Yu Lei, Wang Tianhao, Kapasi Alifiya, Lamar Melissa, Mottola Gary, Arfanakis Konstantinos, Bennett David A, Boyle Patricia A
Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA.
Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
Brain Imaging Behav. 2024 Dec;18(6):1515-1523. doi: 10.1007/s11682-024-00945-z. Epub 2024 Oct 1.
Financial and health literacy is essential for older adults to navigate complex decision processes in late life. However, the neurobiological basis of age-related decline in financial and health literacy is poorly understood. This study aimed to characterize progression of neurodegenerative and vascular conditions over time, and to assess how these changes coincide with declining financial and health literacy in old age. Data came from 319 community-living older adults who were free of dementia at baseline, and underwent annual literacy assessments, as well as biennial 3-Tesla neuroimaging scans. Financial and health literacy was assessed using a battery of 32 items. Two in vivo neuroimaging markers of neurodegenerative and cerebrovascular conditions were used, i.e., hippocampal volume and the ARTS marker of arteriolosclerosis. A multivariate linear mixed effects model estimated the simultaneous changes in financial and health literacy, hippocampal volume, and the ARTS score. Over a mean of 7 years of follow-up, these older adults experienced a significant decline in financial and health literacy, a significant reduction in hippocampal volume, and a significant progression in ARTS score. Individuals with faster hippocampal atrophy had faster decline in literacy. Similarly, those with faster progression in ARTS also had faster decline in literacy. The correlation between the rates of hippocampal atrophy and declining literacy, however, was stronger than the correlation between the progression of ARTS with declining literacy. These findings suggest that neurodegeneration and, to a lesser extent, cerebrovascular conditions are correlated with declining financial and health literacy in old age.
金融和健康素养对于老年人在晚年应对复杂的决策过程至关重要。然而，人们对金融和健康素养与年龄相关的下降的神经生物学基础知之甚少。本研究旨在描述神经退行性和血管性疾病随时间的进展情况，并评估这些变化如何与老年人金融和健康素养的下降相吻合。数据来自319名社区居住的老年人，他们在基线时没有痴呆症，并接受了年度素养评估以及每两年一次的3特斯拉神经影像学扫描。使用一组32个项目评估金融和健康素养。使用了两种神经退行性和脑血管疾病的体内神经影像学标志物，即海马体积和小动脉硬化的ARTS标志物。多元线性混合效应模型估计了金融和健康素养、海马体积和ARTS评分的同时变化。在平均7年的随访中，这些老年人的金融和健康素养显著下降，海马体积显著减小，ARTS评分显著进展。海马萎缩较快的个体识字能力下降也较快。同样，ARTS进展较快的个体识字能力下降也较快。然而，海马萎缩率与识字能力下降之间的相关性比ARTS进展与识字能力下降之间的相关性更强。这些发现表明，神经退行性变以及在较小程度上的脑血管疾病与老年人金融和健康素养的下降相关。
