社交网络对老年人阿尔茨海默病病理与认知功能水平之间关系的影响：一项纵向队列研究。

The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study.

作者信息

Bennett David A, Schneider Julie A, Tang Yuxiao, Arnold Steven E, Wilson Robert S

机构信息

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.

出版信息

Lancet Neurol. 2006 May;5(5):406-12. doi: 10.1016/S1474-4422(06)70417-3.

DOI:10.1016/S1474-4422(06)70417-3

PMID:16632311

Abstract

BACKGROUND

Few data are available about how social networks reduce the risk of cognitive impairment in old age. We aimed to measure this effect using data from a large, longitudinal, epidemiological clinicopathological study.

METHODS

89 elderly people without known dementia participating in the Rush Memory and Aging Project underwent annual clinical evaluation. Brain autopsy was done at the time of death. Social network data were obtained by structured interview. Cognitive function tests were Z scored and averaged to yield a global and specific measure of cognitive function. Alzheimer's disease pathology was quantified as a global measure based on modified Bielschowsky silver stain. Amyloid load and the density of paired helical filament tau tangles were also quantified with antibody-specific immunostains. We used linear regression to examine the relation of disease pathology scores and social networks to level of cognitive function.

FINDINGS

Cognitive function was inversely related to all measures of disease pathology, indicating lower function at more severe levels of pathology. Social network size modified the association between pathology and cognitive function (parameter estimate 0.097, SE 0.039, p=0.016, R(2)=0.295). Even at more severe levels of global disease pathology, cognitive function remained higher for participants with larger network sizes. A similar modifying association was observed with tangles (parameter estimate 0.011, SE 0.003, p=0.001, R(2)=0.454). These modifying effects were most pronounced for semantic memory and working memory. Amyloid load did not modify the relation between pathology and network size. The results were unchanged after controlling for cognitive, physical, and social activities, depressive symptoms, or number of chronic diseases.

INTERPRETATION

These findings suggest that social networks modify the relation of some measures of Alzheimer's disease pathology to level of cognitive function.

摘要

背景

关于社交网络如何降低老年人认知障碍风险的数据很少。我们旨在利用一项大型纵向流行病学临床病理研究的数据来衡量这种影响。

方法

89名无痴呆症的老年人参与了拉什记忆与衰老项目，接受年度临床评估。在死亡时进行脑尸检。通过结构化访谈获取社交网络数据。认知功能测试进行Z评分并取平均值，以得出认知功能的整体和特定指标。阿尔茨海默病病理学根据改良的 Bielschowsky 银染法进行整体量化。淀粉样蛋白负荷和双螺旋丝 tau 缠结的密度也通过抗体特异性免疫染色进行量化。我们使用线性回归来研究疾病病理学评分和社交网络与认知功能水平之间的关系。

研究结果

认知功能与疾病病理学的所有指标呈负相关，表明在更严重的病理学水平上功能较低。社交网络规模改变了病理学与认知功能之间的关联（参数估计值0.097，标准误0.039，p = 0.016，R(2)=0.295）。即使在全球疾病病理学更严重的水平上，社交网络规模较大的参与者的认知功能仍然较高。在缠结方面也观察到类似的改变关联（参数估计值0.011，标准误0.003，p = 0.001，R(2)=0.454）。这些改变效应在语义记忆和工作记忆方面最为明显。淀粉样蛋白负荷并未改变病理学与网络规模之间的关系。在控制了认知、身体和社交活动、抑郁症状或慢性病数量后，结果不变。