Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Faculdade de Medicina, Grupo de Pesquisa em Neurologia Comportamental e Cognitiva, Belo Horizonte MG, Brazil.
Faculdade de Ciências Médicas de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte MG, Brazil.
Arq Neuropsiquiatr. 2023 Feb;81(2):112-118. doi: 10.1055/s-0042-1759760. Epub 2023 Mar 22.
Healthy brain aging can be defined as aging without neurological or psychiatric disorders, sustaining functional independence. In addition to the absence of disease and preserved functionality, there are individuals who stand out for their superior performance to that considered normal for their age in cognitive tests. These individuals are called "high-performance older adults" (HPOA).
To investigate the presence of HPOA in an oldest-old population with low education, and if present, to investigate associations with sociodemographic, clinical, and lifestyle variables.
We evaluated 132 cognitively healthy individuals from the Pietà Study, a population-based investigation with 639 participants. We used the delayed recall from the Rey Auditory-Verbal Learning Test to verify the existence of HPOA and to classify participants based on their performance. Sociodemographic, clinical, and lifestyle variables associated with HPOA were investigated.
We identified 18 individuals fulfilling HPOA criteria (age: 77.4 ± 2.6 years old; 14 women; education: 4.6 ± 3.4 years). The other participants, 114 total (age: 79.8 ± 4.5 years old; 69 women; education: 3.0 ± 2.7 years) were classified as "standard performance older adults" (SPOA). In multivariate analysis, younger age (odds ratio [OR] = 0.672; 95% confidence interval [CI]: 0.462-0.979; = 0.037) and lower scores on the Geriatric Depression Scale (OR = 0.831; 95%CI: 0.688-0.989; = 0.038) were associated with HPOA.
The present study identifies for the first time HPOA with low educational level, thereby reinforcing the existence of biological substrates related to this condition. Furthermore, the data suggest an association between younger age and less depressive symptoms with HPOA.
健康的大脑衰老可以定义为没有神经或精神障碍，保持功能独立的衰老。除了没有疾病和保持功能外，还有一些人在认知测试中的表现优于他们年龄的正常水平，这些人被称为“高表现老年人”（HPOA）。
在受教育程度较低的最年长人群中调查 HPOA 的存在，如果存在，调查与社会人口统计学、临床和生活方式变量的关联。
我们评估了 Pietà 研究中的 132 名认知健康个体，这是一项基于人群的研究，共有 639 名参与者。我们使用 Rey 听觉语言学习测试的延迟回忆来验证 HPOA 的存在，并根据表现对参与者进行分类。调查了与 HPOA 相关的社会人口统计学、临床和生活方式变量。
我们确定了 18 名符合 HPOA 标准的个体（年龄：77.4±2.6 岁；14 名女性；教育：4.6±3.4 年）。其余 114 名参与者（年龄：79.8±4.5 岁；69 名女性；教育：3.0±2.7 年）被归类为“标准表现老年人”（SPOA）。在多变量分析中，年龄较小（优势比 [OR] = 0.672；95%置信区间 [CI]：0.462-0.979； = 0.037）和较低的老年抑郁量表评分（OR = 0.831；95%CI：0.688-0.989； = 0.038）与 HPOA 相关。
本研究首次确定了具有低教育水平的 HPOA，从而加强了与这种情况相关的生物学基础的存在。此外，数据表明 HPOA 与年龄较小和抑郁症状较轻之间存在关联。
