Guan Dylan X, Mortby Moyra E, Pike G Bruce, Ballard Clive, Creese Byron, Corbett Anne, Pickering Ellie, Hampshire Adam, Roach Pamela, Smith Eric E, Ismail Zahinoor
Graduate Science Education University of Calgary Calgary Canada.
Hotchkiss Brain Institute University of Calgary Calgary Canada.
Alzheimers Dement (N Y). 2024 Oct 4;10(4):e12497. doi: 10.1002/trc2.12497. eCollection 2024 Oct.
Changes to the brain due to Alzheimer's disease and other age-related neuropathologies may present with cognitive and behavioral symptoms, even during preclinical and prodromal stages. While cognitive reserve is known to mitigate cognitive decline in the preclinical stages of Alzheimer's disease, links between cognitive reserve and behavioral symptoms remain unclear. This study investigates the relationship between cognitive reserve and mild behavioral impairment (MBI), a neurodegenerative behavioral prodrome.
We analyzed cross-sectional data from 1204 participants in the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behavior, Function, and Caregiving in Aging (CAN-PROTECT) study. A cognitive reserve score (CRS) was generated based on education, occupation, and personal cognitive reserve proxies. MBI presence (MBI+) and MBI global and domain symptom severity were evaluated using the self-reported MBI Checklist. Initial analyses examined the convergent validity of the CRS through associations with objective neuropsychological test performance and self-reported cognitive symptoms (Everyday Cognition [ECog-II] scale). Models were also fitted to assess MBI status and severity as functions of the CRS.
Higher CRS was associated with better neuropsychological test scores, lower odds of subjective cognitive decline (OR = 0.86, 95% CI: [0.76, 0.98], = .03), and lower ECog-II total score. Likewise, higher CRS was associated with lower odds of MBI+ (OR = 0.81, 95% CI: [0.71, 0.93], = .003), and lower MBI symptom severity globally, and in impulse dyscontrol and social inappropriateness domains.
We provide preliminary evidence that engagement in activities known to preserve cognitive function in aging and disease may also preserve behavioral function. Future research should disentangle possible pathways through which cognitive reserve may preserve both cognition and behavior, explore common etiologies for these symptoms, and observe outcomes longitudinally to better understand these relationships.
Education, occupation, and personal activities are cognitive reserve proxies.Cognitive reserve is linked to lower subjective cognitive decline in older persons.Cognitive reserve is linked to lower mild behavioral impairment odds and severity.
阿尔茨海默病和其他与年龄相关的神经病理学导致的大脑变化，即使在临床前和前驱期，也可能表现为认知和行为症状。虽然已知认知储备可减轻阿尔茨海默病临床前阶段的认知衰退，但认知储备与行为症状之间的联系仍不清楚。本研究调查了认知储备与轻度行为损害（MBI）（一种神经退行性行为前驱症状）之间的关系。
我们分析了加拿大在线健康、生活质量、认知、行为、功能和衰老护理研究平台（CAN-PROTECT）中1204名参与者的横断面数据。基于教育程度、职业和个人认知储备指标生成了认知储备分数（CRS）。使用自我报告的MBI清单评估MBI的存在情况（MBI+）以及MBI的总体和各领域症状严重程度。初步分析通过与客观神经心理学测试表现和自我报告的认知症状（日常认知[ECog-II]量表）的关联，检验了CRS的收敛效度。还建立了模型来评估MBI状态和严重程度作为CRS的函数。
较高的CRS与更好的神经心理学测试分数、较低的主观认知衰退几率（OR = 0.86，95%CI：[0.76, 0.98]，P =.03）以及较低的ECog-II总分相关。同样，较高的CRS与较低的MBI+几率（OR = 0.81，95%CI：[0.71, 0.93]，P =.003）以及总体上较低的MBI症状严重程度，以及冲动控制障碍和社交不适当领域的较低严重程度相关。
我们提供了初步证据，表明参与已知可在衰老和疾病中保持认知功能的活动，也可能保持行为功能。未来的研究应理清认知储备可能保持认知和行为的潜在途径，探索这些症状的共同病因，并进行纵向观察以更好地理解这些关系。
教育程度、职业和个人活动是认知储备指标。认知储备与老年人较低的主观认知衰退有关。认知储备与较低的轻度行为损害几率和严重程度有关。
