Rouillard Maud, Audiffren Michel, Albinet Cédric, Ali Bahri Mohamed, Garraux Gaëtan, Collette Fabienne
a GIGA-CRC In Vivo Imaging, University of Liège , Liège , Belgium.
b Centre de Recherches sur la Cognition et l'Apprentissage (UMR CNRS 7295), Sport Sciences Faculty , University of Poitiers , Poitiers , France.
J Clin Exp Neuropsychol. 2017 Mar;39(2):142-162. doi: 10.1080/13803395.2016.1207755. Epub 2016 Aug 12.
Cognitive reserve (CR) was proposed to explain how individual differences in brain function help to cope with the effects of normal aging and neurodegenerative diseases. Education, professional solicitations, and engagement in leisure and physical activities across the lifetime are considered as major determinants of this reserve.
Using multiple linear regression analyses, we tested separately in healthy elderly and Parkinson's disease (PD) populations to what extent cognitive performance in several domains was explained by (a) any of these four environmental lifespan variables; (b) demographic and clinical variables (age, gender, depression score, and, for the PD group, duration of disease and dopaminergic drugs). We also tested for an interaction, if any, between these lifespan variables and brain pathology indexed by global atrophy measured from high-resolution anatomical magnetic resonance imaging.
Age was negatively associated with cognitive performance in the PD group. In healthy elderly participants, we observed significant positive associations between cognitive performance and (a) education, (b) leisure activities, and (c) professional solicitation (decisional latitude). Furthermore, participants with greater brain atrophy benefited more from CR. In PD patients, education and professional solicitations contributed to cognitive performance but to a lesser extent than in controls. CR factors modulated the relationship between cognition and brain atrophy only in patients with a slight or moderate brain atrophy.
Education is the CR factor that contributed the most to late cognitive functioning in both groups, closely followed by leisure activity in normal aging and professional solicitations in PD. Our results also provide evidence suggesting that the effects of CR does not express similarly in normal aging and PD. From a broader perspective, these results seem to indicate that CR factors the most consistently practiced across lifespan (education and professional solicitation) are those that are the more strongly associated to late cognitive efficiency.
认知储备（CR）的提出是为了解释大脑功能的个体差异如何有助于应对正常衰老和神经退行性疾病的影响。一生中的教育、职业诉求以及参与休闲和体育活动被视为这种储备的主要决定因素。
我们使用多元线性回归分析，分别在健康老年人和帕金森病（PD）人群中测试了以下内容：（a）这四个环境寿命变量中的任何一个在多大程度上解释了几个领域的认知表现；（b）人口统计学和临床变量（年龄、性别、抑郁评分，对于PD组，还包括疾病持续时间和多巴胺能药物）。我们还测试了这些寿命变量与通过高分辨率解剖磁共振成像测量的全脑萎缩所索引的脑病理学之间是否存在相互作用。
在PD组中，年龄与认知表现呈负相关。在健康老年参与者中，我们观察到认知表现与（a）教育、（b）休闲活动和（c）职业诉求（决策自由度）之间存在显著的正相关。此外，脑萎缩程度较大的参与者从认知储备中获益更多。在PD患者中，教育和职业诉求对认知表现有贡献，但程度低于对照组。认知储备因素仅在轻度或中度脑萎缩的患者中调节了认知与脑萎缩之间的关系。
教育是对两组后期认知功能贡献最大的认知储备因素，在正常衰老中紧随其后的是休闲活动，在PD中是职业诉求。我们的结果还提供了证据表明，认知储备的影响在正常衰老和PD中表现不同。从更广泛的角度来看，这些结果似乎表明，在整个生命周期中最持续实践的认知储备因素（教育和职业诉求）是那些与后期认知效率关联更强的因素。
