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出生队列和认知储备对老年人认知表现的影响。

Birth Cohorts and Cognitive Reserve Influence Cognitive Performances in Older Adults.

作者信息

Turcotte Valérie, Potvin Olivier, Dadar Mahsa, Hudon Carol, Duchesne Simon

机构信息

École de psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada.

CERVO Brain Research Centre, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Québec, QC, Canada.

出版信息

J Alzheimers Dis. 2022;85(2):587-604. doi: 10.3233/JAD-215044.

Abstract

BACKGROUND

Evidence suggests birth cohort differences in cognitive performance of older adults. Proxies of cognitive reserve (CR), such as educational attainment and occupational complexity, could also partly account for these differences as they are influenced by the sociocultural environment of the birth cohorts.

OBJECTIVE

To predict cognitive performance using birth cohorts and CR and examine the moderating influence of CR on cognitive performance and structural brain health association.

METHODS

Using ADNI data (n = 1628), four birth cohorts were defined (1915-1928; 1929-1938; 1939-1945; 1946-1964). CR proxies were education, occupational complexity, and verbal IQ. We predicted baseline cognitive performances (verbal episodic memory; language and semantic memory; attention capacities; executive functions) using multiple linear regressions with CR, birth cohorts, age, structural brain health (total brain volume; total white matter hyperintensities volume) and vascular risk factors burden as predictors. Sex and CR interactions were also explored.

RESULTS

Recent birth cohorts, higher CR, and healthier brain structures predicted better performance in verbal episodic memory, language and semantic memory, and attention capacities, with large effect sizes. Better performance in executive functions was predicted by a higher CR and a larger total brain volume, with a small effect size. With equal score of CR, women outperformed men in verbal episodic memory and language and semantic memory in all cohorts. Higher level of CR predicted better performance in verbal episodic memory, only when total brain volume was lower.

CONCLUSION

Cohort differences in cognitive performance favor more recent birth cohorts and suggests that this association may be partly explained by proxies of CR.

摘要

背景

有证据表明老年人的认知表现存在出生队列差异。认知储备(CR)的代理指标,如教育程度和职业复杂性,也可能部分解释这些差异,因为它们受到出生队列社会文化环境的影响。

目的

使用出生队列和CR预测认知表现,并检验CR对认知表现和脑结构健康关联的调节作用。

方法

利用阿尔茨海默病神经影像学计划(ADNI)数据(n = 1628),定义了四个出生队列(1915 - 1928年;1929 - 1938年;1939 - 1945年;1946 - 1964年)。CR代理指标为教育程度、职业复杂性和言语智商。我们使用多元线性回归,以CR、出生队列、年龄、脑结构健康(全脑体积;总白质高信号体积)和血管危险因素负担作为预测变量,预测基线认知表现(言语情景记忆;语言和语义记忆;注意力;执行功能)。还探讨了性别与CR的相互作用。

结果

较近的出生队列、较高的CR和更健康的脑结构预测在言语情景记忆、语言和语义记忆以及注意力方面表现更好,效应量较大。较高的CR和较大的全脑体积预测执行功能表现更好,效应量较小。在所有队列中,CR得分相同时,女性在言语情景记忆以及语言和语义记忆方面的表现优于男性。仅当全脑体积较低时,较高水平的CR预测言语情景记忆表现更好。

结论

认知表现的队列差异有利于较近的出生队列,表明这种关联可能部分由CR代理指标解释。

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