University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inserm, CIC1401-EC, F-33000, Bordeaux, France.
CATI Multicenter Neuroimaging Platform, 75000, Paris, France.
Alzheimers Res Ther. 2022 May 18;14(1):68. doi: 10.1186/s13195-022-01013-8.
This work aimed to investigate the potential pathways involved in the association between social and lifestyle factors, biomarkers of Alzheimer's disease and related dementia (ADRD), and cognition.
The authors studied 2323 participants from the Memento study, a French nationwide clinical cohort. Social and lifestyle factors were education level, current household incomes, physical activity, leisure activities, and social network from which two continuous latent variables were computed: an early to midlife (EML) and a latelife (LL) indicator. Brain magnetic resonance imaging (MRI), lumbar puncture, and amyloid-positron emission tomography (PET) were used to define three latent variables: neurodegeneration, small vessel disease (SVD), and AD pathology. Cognitive function was defined as the underlying factor of a latent variable with four cognitive tests. Structural equation models were used to evaluate cross-sectional pathways between social and lifestyle factors and cognition.
Participants' mean age was 70.9 years old, 62% were women, 28% were apolipoprotein-ε4 carriers, and 59% had a Clinical Dementia Rating (CDR) score of 0.5. Higher early to midlife social indicator was only directly associated with better cognitive function (direct β = 0.364 (0.322; 0.405), with no indirect pathway through ADRD biomarkers (total β = 0.392 (0.351; 0.429)). In addition to a direct effect on cognition (direct β = 0.076 (0.033; 0.118)), the association between latelife lifestyle indicator and cognition was also mostly mediated by an indirect effect through lower neurodegeneration (indirect β = 0.066 (0.042; 0.090) and direct β = - 0.116 (- 0.153; - 0.079)), but not through AD pathology nor SVD.
Early to midlife social factors are directly associated with higher cognitive functions. Latelife lifestyle factors may help preserve cognitive functions through lower neurodegeneration.
本研究旨在探讨社会和生活方式因素、阿尔茨海默病和相关痴呆症（ADRD）生物标志物与认知之间关联的潜在途径。
作者研究了来自法国全国性临床队列 Memento 研究的 2323 名参与者。社会和生活方式因素包括教育水平、当前家庭收入、身体活动、休闲活动和社交网络，从中计算出两个连续的潜在变量：早期到中年（EML）和晚年（LL）指标。脑磁共振成像（MRI）、腰椎穿刺和淀粉样蛋白正电子发射断层扫描（PET）用于定义三个潜在变量：神经退行性变、小血管疾病（SVD）和 AD 病理。认知功能被定义为潜在变量下的四个认知测试。结构方程模型用于评估社会和生活方式因素与认知之间的横断面途径。
参与者的平均年龄为 70.9 岁，62%为女性，28%为载脂蛋白 E4 携带者，59%的临床痴呆评定量表（CDR）评分为 0.5。较高的早期到中年社会指标仅与更好的认知功能直接相关（直接β=0.364（0.322；0.405），没有通过 ADRD 生物标志物的间接途径（总β=0.392（0.351；0.429））。除了对认知有直接影响（直接β=0.076（0.033；0.118）），晚年生活方式指标与认知的关联也主要通过间接途径通过较低的神经退行性变来介导（间接β=0.066（0.042；0.090）和直接β= -0.116（-0.153；-0.079）），而不是通过 AD 病理学或 SVD。
早期到中年的社会因素与较高的认知功能直接相关。晚年的生活方式因素可能通过降低神经退行性变来帮助维持认知功能。
Zotero 插件