Powell Alice, Lam Ben C P, Foxe David, Close Jacqueline C T, Sachdev Perminder S, Brodaty Henry
Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
Int Psychogeriatr. 2024 Oct;36(10):939-955. doi: 10.1017/S1041610223000935. Epub 2023 Nov 24.
To investigate the frequency of exceptional cognition (cognitive super-aging) in Australian older adults using different published definitions, agreement between definitions, and the relationship of super-aging status with function, brain imaging markers, and incident dementia.
Three longitudinal cohort studies.
Participants recruited from the electoral roll, Australian Twins Registry, and community advertisements.
Older adults (aged 65-106) without dementia from the Sydney Memory and Ageing Study ( = 1037; median age 78), Older Australian Twins Study ( = 361; median age 68), and Sydney Centenarian Study ( = 217; median age 97).
Frequency of super-aging was assessed using nine super-aging definitions based on performance on neuropsychological testing. Levels of agreement between definitions were calculated, and associations between super-aging status for each definition and functioning (Bayer ADL score), structural brain imaging measures, and incident dementia were explored.
Frequency of super-aging varied between 2.9 and 43.4 percent with more stringent definitions associated with lower frequency. Agreement between different criteria varied from poor (K = 0.04, AC1 = .24) to very good (K = 0.83, AC1 = .91) with better agreement between definitions using similar tests and cutoffs. Super-aging was associated with better functional performance (4.7-11%) and lower rates of incident dementia (hazard ratios 0.08-0.48) for most definitions. Super-aging status was associated with a lower burden of white matter hyperintensities (3.8-33.2%) for all definitions.
The frequency of super-aging is strongly affected by the demographic and neuropsychological testing parameters used. Greater consistency in defining super-aging would enable better characterization of this exceptional minority.
使用不同的已发表定义，调查澳大利亚老年人中超常认知（认知超老龄化）的频率、定义之间的一致性，以及超老龄化状态与功能、脑成像标志物和新发痴呆症之间的关系。
三项纵向队列研究。
从选民名册、澳大利亚双胞胎登记处和社区广告中招募参与者。
来自悉尼记忆与衰老研究（n = 1037；中位年龄78岁）、澳大利亚老年双胞胎研究（n = 361；中位年龄68岁）和悉尼百岁老人研究（n = 217；中位年龄97岁）的无痴呆症老年人。
基于神经心理学测试表现，使用九种超老龄化定义评估超老龄化频率。计算定义之间的一致性水平，并探讨每种定义的超老龄化状态与功能（拜耳日常生活活动评分）、脑结构成像测量和新发痴呆症之间的关联。
超老龄化频率在2.9%至43.4%之间变化，定义越严格，频率越低。不同标准之间的一致性从差（K = 0.04，AC1 = 0.24）到非常好（K = 0.83，AC1 = 0.91）不等，使用相似测试和临界值的定义之间一致性更好。大多数定义下，超老龄化与更好的功能表现（4.7 - 11%）和更低的新发痴呆症发生率（风险比0.08 - 0.48）相关。所有定义下，超老龄化状态与较低的白质高信号负担（3.8 - 33.2%）相关。
超老龄化频率受所用人选和神经心理学测试参数的强烈影响。在定义超老龄化方面提高一致性将有助于更好地描述这一特殊少数群体。
