Vaqué-Alcázar Lídia, Sala-Llonch Roser, Valls-Pedret Cinta, Vidal-Piñeiro Dídac, Fernández-Cabello Sara, Bargalló Núria, Ros Emilio, Bartrés-Faz David
Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, C/ Casanova 143, 08036, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Brain Imaging Behav. 2017 Apr;11(2):318-332. doi: 10.1007/s11682-016-9584-8.
High education, as a proxy of cognitive reserve (CR), has been associated with cognitive advantage amongst old adults and may operate through neuroprotective and/or compensation mechanisms. In neuromaging studies, indirect evidences of neuroprotection can be inferred from positive relationships between CR and brain integrity measures. In contrast, compensation allows high CR elders to sustain greater brain damage. We included 100 cognitively normal old-adults and investigated the associations and interactions between education, speed of processing (SP), memory and two brain integrity measures: cortical thickness (CTh) of gray matter (GM) and fractional anisotropy (FA) in the white matter (WM). High education was associated with better cognitive performance, enlarged CTh in frontal lobe areas and reduced measures of FA in several areas. Better SP performance in higher educated subjects was related to more preserved GM and WM, while memory status amongst high educated elders was better explained by a putative compensatory mechanism and independently from cerebrovascular risk indicators. Moreover, we analyzed the direct effect of age on measures of brain integrity and found a stronger negative effect on WM than in CTh, which was accentuated amongst the high CR sample. Our study suggests that the cognitive advantage associated to high education among healthy aging is related to the coexistence of both neuroprotective and compensatory mechanisms. In particular, high educated elders seem to have greater capacity to counteract a more abrupt age impact on WM integrity.
高等教育作为认知储备(CR)的一个代表指标,已被证明与老年人的认知优势相关,并且可能通过神经保护和/或补偿机制发挥作用。在神经影像学研究中,神经保护的间接证据可从CR与脑完整性指标之间的正相关关系中推断出来。相比之下,补偿作用使具有高认知储备的老年人能够承受更大的脑损伤。我们纳入了100名认知正常的老年人,研究了教育程度、加工速度(SP)、记忆力与两种脑完整性指标之间的关联和相互作用,这两种指标分别是灰质(GM)的皮质厚度(CTh)和白质(WM)的分数各向异性(FA)。高等教育与更好的认知表现、额叶区域CTh增大以及多个区域FA指标降低相关。在受教育程度较高的受试者中,更好的SP表现与更多保留的GM和WM相关,而高学历老年人的记忆状况更能通过一种假定的补偿机制来解释,且独立于脑血管风险指标。此外,我们分析了年龄对脑完整性指标的直接影响,发现年龄对WM的负面影响比对CTh更强,在高CR样本中这种影响更为明显。我们的研究表明,健康老龄化过程中与高等教育相关的认知优势与神经保护和补偿机制的共存有关。特别是,高学历老年人似乎有更大的能力抵消年龄对WM完整性的更突然的影响。