We examined the relationship between active cognitive lifestyle (i.e. social network size and participation in cognitive activities) and transitions between different cognitive states (i.e., normal MMSE, mild MMSE impairment, severe MMSE impairment) and evaluated the consistency of results across four longitudinal studies of aging (i.e. OCTO-Twin, LASA, H70, MAP). Multi-state models (MSM) were
... [Show full abstract] run independently across all longitudinal studies controlling for age, sex, and education. Less participation in cognitive activities was associated with an increased risk of transitioning from normal MMSE to mild MMSE impairment and from normal MMSE to death in two studies. Larger social network size was associated with a lower risk of transitioning from normal MMSE to mild MMSE in three studies. These results highlight how lifestyles factors can delay cognitive decline and highlights the need for more policies and interventions that make it easier for older adults to keep their mind active and remain socially involved.