Health literacy, but not memory, is associated with hippocampal connectivity in adults with low levels of formal education.

IF 4 Q1 CLINICAL NEUROLOGY Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2024-09-11 eCollection Date: 2024-07-01 DOI:10.1002/dad2.12634
Elisa de Paula França Resende, Vivian P Lara, Ana Luisa C Santiago, Clarisse V Friedlaender, Howard J Rosen, Jesse A Brown, Yann Cobigo, Lênio L G Silva, Leonardo Cruz de Souza, Luciana Rincon, Lea T Grinberg, Francisca I P Maciel, Paulo Caramelli
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Abstract

Introduction: The influence of hippocampal connectivity on memory performance is well established in individuals with high educational attainment. However, the role of hippocampal connectivity in illiterate populations remains poorly understood.

Methods: Thirty-five illiterate adults were administered a literacy assessment (Test of Functional Health Literacy in Adults [TOFHLA]), structural and resting state functional magnetic resonance imaging, and an episodic memory test (Free and Cued Selective Reminding Test). Illiteracy was defined as a TOFHLA score < 53. We evaluated the correlation between hippocampal connectivity at rest and both free recall and literacy scores.

Results: Participants were mostly female (57.1%) and self-declared as being Black individuals (84.8%), with a median age of 50 years. The median TOFHLA literacy score was 28.0 [21.0; 42.5] out of 100 points and the median free recall score was 30.0 [26.2; 35] out of 48 points. The median gray matter volume of both the left and right hippocampi was 2.3 [2.1; 2.4] cm3. We observed a significant connectivity between both hippocampi and the precuneus and the ventral medial prefrontal cortex. The right hippocampal connectivity positively correlated with the literacy scores (β = 0.58, P = 0.008). There was no significant association between episodic memory and hippocampal connectivity. Neither memory nor literacy scores correlated with hippocampal gray matter volume.

Discussion: Low literacy levels correlated with hippocampal connectivity in illiterate adults. The lack of association with memory scores might be associated with low brain reserve in this sample.

Highlights: A significant link was found between health literacy and hippocampal connectivity.Enhanced hippocampus- ventromedial prefrontal cortex connectivity suggests potential cognitive reserve improvement.Higher cognitive reserve may protect against hippocampal atrophy and neurodegeneration.Health literacy improvements could help prevent cognitive impairment in illiterate populations.Study highlights importance of considering structural racism in brain connectivity research.

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在正规教育水平较低的成年人中,健康素养(而非记忆力)与海马连通性有关。
简介海马连通性对高学历人群记忆表现的影响已被证实。然而,人们对文盲群体中海马连通性的作用仍知之甚少:对 35 名成人文盲进行了识字评估(成人功能性健康识字测试 [TOFHLA])、结构和静息状态功能磁共振成像以及外显记忆测试(自由和提示选择性记忆测试)。TOFHLA得分小于53分为文盲。我们评估了静息状态下海马连通性与自由回忆和识字率得分之间的相关性:参与者大多为女性(57.1%),自称为黑人(84.8%),年龄中位数为 50 岁。TOFHLA读写能力得分中位数为28.0 [21.0; 42.5](满分100分),自由回忆得分中位数为30.0 [26.2; 35](满分48分)。左右海马灰质体积的中位数均为 2.3 [2.1; 2.4] 立方厘米。我们观察到,两个海马与楔前皮质和腹内侧前额叶皮质之间存在明显的连接。右侧海马连通性与读写能力得分呈正相关(β = 0.58,P = 0.008)。外显记忆与海马连通性之间没有明显关联。记忆力和识字率得分均与海马灰质体积无关:讨论:低识字水平与成人文盲的海马连通性相关。讨论:在文盲成年人中,低识字水平与海马连通性相关,而与记忆力得分缺乏关联可能与该样本中脑储备较低有关:研究强调了在大脑连接性研究中考虑结构性种族主义的重要性。
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来源期刊
CiteScore
7.80
自引率
7.50%
发文量
101
审稿时长
8 weeks
期刊介绍: Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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