教育加剧了大脑萎缩对认知能力下降的影响：对认知储备的启示。
Education amplifies brain atrophy effect on cognitive decline: implications for cognitive reserve.
机构信息
Department of Neurology, University of California, Davis, CA, USA.
Department of Psychology, University of Colorado, Colorado Springs, CO, USA.
出版信息
Neurobiol Aging. 2018 Aug;68:142-150. doi: 10.1016/j.neurobiolaging.2018.04.002. Epub 2018 Apr 12.
Level of education is often regarded as a proxy for cognitive reserve in older adults. This implies that brain degeneration has a smaller effect on cognitive decline in those with more education, but this has not been directly tested in previous research. We examined how education, quantitative magnetic resonance imaging-based measurement of brain degeneration, and their interaction affect cognitive decline in diverse older adults spanning the spectrum from normal cognition to dementia. Gray matter atrophy was strongly related to cognitive decline. While education was not related to cognitive decline, brain atrophy had a stronger effect on cognitive decline in those with more education. Importantly, high education was associated with slower decline in individuals with lesser atrophy but with faster decline in those with greater atrophy. This moderation effect was observed in Hispanics (who had high heterogeneity of education) but not in African-Americans or Caucasians. These results suggest that education is an indicator of cognitive reserve in individuals with low levels of brain degeneration, but the protective effect of higher education is rapidly depleted as brain degeneration progresses.
受教育程度通常被视为老年人认知储备的替代指标。这意味着在受教育程度较高的人群中，大脑退化对认知能力下降的影响较小，但之前的研究并未对此进行直接验证。我们研究了教育程度、基于定量磁共振成像的大脑退化测量值以及它们之间的相互作用如何影响从认知正常到痴呆等不同年龄段老年人的认知能力下降。灰质萎缩与认知能力下降密切相关。虽然教育程度与认知能力下降无关，但在受教育程度较高的人群中，大脑萎缩对认知能力下降的影响更大。重要的是，在灰质萎缩程度较低的个体中，高教育程度与较慢的认知下降相关，但在灰质萎缩程度较高的个体中与较快的认知下降相关。这种调节作用仅在西班牙裔人群中（其教育程度异质性较高）观察到，而在非裔美国人和白种人群体中未观察到。这些结果表明，在大脑退化程度较低的个体中，教育程度是认知储备的指标，但随着大脑退化的进展，较高的教育程度的保护作用会迅速耗尽。
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