Roe Catherine M, Xiong Chengjie, Miller J Phillip, Cairns Nigel J, Morris John C
Alzheimer's Disease Research Center, Washington University School of Medicine, 4488 Forest Park Avenue, St Louis, MO 63108, USA.
Alzheimer Dis Assoc Disord. 2008 Apr-Jun;22(2):188-93. doi: 10.1097/WAD.0b013e3181610fff.
In exploring the cognitive reserve hypothesis in persons with substantial Alzheimer disease neuropathology, we aimed to determine the extent to which educational attainment and densities of diffuse plaques, neuritic plaques, and neurofibrillary tangles predict dementia. Participants were 1563 individuals aged 65 years or above who were assessed for dementia within 1 year of death. Generalized linear mixed models were used to examine whether education and density ratings of diffuse plaques and neuritic plaques, and neurofibrillary tangle stage were associated with a dementia diagnosis. Education interacted with densities of neuritic plaques to predict dementia. Tangle density independently predicted dementia, but did not interact with education. Diffuse plaque density was unrelated to dementia when adjusted for densities of neuritic plaques and tangles. Among individuals with Alzheimer disease neuropathology, educational attainment, as a surrogate of cognitive reserve, modifies the influence of neuritic, but not diffuse, plaque neuropathology on the expression of dementia.
在对患有严重阿尔茨海默病神经病理学改变的人群进行认知储备假说的探索中，我们旨在确定教育程度以及弥漫性斑块、神经炎性斑块和神经原纤维缠结的密度对痴呆症的预测程度。研究参与者为1563名65岁及以上的个体，他们在死亡前1年内接受了痴呆症评估。使用广义线性混合模型来检验教育程度、弥漫性斑块和神经炎性斑块的密度评级以及神经原纤维缠结阶段是否与痴呆症诊断相关。教育程度与神经炎性斑块的密度相互作用以预测痴呆症。缠结密度可独立预测痴呆症，但与教育程度无相互作用。在对神经炎性斑块和缠结的密度进行校正后，弥漫性斑块密度与痴呆症无关。在患有阿尔茨海默病神经病理学改变的个体中，作为认知储备替代指标的教育程度会改变神经炎性而非弥漫性斑块神经病理学对痴呆症表现的影响。
