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认知储备的保护作用:轻度认知障碍的实证研究。

The protective role of cognitive reserve: an empirical study in mild cognitive impairment.

机构信息

Department of Psychology, "Sapienza" University of Rome, Rome, Italy.

Department of Dynamic and Clinical Psychology and Health, "Sapienza" University of Rome, Via degli Apuli 1, Rome, 00184, Italy.

出版信息

BMC Psychol. 2024 Jun 7;12(1):334. doi: 10.1186/s40359-024-01831-5.

Abstract

BACKGROUND

Mild cognitive impairment (MCI) describes an aging profile characterized by a cognitive decline that is worse than expected in normal aging but less pervasive and critical than full-blown dementia. In the absence of an effective treatment strategy, it is important to identify factors that can protect against progression to dementia. In this field, it is hypothesized that one aspect that may be a protective factor against the neurotypical outcome of dementia is cognitive reserve (CR). Cognitive reserve is the ability to maintain cognitive functionality despite accumulating brain pathology.

OBJECTIVES

The present study aimed to identify and analyze the differences in CR between healthy adults and patients with MCI. Specifically, it is hypothesized that (i) healthy older adult people have higher CR than older adult people diagnosed with MCI, and (II) CR could predict the classification of subjects into people with or without MCI.

METHODS

Two hundred forty-three adults (mean age = 60.4, SD = 7.4) participated in the present study and were classified into three groups based on Petersen's MCI criteria: healthy controls (HC), amnestic MCI (aMCI), and non-amnestic MCI (naMCI). The Cognitive Reserve Index questionnaire (CRIq) was administered to assess the level of CR, FINDINGS: Results showed that HC had significantly higher CR scores than participants diagnosed with aMCI and naMCI. Moreover, a binomial logistic regression suggested that low CR was a significant risk factor for the MCI diagnosis.

CONCLUSIONS

The clinical picture that emerged from the results showed that lower CR could be considered a characteristic of pathological aging, such as MCI.Public significance statement, Since the brain attempts to cope with life-related changes or pathologies, it is fundamental for both clinicians and researchers to investigate further the factors that contribute to brain resilience. As an indirect expression of brain reserve, cognitive reserve may be both a marker and a predictor of adaptive aging.

摘要

背景

轻度认知障碍 (MCI) 描述了一种衰老模式,其认知能力下降程度高于正常衰老,但不如全面痴呆严重。在缺乏有效治疗策略的情况下,确定可以预防进展为痴呆的因素非常重要。在这一领域,有人假设,一个可能是预防痴呆神经典型结局的保护因素是认知储备 (CR)。认知储备是指尽管大脑病理学不断积累,但仍能保持认知功能的能力。

目的

本研究旨在确定并分析健康成年人与 MCI 患者之间 CR 的差异。具体来说,假设 (i) 健康老年人的 CR 高于被诊断为 MCI 的老年人,以及 (ii) CR 可以预测受试者分类为有无 MCI 的人。

方法

本研究共有 243 名成年人(平均年龄 60.4,标准差 7.4)参与,根据 Petersen 的 MCI 标准分为三组:健康对照组 (HC)、遗忘型 MCI (aMCI) 和非遗忘型 MCI (naMCI)。使用认知储备指数问卷 (CRIq) 评估 CR 水平。

结果

结果表明,HC 的 CR 得分明显高于被诊断为 aMCI 和 naMCI 的参与者。此外,二项逻辑回归表明,CR 较低是 MCI 诊断的一个显著危险因素。

结论

结果显示的临床情况表明,较低的 CR 可能被认为是病理性衰老的特征,例如 MCI。

研究意义

由于大脑试图应对与生活相关的变化或病理学,因此对于临床医生和研究人员来说,进一步研究有助于大脑恢复力的因素非常重要。作为大脑储备的间接表现,认知储备可能既是适应性衰老的标志物,也是其预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e21/11157959/59aa34eaa3cf/40359_2024_1831_Fig1_HTML.jpg

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