认知储备指标与中老年认知衰退和大脑结构差异的关系:英国生物库的研究结果

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引用次数: 0

摘要

摘要 背景 认知储备(CR)有助于在面临大脑衰老和损伤时保持认知能力。认知储备与晚年痴呆症风险有关。然而,认知储备与认知变化和脑成像测量之间的关系尚不清楚,尤其是在中年时期。 目的 我们旨在探讨 CR 与中老年认知能力下降和大脑结构差异之间的关系。 设计 这项纵向研究来自英国生物库项目,参与者在 2006 年至 2010 年间完成基线调查并接受随访(平均随访时间:9 年)。 环境 基于人口的研究。 参与者 对 42,301 名 40-70 岁未患痴呆症的参与者进行了随访,以检测其认知能力的变化。一个子样本(n=34,041)接受了脑磁共振成像扫描。 测量 我们使用潜类分析法,根据教育、职业和多种刺激认知的活动生成 CR 指标(分为高、中、低三类)。我们在基线和随访期间进行了全面认知和特定领域认知测试。随访检查时评估了大脑总体积、白质体积、灰质体积、海马体积和白质高密度体积(TBV、WMV、GMV、HV 和 WMHV)。数据采用混合效应模型和协方差分析法进行分析。 结果 在基线时,16,032 人(37.9%)、10,709 人(25.3%)和 15,560 人(36.8%)的 CR 水平分别为低、中和高。与低 CR 相比,高 CR 与整体认知(β [95% 置信区间]:0.10 [0.08, 0.11])、前瞻记忆(0.10 [0.06, 0.15])、流体智能(0.07 [0.04, 0.10])和反应时间(0.04 [0.02, 0.06])的下降速度较慢有关。高CR参与者的TBV、WMV、GMV和WMHV较低,但在控制整体认知的情况下,HV较高(校正后的P均为0.01)。在中年(60 岁)和老年(≥60 岁)参与者中,CR 与认知和 TBV 之间均存在重要关系。尽管大脑结构特性有所下降,但 CR 与认知之间的关系仍然显著。 结论 CR 值越高,认知能力衰退越慢,HV 值越高,微血管负担越低,尤其是在中年时期。高CR的人可以忍受较小的脑容量,同时保持认知能力。CR 对认知的益处与大脑结构差异无关。我们的研究结果凸显了提高CR有助于补偿神经影像学改变并最终防止认知能力下降。
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Association of Cognitive Reserve Indicator with Cognitive Decline and Structural Brain Differences in Middle and Older Age: Findings from the UK Biobank

Abstract

Background

Cognitive reserve (CR) contributes to preserving cognition when facing brain aging and damage. CR has been linked to dementia risk in late life. However, the association between CR and cognitive changes and brain imaging measures, especially in midlife, is unclear.

Objective

We aimed to explore the association of CR with cognitive decline and structural brain differences in middle and older age.

Design

This longitudinal study was from the UK Biobank project where participants completed baseline surveys between 2006 to 2010 and were followed (mean follow-up: 9 years).

Setting

A population-based study.

Participants

A total of 42,301 dementia-free participants aged 40–70 were followed-up to detect cognitive changes. A subsample (n=34,041) underwent brain magnetic resonance imaging scans.

Measurements

We used latent class analysis to generate a CR indicator (categorized as high, moderate, and low) based on education, occupation, and multiple cognitively stimulating activities. Cognitive tests for global and domain-specific cognition were administrated at baseline and follow-up. Total brain, white matter, grey matter, hippocampal, and white matter hyperintensity volumes (TBV, WMV, GMV, HV, and WMHV) were assessed at the follow-up examination. Data were analyzed using mixed-effects models and analysis of covariance.

Results

At baseline, 16,032 (37.9%), 10,709 (25.3%), and 15,560 (36.8%) participants had low, moderate, and high levels of CR, respectively. Compared with low CR, high CR was associated with slower declines in global cognition (β [95% confidence interval]: 0.10 [0.08, 0.11]), prospective memory (0.10 [0.06, 0.15]), fluid intelligence (0.07 [0.04, 0.10]), and reaction time (0.04 [0.02, 0.06]). Participants with high CR had lower TBV, WMV, GMV, and WMHV, but higher HV when controlling for global cognition (corrected P <0.01 for all). The significant relationships between CR and cognition and TBV were present among both middle-aged (<60 years) and older (≥60 years) participants. The CR-cognition association remained significant despite reductions in brain structural properties.

Conclusions

Higher CR is associated with slower cognitive decline, higher HV, and lower microvascular burden, especially in middle age. Individuals with high CR could tolerate smaller brain volumes while maintaining cognition. The benefit of CR for cognition is independent of structural brain differences. Our findings highlight the contribution of enhancing CR to helping compensate for neuroimaging alterations and ultimately prevent cognitive decline.

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The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
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9.20
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期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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