Durrani Romella, Badhwar Amanpreet, Bhangu Jaspreet, Ganesh Aravind, Black Sandra E, Barber Philip A, Frayne Richard, Field Thalia S, Hachinski Vladimir, Sahlas Demetrios, Mai Lauren M, Sharma Mukul, Swartz Richard H, Smith Eric E
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Pharmacology and Physiology, University of Montreal, and Centre de recherche de l'Institut Universitaire de de Gériatrie, Université de Montreal, Montreal, QC, Canada.
J Alzheimers Dis Rep. 2022 Oct 7;6(1):607-616. doi: 10.3233/ADR-220054. eCollection 2022.
Cognitive reserve may protect against the effects of brain pathology, but few studies have looked at whether cognitive reserve modifies the adverse effects of vascular brain pathology.
We determined if cognitive reserve attenuates the associations of vascular brain lesions with worse cognition in persons with subjective concerns or mild impairment.
We analyzed 200 participants aged 50-90 years from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. Cognition was measured using the Montreal Cognitive Assessment and a neuropsychological test battery. High vascular lesion burden was defined as two or more supratentorial infarcts or beginning confluent or confluent white matter hyperintensity. Cognitive reserve proxies included education, occupational attainment, marital status, social activities, physical activity, household income, and multilingualism.
Mean age was 72.8 years and 48% were female; 73.5% had mild cognitive impairment and 26.5% had subjective concerns. Professional/managerial occupations, annual household income≥$60,000 per year, not being married/common law, and high physical activity were independently associated with higher cognition. Higher vascular lesion burden was associated with lower executive function, but the association was not modified by cognitive reserve.
Markers of cognitive reserve are associated with higher cognition. Vascular lesion burden is associated with lower executive function. However, cognitive reserve does not mitigate the effects of vascular lesion burden on executive function. Public health efforts should focus on preventing vascular brain injury as well as promoting lifestyle factors related to cognitive reserve, as cognitive reserve alone may not mitigate the effects of vascular brain injury.
认知储备可能会抵御脑病理学的影响，但很少有研究探讨认知储备是否会改变血管性脑病理学的不良影响。
我们确定认知储备是否能减轻血管性脑病变与主观担忧或轻度认知障碍患者认知功能较差之间的关联。
我们分析了来自神经退行性疾病和痴呆综合评估（COMPASS-ND）研究的200名年龄在50-90岁之间的参与者。使用蒙特利尔认知评估和一套神经心理学测试来测量认知功能。高血管病变负担定义为两个或更多幕上梗死灶或开始融合或融合的白质高信号。认知储备指标包括教育程度、职业成就、婚姻状况、社交活动、体育活动、家庭收入和多语言能力。
平均年龄为72.8岁，48%为女性；73.5%有轻度认知障碍，26.5%有主观担忧。专业/管理职业、家庭年收入≥60,000美元/年、未婚/同居伴侣关系以及高体育活动与较高的认知功能独立相关。较高的血管病变负担与较低的执行功能相关，但这种关联并未因认知储备而改变。
认知储备指标与较高的认知功能相关。血管病变负担与较低的执行功能相关。然而，认知储备并不能减轻血管病变负担对执行功能的影响。公共卫生工作应侧重于预防血管性脑损伤以及促进与认知储备相关的生活方式因素，因为仅靠认知储备可能无法减轻血管性脑损伤的影响。
