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.
J Alzheimers Dis. 2023;93(1):179-191. doi: 10.3233/JAD-220951.
Slowed rates of cognitive decline have been reported in individuals with higher cognitive reserve (CR), but interindividual discrepancies remain unexplained. Few studies have reported a birth cohort effect, favoring later-born individuals, but these studies remain scarce.
We aimed to predict cognitive decline in older adults using birth cohorts and CR.
Within the Alzheimer's Disease Neuroimaging Initiative, 1,041 dementia-free participants were assessed on four cognitive domains (verbal episodic memory; language and semantic memory; attention; executive functions) at each follow-up visit up to 14 years. Four birth cohorts were formed according to the major historical events of the 20th century (1916-1928; 1929-1938; 1939-1945; 1946-1962). CR was operationalized by merging education, complexity of occupation, and verbal IQ. We used linear mixed-effect models to evaluate the effects of CR and birth cohorts on rate of performance change over time. Age at baseline, baseline structural brain health (total brain and total white matter hyperintensities volumes), and baseline vascular risk factors burden were used as covariates.
CR was only associated with slower decline in verbal episodic memory. However, more recent birth cohorts predicted slower annual cognitive decline in all domains, except for executive functions. This effect increased as the birth cohort became more recent.
We found that both CR and birth cohorts influence future cognitive decline, which has strong public policy implications.
高认知储备（CR）个体的认知衰退速度较慢，但个体间的差异仍未得到解释。少数研究报告了出生队列效应，有利于晚出生的个体，但这些研究仍然很少。
我们旨在使用出生队列和 CR 预测老年人的认知下降。
在阿尔茨海默病神经影像学倡议中，1041 名无痴呆症的参与者在每次随访中接受四项认知领域（口头情景记忆；语言和语义记忆；注意力；执行功能）的评估，随访时间长达 14 年。根据 20 世纪的重大历史事件（1916-1928；1929-1938；1939-1945；1946-1962）形成了四个出生队列。CR 通过合并教育、职业复杂性和语言智商来操作化。我们使用线性混合效应模型来评估 CR 和出生队列对随时间变化的表现变化率的影响。基线时的年龄、基线结构脑健康（总脑和总白质高信号体积）和基线血管危险因素负担被用作协变量。
CR 仅与口头情景记忆的下降速度较慢相关。然而，最近的出生队列预测了除执行功能外的所有领域的认知衰退速度较慢。这种影响随着出生队列的更新而增加。
我们发现 CR 和出生队列都影响未来的认知下降，这具有强烈的公共政策意义。
