Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neurobiol Aging. 2013 Dec;34(12):2827-34. doi: 10.1016/j.neurobiolaging.2013.06.017. Epub 2013 Aug 1.
The levels of β-amyloid (Aβ) and phosphorylated tau (p-tau), as measured in cerebrospinal fluid, have been associated with the risk of progressing from normal cognition to onset of clinical symptoms during preclinical Alzheimer's disease. We examined whether cognitive reserve (CR) modifies this association. Cerebrospinal fluid was obtained at baseline from 239 participants (mean age, 57.2 years) who had been followed for up to 17 years with clinical and cognitive assessments (mean follow-up, 8 years). A composite score based on the National Adult Reading Test, vocabulary, and years of education at baseline was used as an index of CR. Cox regression models showed that the increased risk of progressing from normal cognition to symptom onset was associated with lower CR, lower baseline Aβ, and higher baseline p-tau. There was no interaction between CR and Aβ, suggesting that the protective effects of higher CR are equivalent across the observed range of amyloid levels. In contrast, both tau and p-tau interacted with CR, indicating that CR was more protective at lower levels of tau and p-tau.
β-淀粉样蛋白（Aβ）和磷酸化 tau（p-tau）的水平，如脑脊液中所测，与从正常认知进展到临床症状前阿尔茨海默病的发病风险有关。我们研究了认知储备（CR）是否会改变这种关联。从 239 名参与者（平均年龄 57.2 岁）的基线获得脑脊液，这些参与者已接受长达 17 年的临床和认知评估（平均随访 8 年）。基于国家成人阅读测试、词汇和基线教育年限的综合评分作为 CR 的指标。Cox 回归模型显示，从正常认知进展到症状发作的风险增加与较低的 CR、较低的基线 Aβ和较高的基线 p-tau 相关。CR 和 Aβ 之间没有相互作用，这表明较高的 CR 的保护作用在观察到的淀粉样蛋白水平范围内是等效的。相比之下，tau 和 p-tau 都与 CR 相互作用，这表明 CR 在较低的 tau 和 p-tau 水平下更具保护作用。
