Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.
Neuroepidemiology. 2023;57(4):229-237. doi: 10.1159/000531208. Epub 2023 Jun 1.
More frequent engagement in cognitive activity is associated with better cognitive function in older adults, but the mechanism of action is not fully understood. Debate remains whether increased cognitive activity provides a meaningful benefit for cognitive health or if decreased cognitive activity represents a prodrome of cognitive impairment. Neurological biomarkers provide a novel way to examine this relationship in the context of cognitive aging.
We examined the association of self-reported cognitive activity, cognitive function, and concentrations of three biomarkers in community-dwelling participants of a longitudinal, population-based study. Cognitive activity was measured at baseline by asking participants to rate the frequency of 7 activities: (1) viewing television, (2) listening to the radio, (3) visiting a museum, (4) playing games, such as cards, checkers, crosswords, or other puzzles or games, (5) reading books, (6) reading magazines, and (7) reading newspapers. Cognitive function was measured with a battery of four tests (Mini-Mental State Examination, Digit Symbol Test, and the immediate and delayed recall of the East Boston Test) averaged into a composite score. At baseline, we evaluated the concentration of total tau (tau), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP).
The study sample comprised 1,168 older participants, primarily non-Hispanic Blacks (60%) and women (63%). At baseline, they were an average of 77 years old with 12.6 years of education. Mixed-effects models showed that cognitive activity was associated with better cognitive functioning at baseline and over time. These relationships remained after each biomarker was added to the model. Over an average of 6.4 years of follow-up, cognitive activity was associated with cognitive decline in the model with tau (estimate = 0.0123; p value = 0.03) and was mildly attenuated in the models with NfL (estimate = 0.0110; p value = 0.06) and GFAP (estimate = 0.0111; p value = 0.06). Biomarkers did not modify the association between cognitive activity and cognitive function over time.
The benefits of cognitive activity on cognition appear to be independent of biomarkers: tau, NfL, and GFAP, measured at baseline. More frequent cognitive activity may benefit the cognitive health of older adults with a wide range of potential disease risk and presentations.
频繁参与认知活动与老年人更好的认知功能相关，但作用机制尚不完全清楚。目前仍存在争议，即增加认知活动是否对认知健康有意义，或者减少认知活动是否代表认知障碍的先兆。神经生物学标志物为在认知老化的背景下研究这种关系提供了一种新方法。
我们在一项基于人群的纵向研究中，检查了自我报告的认知活动、认知功能和三种生物标志物浓度与社区居住参与者之间的关联。在基线时，通过让参与者对以下 7 种活动的频率进行评分来测量认知活动：（1）看电视，（2）听广播，（3）参观博物馆，（4）玩纸牌、跳棋、填字游戏或其他拼图或游戏，（5）阅读书籍，（6）阅读杂志，（7）阅读报纸。认知功能通过四项测试（简易精神状态检查、数字符号测试和东波士顿测试的即时和延迟回忆）的平均值构成综合得分来测量。在基线时，我们评估了总 tau（tau）、神经丝轻链（NfL）和神经胶质纤维酸性蛋白（GFAP）的浓度。
研究样本包括 1168 名年龄较大的参与者，主要是非裔美国人（60%）和女性（63%）。他们在基线时的平均年龄为 77 岁，受教育年限为 12.6 年。混合效应模型显示，认知活动与基线和随时间推移的认知功能更好相关。在向模型中添加每个生物标志物后，这些关系仍然存在。在平均 6.4 年的随访中，在 tau 模型中（估计值=0.0123；p 值=0.03），认知活动与认知衰退相关，在 NfL 模型中（估计值=0.0110；p 值=0.06）和 GFAP 模型中（估计值=0.0111；p 值=0.06），认知活动与认知衰退的相关性略有减弱。生物标志物并未改变认知活动与随时间推移的认知功能之间的关联。
认知活动对认知的益处似乎独立于基线时测量的生物标志物：tau、NfL 和 GFAP。更频繁的认知活动可能有益于认知健康，而且与认知障碍的各种潜在疾病风险和表现有关。
