中年认知储备对老年慢性病与认知衰退关系的作用：一项跨越六年的纵向随访研究。
The role of cognitive reserve accumulated in midlife for the relation between chronic diseases and cognitive decline in old age: A longitudinal follow-up across six years.
机构信息
Department of Psychology, University of Geneva, Geneva, Switzerland; Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland; Swiss National Centre of Competence in Research LIVES - Overcoming vulnerability: Life course perspectives, Lausanne and Geneva, Switzerland.
Department of Psychology, University of Geneva, Geneva, Switzerland; Swiss National Centre of Competence in Research LIVES - Overcoming vulnerability: Life course perspectives, Lausanne and Geneva, Switzerland; Distance Learning University Switzerland, Sierre, Switzerland.
出版信息
Neuropsychologia. 2018 Dec;121:37-46. doi: 10.1016/j.neuropsychologia.2018.10.013. Epub 2018 Oct 22.
OBJECTIVES
The present study set out to investigate relations of the number of chronic diseases (as a global indicator of individuals' multimorbidity) to cognitive status and cognitive decline over six years as measured by changes in Trail Making Test (TMT) completion time in old adults and whether those relations differed by key life course markers of cognitive reserve (education, occupation, and cognitively stimulating leisure activities).
METHOD
We analyzed data from 897 participants tested on TMT parts A and B in two waves six years apart. Mean age in the first wave was 74.33 years. Participants reported information on chronic diseases, education, occupation, and cognitively stimulating leisure activities.
RESULTS
Latent change score modeling testing for moderation effects revealed that a larger number of chronic diseases significantly predicted stronger increase in TMT completion time (i.e., steeper cognitive performance decline). Notably, the detrimental relation of the number of chronic diseases to stronger increase in TMT completion time (i.e., cognitive performance decline) was significantly stronger in individuals with less engagement in cognitively stimulating leisure activities in midlife.
DISCUSSION
Present data suggest that disease-related cognitive decline may be steeper in individuals who have accumulated less cognitive reserve in midlife. However, greater midlife activity engagement seemed to be associated with steeper cognitive decline in any case. Implications for current cognitive reserve and neuropsychological aging research are discussed.
目的
本研究旨在探讨老年人中慢性疾病数量（作为个体多病的全球指标）与认知状态和认知衰退的关系，其通过 Trail Making Test（TMT）完成时间的变化六年进行衡量，并研究这些关系是否因认知储备的关键人生轨迹标志物（教育、职业和认知刺激的休闲活动）而有所不同。
方法
我们分析了 897 名参与者在两次相隔六年的测试中 TMT 部分 A 和 B 的数据。第一次波的平均年龄为 74.33 岁。参与者报告了慢性疾病、教育、职业和认知刺激的休闲活动信息。
结果
潜在变化得分模型测试表明，更多的慢性疾病显著预测了 TMT 完成时间的显著增加（即认知表现下降更快）。值得注意的是，在中年期较少参与认知刺激的休闲活动的个体中，慢性疾病数量与 TMT 完成时间（即认知表现下降）显著增加之间的不利关系更强。
讨论
目前的数据表明，与疾病相关的认知衰退在中年时期积累较少认知储备的个体中可能更为严重。然而，无论如何，更多的中年期活动参与似乎与更严重的认知衰退有关。本文讨论了当前认知储备和神经心理学衰老研究的意义。
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