Barnes Deborah E, Tager Ira B, Satariano William A, Yaffe Kristine
Department of Medicine, University of California, San Francisco, CA, USA.
J Gerontol A Biol Sci Med Sci. 2004 Apr;59(4):390-5. doi: 10.1093/gerona/59.4.m390.
Literacy is correlated with general intelligence and is often used to estimate premorbid intelligence in persons with dementia. However, little is known about the relationship between literacy and specific cognitive domains.
Study participants were 664 community-living adults aged 65 years or older who were participating in a community-based study of health and function in Sonoma, California. Literacy was measured using the North American Adult Reading Test, which evaluates the ability to pronounce words with irregular spellings (such as indict). Cognitive function was assessed using a neuropsychological test battery that included the Mini-Mental State Examination and measures of attention and executive function (Trails B, Stroop, Digit Symbol), verbal learning and memory (California Verbal Learning Test), and verbal fluency (letter "s," animals).
The mean age of the participants was 76 years, 50% were women, 97% were white, and 92% had 12 or more years of education. A strong, linear association was observed between literacy and all cognitive measures (all p <.001). Results were similar after adjustment for age, sex, education, and health-related covariates and were consistent in subgroups of the study population (e.g., women vs men; English vs other native languages). Education was not associated with most cognitive measures after adjustment for literacy.
Literacy is strongly associated with cognitive function across all cognitive domains in well-educated, elderly white persons. Future studies should determine whether interventions to improve lifetime literacy may help prevent cognitive deterioration with age.
读写能力与一般智力相关，常用于评估痴呆症患者的病前智力。然而，对于读写能力与特定认知领域之间的关系，我们知之甚少。
研究参与者为664名年龄在65岁及以上的社区居住成年人，他们参与了加利福尼亚州索诺马县一项基于社区的健康与功能研究。使用北美成人阅读测试来测量读写能力，该测试评估拼读不规则拼写单词（如indict）的能力。使用一套神经心理测试组合来评估认知功能，包括简易精神状态检查表以及注意力和执行功能测试（连线测验B、斯特鲁普测验、数字符号替换测验）、言语学习和记忆测试（加利福尼亚言语学习测验）以及言语流畅性测试（以字母“s”开头的单词、动物）。
参与者的平均年龄为76岁，50%为女性，97%为白人，92%接受过12年或以上教育。在读写能力与所有认知测量之间观察到强烈的线性关联（所有p<.001）。在对年龄、性别、教育程度和健康相关协变量进行调整后，结果相似，并且在研究人群的亚组中（如女性与男性；英语与其他母语）也一致。在对读写能力进行调整后，教育程度与大多数认知测量无关。
在受过良好教育的老年白人中，读写能力与所有认知领域的认知功能密切相关。未来的研究应确定提高终身读写能力的干预措施是否有助于预防认知功能随年龄衰退。
