ quantitatively (e.g., larger or smaller decline) or qualitatively (e.g., decline vs improvement), as well as in the degree of heterogeneity of change across different cognitive domains or different tasks. The present paper aims at exploring, within the Geneva Variability Study, individual change across several cognitive domains in 92 older adults (aged 59-89 years at baseline) over a maximum of seven years and a half. Two novel, complementary methods were used to explore change in cognitive performance while remaining entirely at the intra-individual level. A bootstrap based confidence interval was estimated, for each participant and for each experimental condition, making it possible to define three patterns: stability, increase or decrease in performance. Within-person ANOVAs were also conducted for each individual on all the tasks. Those two methods allowed quantifying the direction, the amplitude and the heterogeneity of change for each individual. Results show that trajectories differed widely among individuals and that decline is far from being the rule.

Intra-Individual Variability from a Lifespan Perspective: A Comparison of Latency and Accuracy Measures.

Within-task variability across trials (intra-individual variability (IIV)) has been mainly studied using latency measures but rarely with accuracy measures. The aim of the Geneva Variability Study was to examine IIV in both latency and accuracy measures of cognitive performance across the lifespan, administering the same tasks to children, younger adults, and older adults. Six processing speed tasks (Response Time (RT) tasks, 8 conditions) and two working memory tasks scored in terms of the number of correct responses (Working Memory (WM)-verbal and visuo-spatial, 6 conditions), as well as control tasks, were administered to over 500 individuals distributed across the three age periods. The main questions were whether age differences in IIV would vary throughout the lifespan according (i) to the type of measure used (RTs vs. accuracy); and (ii) to task complexity. The objective of this paper was to present the general experimental design and to provide an essentially descriptive picture of the results. For all experimental tasks, IIV was estimated using intra-individual standard deviation (iSDr), controlling for the individual level (mean) of performance and for potential practice effects. As concerns RTs, and in conformity with a majority of the literature, younger adults were less variable than both children and older adults, and the young children were often the most variable. In contrast, IIV in the WM accuracy scores pointed to different age trends-age effects were either not observed or, when found, they indicated that younger adults were the more variable group. Overall, the findings suggest that IIV provides complementary information to that based on a mean performance, and that the relation of IIV to cognitive development depends on the type of measure used.

Associations of educational attainment and cognitive level of job with old age verbal ability and processing speed: The mediating role of chronic diseases.

We investigated whether the relation of educational attainment and cognitive level of job to performance in verbal ability and processing speed in old age was mediated via the number of chronic diseases. A total of 2,812 older adults participated. Psychometric tests on verbal ability and processing speed were administered. Individuals were interviewed regarding their education, midlife occupation, and chronic diseases in old age. Higher educational attainment and higher cognitive level of job were correlated with better performance in verbal ability and processing speed (.15 ≤ r ≤ .33, ps < .001). 1.4 to 7.3% of these relations was mediated via the number of chronic diseases (ß = .01, ps < .026). In conclusion, individuals with higher educational attainment and higher cognitive level of job may possibly suffer from fewer chronic diseases later in life. Possibly, this may finally be related to better performance in verbal ability and processing speed in those individuals in old age.

Interaction between BDNF Polymorphism and Physical Activity on Inhibitory Performance in the Elderly without Cognitive Impairment.

Background: In the elderly, physical activity (PA) enhances cognitive performances, increases brain plasticity and improves brain health. The neurotrophic hypothesis is that the release of brain-derived neurotrophic factor (BDNF), which is implicated in brain plasticity and cognition, is triggered by PA because motoneurons secrete BDNF into the bloodstream during exercise. Individual differences in cognitive performance may be explained by individual differences in genetic predisposition. A single nucleotide polymorphism on the BDNF gene, BDNFVal66Met, affects activity-dependent BDNF secretion. This study investigated the influence of the BDNFVal66Met polymorphism on the relationship between PA and controlled inhibition performance in older adults. Methods: A total of 114 healthy elderly volunteers (mean age = 71.53 years old) were evaluated. Participants were genotyped for the BDNFVal66Met polymorphism. We evaluated inhibitory performance using choice reaction times (RT) and error rates from a Simon-like task and estimated their PA using two self-reported questionnaires. We established four groups according to PA level (active vs. inactive) and BDNFVal66Met genotype (Met carriers vs. Val-homozygous). The results were analyzed using ANOVA and ANCOVA, including age, gender and body mass index as covariates. Results: The BDNFVal66Met polymorphism interacted with PA on controlled inhibition performance. More specifically, inactive Val-homozygous participants exhibited a lower inhibition performance than active Val homozygotes and inactive Met carriers; the former had a higher error rate without differences in RT. Conclusion: Differences between individuals on inhibitory performance may be partially understood by the interaction between genetic influence in BDNF secretion and PA level. The results of this study clearly support the neurotrophic hypothesis that BDNF synthesis is an important mechanism underlying the influence of physical activity on brain structure and functions.

The Role of Leisure Activities in Mediating the Relationship between Physical Health and Well-Being: Differential Patterns in Old and Very Old Age.

BACKGROUND: Recently, Paggi et al. [Gerontology 2016;62:450-458] for the very first time showed in a cross-sectional sample of 259 adults aged 18-81 years that the relation of physical health to psychological well-being was mediated via frequency of leisure activity participation. OBJECTIVE: To extend this framework, we followed theories on successful aging and vulnerability to propose to add a differential perspective predicting that certain individuals may be more vulnerable than others and therefore may show differences in the mediation pattern. Specifically, we examined whether mediation patterns were differential in certain populations, such as in old-old (compared to young-old) adults and in individuals who carried out a low (compared to those with a high) number of activities. METHODS: We analyzed data from 3,080 individuals on physical health (number of chronic diseases, subjective health status, and subjective evaluation of change in health over the last 10 years), frequency of participation in 18 leisure activities, and physical and psychological well-being using moderated mediation models with a path model approach that allowed the simultaneous estimation of all model paths, including their significance. RESULTS: We found that the relation of physical health to physical and psychological well-being was mediated via frequency of activity participation. For physical (but not for psychological) well-being, this mediation was more pronounced in old-old (compared to young-old) adults and in individuals who carried out a low (compared to those with a high) number of activities. These moderated mediations were attributable to differential relations of physical health to frequency of activity participation and to differential relations of frequency of activity participation to physical well-being between the investigated moderator levels. CONCLUSION: Present data suggest that participation in leisure activities may play a key role in mediating the relationship between physical health and well-being, particularly in very old age. Findings are discussed with respect to theories of successful aging and differences between physical and psychological well-being.

No cross-sectional evidence for an increased relation of cognitive and sensory abilities in old age.

OBJECTIVES: A key question in gerontological research concerns whether good functioning can be maintained in some cognitive abilities in old age, even if deficits occur in other cognitive or sensory abilities. Our goals were to investigate relations of cognitive and sensory abilities in old age, whether these relations differed in size across old age, and whether this was affected by general cognitive ability (processing speed), educational level, and/or general health status. METHODS: Two thousand eight hundred and twelve older adults (aged 65-101, M = 77.9 years) from the Vivre-Leben-Vivere survey served as cross-sectional sample for the present study. We administered psychometric tests on processing speed (the speed of cognitive processing), cognitive flexibility (the ability to alternate between cognitive operations), and verbal abilities (vocabulary). In addition, we interviewed individuals on their hearing, eyesight, educational level, and general health status. We regressed sizes of relations between abilities (calculated within each 1-year age tranche) on mean age within the corresponding age tranche, with the number of participants within the corresponding age tranche as case weights. RESULTS: We observed a decrease in relations between processing speed and cognitive flexibility in old age that was particularly pronounced in individuals with high educational level (r = -.41). In contrast, we did not find differences in relations between other cognitive and sensory abilities across old age, which held for different levels of general cognitive ability, education, and general health status. CONCLUSION: Present data do not support the view of a generally increased relation of cognitive and sensory abilities in old age.

Investigating Discontinuity of Age Relations in Cognitive Functioning, General Health Status, Activity Participation, and Life Satisfaction between Young-Old and Old-Old Age.

Health research suggests that findings on young-old adults cannot be generalized to old-old adults and thus that old-old age seems not a simple continuation of young-old age due to qualitative changes that result in a discontinuity in old age. Specifically, it would be of conceptual and methodological importance to inform research regarding estimates around which chronological age the beginning of old-old age could be placed at a population level, and whether this is universal or domain-specific. To derive such criteria, we investigated potential discontinuity of age relations between young-old and old-old age in a large population-based sample considering measures in different domains (processing speed, verbal abilities, general health status, activity participation, and life satisfaction). For processing speed, verbal abilities, general health status, and life satisfaction we observed some very small indication that there might be a discontinuity of age relations at the end of individuals' eighties, and for activity participation already at the beginning of individuals' eighties. In conclusion, models conceptualizing aging as a gradual development might not suffice to adequately represent the differences between the stages of young-old and old-old age due to some very small indication that there might be discontinuity in late adulthood.

The Relation of Obesity to Performance in Verbal Abilities, Processing Speed, and Cognitive Flexibility in Old Age: The Role of Cognitive Reserve.

AIMS: The present study set out to investigate the relation of obesity to performance in verbal abilities, processing speed, and cognitive flexibility and its interplay with key correlates of cognitive reserve in a large sample of older adults. METHODS: A total of 2,812 older adults served as a sample for the present study. Psychometric tests on verbal abilities, processing speed, and cognitive flexibility were administered. In addition, individuals were interviewed on their weight and height (to calculate body mass index; BMI), educational attainment, occupation, and engaging in different activities throughout adulthood. RESULTS: Obesity (BMI ≥30) was significantly associated with a lower performance in verbal abilities, processing speed, and cognitive flexibility. Moderation analyses showed that obesity was related to lower processing speed and cognitive flexibility only in individuals with low engagement in activities and low education. Hierarchical regression analyses showed that obesity was not related to any of the three investigated cognitive performance measures when cognitive reserve in early and midlife was taken into account. CONCLUSION: Present data suggest that cognitive reserve accumulated during the life course may reduce the detrimental influences of obesity on cognitive functioning in old age.

The association of timing of retirement with cognitive performance in old age: the role of leisure activities after retirement.

BACKGROUND: The role of timing of retirement on cognitive functioning in old age is inconclusive so far. Therefore, the present study set out to investigate the association of timing of retirement with cognitive performance and its interplay with key correlates of cognitive reserve in a large sample of older adults. METHODS: Two thousand two hundred and sixty three older adults served as sample for the present study. Different psychometric tests (Trail Making Test part A (TMT A), Trail Making Test part B (TMT B), Mill Hill) were administered. In addition, individuals were interviewed on their retirement, occupation, educational attainment, and regarding 18 leisure activities that have been carried out after retirement. RESULTS: Earlier retirement (compared to retirement at legal age) was significantly associated with better performance in the TMT A, the TMT B, and the Mill Hill vocabulary test. Moderation analyses showed that in individuals with a moderate number of leisure activities in old age, earlier retirement was related to better cognitive performance, but not in those with a relatively large number of leisure activities. Hierarchical regression analyses revealed that entering leisure activities as additional predictor significantly increased explained variance in the cognitive measures over and above all other investigated markers of cognitive reserve (i.e. occupation and education). CONCLUSIONS: Present data further corroborate the view that leisure activities even in old age may lead to further enrichment effects and thereby may be related to better cognitive functioning. The role of engaging in activities in the context of major life events such as retirement is discussed.

The relation of the number of languages spoken to performance in different cognitive abilities in old age.

INTRODUCTION: Findings on the association of speaking different languages with cognitive functioning in old age are inconsistent and inconclusive so far. Therefore, the present study set out to investigate the relation of the number of languages spoken to cognitive performance and its interplay with several other markers of cognitive reserve in a large sample of older adults. METHOD: Two thousand eight hundred and twelve older adults served as sample for the present study. Psychometric tests on verbal abilities, basic processing speed, and cognitive flexibility were administered. In addition, individuals were interviewed on their different languages spoken on a regular basis, educational attainment, occupation, and engaging in different activities throughout adulthood. RESULTS: Higher number of languages regularly spoken was significantly associated with better performance in verbal abilities and processing speed, but unrelated to cognitive flexibility. Regression analyses showed that the number of languages spoken predicted cognitive performance over and above leisure activities/physical demand of job/gainful activity as respective additional predictor, but not over and above educational attainment/cognitive level of job as respective additional predictor. There was no significant moderation of the association of the number of languages spoken with cognitive performance in any model. CONCLUSIONS: Present data suggest that speaking different languages on a regular basis may additionally contribute to the build-up of cognitive reserve in old age. Yet, this may not be universal, but linked to verbal abilities and basic cognitive processing speed. Moreover, it may be dependent on other types of cognitive stimulation that individuals also engaged in during their life course.

The association of educational attainment, cognitive level of job, and leisure activities during the course of adulthood with cognitive performance in old age: the role of openness to experience.

BACKGROUND: The relevance of mental health for everyday life functioning and well-being is crucial. In this context, higher educational attainment, higher cognitive level of one's occupation, and more engaging in stimulating leisure activities have been found to be associated with better cognitive functioning in old age. Yet, the detailed pattern of the potential interplay of such a cognitively engaged lifestyle with personality dimensions, such as openness to experience, in their relations to cognitive functioning remains unclear. METHODS: Two thousand eight hundred and twelve older adults served as sample for the present study. Psychometric tests on verbal abilities and processing speed were administered. In addition, individuals were retrospectively interviewed on their educational attainment, occupation, and regarding 18 leisure activities that had been carried out in mid-life. Moreover, openness to experience was assessed. RESULTS: We found that the effect of openness to experience on cognitive functioning was mediated by educational attainment, cognitive level of job, and engaging in different leisure activities. Data were not better described by alternative moderation models testing for interactive (i.e. dependent) effects of openness to experience and cognitively stimulating engagement. CONCLUSIONS: To explain interindividual differences in cognitive functioning in old age, present data are in line with a mechanism in which individuals with high openness to experience may have been more engaged in stimulating activities in early and mid-life. Possibly by increasing their cognitive reserve throughout adulthood, this may finally enhance their cognitive performance level later in old age.

Dispersion in cognitive functioning: Age differences over the lifespan.

INTRODUCTION: A growing body of research suggests that intraindividual variability (IIV) may bring specific information on cognitive functioning, additional to that provided by the mean. The present paper focuses on dispersion, that is IIV across tasks, and its developmental trend across the lifespan. METHOD: A total of 557 participants (9-89 years) were administered a battery of response time (RT) tasks and of working memory (WM) tasks. Dispersion was analyzed separately for the two types of tasks. RESULTS: Dispersion across RT tasks showed a U-shaped age differences trend, young adults being less variable than both children and older adults. Dispersion across WM tasks (using accuracy scores) presented an opposite developmental trend. A cluster analysis revealed a group of individuals showing relatively little dispersion and good overall performance (faster in RTs and better in WM), contrasted with a group of individuals showing a large dispersion in the RT tasks as well as poorer overall performance. All young adults were grouped in the first cluster; children and older adults were distributed in both clusters. CONCLUSION: It is concluded that (a) across-task IIV is relatively large in the entire sample and should not be neglected, (b) children and older adults show a larger dispersion than young adults, but only as far as the RT tasks are concerned,

The Association of Leisure Activities in Middle Adulthood with Cognitive Performance in Old Age: The Moderating Role of Educational Level.

BACKGROUND: One of the fundamental challenges for gerontological research is how to maintain and promote intact cognitive functioning in old age. Previous research revealed that high educational level, good health status, and an active lifestyle during adulthood seem to be protective against cognitive impairment in old age. However, up to now, a detailed examination of the interaction of these relations based on a broader variety of activities and considering past and current activities is missing. OBJECTIVE: The present study set out to extend the literature by investigating in more detail the interactions of educational level and health status with a broad variety of past and current leisure activities in their association with cognitive functioning in a large sample of older adults with a wide age range. METHODS: A total of 2,812 older adults (aged 65-101 years) served as the sample for the present study. A test on verbal abilities and one on processing speed were applied. In addition, individuals were retrospectively interviewed regarding their educational level, current general health status, and 18 leisure activities (in terms of currently performed activities and those that had been carried out at the age of 45 years). RESULTS: Regressions indicated that engaging in more current activities and in more activities at the age of 45 years (both analyzed as an overall activity measure) was related to better cognitive performance in old age (r values up to 0.39, p values <0.001). These associations were more pronounced in individuals with a low (compared to a high) educational level. CONCLUSION: Present results suggest that an active lifestyle during middle adulthood may be related to better cognitive functioning in old age, particularly in individuals with a low educational level. These findings are discussed with respect to models of cognitive aging.