Effect of increasing cognitive activity participation via calligraphy practice on salient network and central executive network in older adults with subjective cognitive decline: a secondary analysis of a randomized controlled trial.

OBJECTIVES: Regular participation in late-life cognitive activities is associated with a reduced risk of dementia. In a prior randomized controlled trial, we demonstrated that increased calligraphy practice improved working memory and strengthened functional connectivity (FC) within the default mode network in older adults with subjective cognitive decline (SCD). This exploratory secondary analysis examined whether increased calligraphy practice also modulates FC in other large-scale brain networks. METHODS: A total of 112 community-dwelling Chinese adults aged 55-75 years with SCD and prior calligraphy experience were randomly assigned to a control or intervention group. The control group maintained their usual calligraphy practice, while the intervention group doubled their weekly practice time for 6 months. Resting-state FC was assessed at baseline and post-intervention using functional magnetic resonance imaging (fMRI). Mixed models for repeated measures were conducted to compare longitudinal FC changes within the salient network and central executive network between groups. RESULTS: Compared with the control group, doubling calligraphy practice for 6 months was associated with a significantly greater increase in resting-state FC between right rostral prefrontal cortex and right supramarginal gyrus within the salient network (between-group mean difference = 0.12; 95% CI = 0.03-0.22; p = 0.01). In pooled analyses of the whole sample, no significant pre-post changes in FCs within SAN were observed. No significant between-group FC changes were observed within the central executive network. CONCLUSION: Increased calligraphy practice was associated with localized FC changes within the salient network, extending our prior findings of more distributed FC changes within the default mode network. Together, these findings suggest late-life engagement in cognitive activities may be relevant to large-scale brain network organization in older adults at risk of dementia.