Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Psychiatry and Behavioral Sciences (ML, DAF, PB), Rush University Medical Center, Chicago, IL.
Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Diagnostic Radiology and Nuclear Medicine (KA, AK), Rush University Medical Center, Chicago, IL; Department of Biomedical Engineering (KA), Illinois Institute of Technology, Chicago, IL.
Am J Geriatr Psychiatry. 2023 Dec;31(12):1129-1139. doi: 10.1016/j.jagp.2023.07.008. Epub 2023 Jul 22.
The cortical thickness "signature" of Alzheimer's disease (AD-CT) and white matter hyperintensity (WMH) burden have each been associated with cognitive aging and incident AD and related dementias. Less is known about how these structural neuroimaging markers associate with other critical behaviors. We investigated associations of AD-CT and WMH volumes with a composite index of health and financial literacy given that the ability to access, understand, and utilize health and financial information significantly influences older adults' health outcomes.
DESIGN, SETTING, PARTICIPANTS: Participants were 303 adults without dementia (age∼80 years; 74% women) from the Rush Memory and Aging Project.
Baseline 3T MRI T1-weighted structural and T2-weighted FLAIR data were used to assess AD-CT and WMH volumes, respectively. Literacy was measured using questions designed to assess comprehension of health and financial information and concepts, yielding a total literacy score. Multivariable linear mixed effects regression models determined the relationship of each neuroimaging marker, first separately and then combined, with the level of and change in literacy.
Reduced AD-CT and higher WMH at baseline were each associated with lower levels of literacy; only AD-CT was associated with the rate of decline in literacy over time. The association of AD-CT with change in literacy persisted when both neuroimaging markers were included in the same model.
The cortical thickness signature of AD predicts changes in health and financial literacy in nondemented older adults suggesting that the multidimensional construct of health and financial literacy relies on specific brain networks implicated in AD.
阿尔茨海默病（AD）的皮质厚度“特征”和白质高信号（WMH）负担均与认知老化和 AD 及相关痴呆的发病相关。关于这些结构神经影像学标志物如何与其他关键行为相关联的信息知之甚少。我们研究了 AD 皮质厚度和 WMH 体积与健康和金融知识综合指数的相关性，因为获取、理解和利用健康和金融信息的能力极大地影响老年人的健康结果。
设计、环境、参与者：参与者为来自拉什记忆与衰老项目的 303 名无痴呆症的成年人（年龄约 80 岁；74%为女性）。
使用基线 3T MRI T1 加权结构和 T2 加权 FLAIR 数据分别评估 AD 皮质厚度和 WMH 体积。使用旨在评估对健康和金融信息及概念的理解的问题来测量读写能力，得出总的读写能力评分。多变量线性混合效应回归模型确定了每个神经影像学标志物与读写能力水平和变化的关系，首先分别进行，然后再结合进行。
基线时皮质厚度降低和 WMH 升高均与较低的读写能力水平相关；只有 AD 皮质厚度与读写能力随时间的下降速度相关。当将两个神经影像学标志物都包含在同一个模型中时，AD 皮质厚度与读写能力变化的关联仍然存在。
AD 的皮质厚度特征预测了认知正常的老年患者健康和金融读写能力的变化，表明健康和金融读写能力的多维结构依赖于 AD 所涉及的特定大脑网络。
