Educational attainment, Aβ, tau, and structural brain reserve in Alzheimer's disease

IF 11.1 1区医学 Q1 CLINICAL NEUROLOGY Alzheimer's & Dementia Pub Date : 2025-01-24 DOI:10.1002/alz.14400

Yue Cai, Lili Fang, Anqi Li, Jie Yang, Xin Zhou, Zhengbo He, Pan Sun, Qingyong Wang, Tengfei Guo, Alzheimer's Disease Neuroimaging Initiative

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Abstract

INTRODUCTION

Alzheimer's disease (AD) patients with higher educational attainment (EA) often exhibit better cognitive function. However, the relationship among EA status, AD pathology, structural brain reserve, and cognitive decline requires further investigation.

METHODS

We compared cognitive performance across different amyloid beta (Aβ) positron emission tomography (A ±) statuses and EA levels (High EA/Low EA). We examined the effects of Aβ plaques, tau tangles, and gray matter volume (GMV) on the relationship between EA and domain-specific cognitive decline.

RESULTS

A+/High-EA individuals exhibited slower cognitive decline in global cognition and language domains than A+/Low-EA individuals. This cognitive benefit was independently and synergistically explained by reduced AD pathology, including lower Aβ and tau burdens, as well as preserved GMV. Additionally, High-EA individuals experienced a median delay of 1.9 years in the onset of significant brain atrophy among A+ individuals.

DISCUSSION

These findings highlight the independent and synergistic contributions of EA-associated AD pathology and GMV alterations to longitudinal cognitive decline.

Highlights

Alzheimer's disease (AD) individuals with high educational attainment (EA) show slower declines in global cognition and language.
EA-related slower cognitive decline is linked to reduced tau and greater gray matter volume in AD.
AD individuals with high EA show a median 1.9 year delayed onset of brain atrophy.

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阿尔茨海默病的教育程度、Aβ、tau和结构脑储备

教育程度较高的阿尔茨海默病（AD）患者往往表现出较好的认知功能。然而，EA状态与AD病理、脑结构储备与认知能力下降之间的关系有待进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.