Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.
The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.
J Alzheimers Dis. 2023;93(1):97-106. doi: 10.3233/JAD-220923.
Cognitive and brain reserve refer to individual differences that allow some people to better withstand brain pathology than others. Although early life stress has been recognized as a risk factor for low reserve in late life, no research yet has studied this across midlife.
To examine the associations of life stress with brain and cognitive reserve in midlife.
We included 1,232 middle-aged women who participated in the ORACLE Study between 2002-2006). Life stress was calculated as the shared variance of four cumulative stress domains, created from items measured between pregnancy and 10 years after childbirth. Brain reserve was defined as healthy-appearing brain volume measured with MRI; cognitive reserve as better cognitive functioning than expected based on age, education, and brain MRI measures, using structural equation modelling.
More life stress was associated with lower brain (standardized adjusted difference: -0.18 [95% CI 0.25,-0.12]) and cognitive reserve (-0.19 [-0.28,-0.10]). Although, effect sizes were typically smaller, cumulative stress domains were also associated with brain reserve (life events: -0.10 [-0.16,-0.04]; contextual stress: -0.13 [-0.19,-0.07]; parenting-related stress: -0.13[-0.19,-0.07]; interpersonal stress: -0.10 [-0.16,-0.04]) and cognitive reserve (life events: -0.18 [-0.25,-0.11]; contextual stress: -0.15 [-0.10,-0.02]; parenting-related stress: -0.10 [-0.18,-0.03]; interpersonal stress not significant).
Women who experience more life stress in midlife were found to have lower reserve. Effects were primarily driven by shared variance across cumulative stress domains, suggesting that focusing on single domains may underestimate effects. The effect of life stress on lower reserve may make women with stress more prone to neurodegenerative disease later in life than women without stress.
认知和大脑储备是指个体差异，使一些人能够比其他人更好地承受大脑病理变化。尽管人们已经认识到早期生活压力是晚年储备能力低的一个风险因素，但目前还没有研究在中年时期研究这一问题。
研究中年生活压力与大脑和认知储备的关系。
我们纳入了 1232 名参加 2002-2006 年 ORACLE 研究的中年女性。生活压力是通过从怀孕到产后 10 年期间测量的四个累积压力领域的共同方差计算得出的。大脑储备定义为 MRI 测量的健康大脑体积；认知储备定义为根据年龄、教育和大脑 MRI 测量值，认知功能优于预期，使用结构方程模型。
生活压力越大，大脑储备（标准化调整差异：-0.18 [95% CI 0.25，-0.12]）和认知储备（-0.19 [0.28，-0.10]）越低。尽管效应大小通常较小，但累积压力领域也与大脑储备（生活事件：-0.10 [0.16，-0.04]；情境压力：-0.13 [0.19，-0.07]；与育儿相关的压力：-0.13[-0.19，-0.07]；人际压力：-0.10 [0.16，-0.04]）和认知储备（生活事件：-0.18 [0.25，-0.11]；情境压力：-0.15 [0.10，-0.02]；与育儿相关的压力：-0.10 [-0.18，-0.03]；人际压力无统计学意义）相关。
研究发现，中年生活压力较大的女性储备能力较低。影响主要由累积压力领域的共同方差驱动，这表明关注单一领域可能会低估影响。生活压力对较低储备的影响可能使生活压力较大的女性在晚年比没有生活压力的女性更容易患神经退行性疾病。
