无痴呆症老年人的终身认知储备、阿尔茨海默病相关血浆生物标志物与认知功能之间的关联：一项基于人群的研究。

Associations between lifelong cognitive reserve, Alzheimer's disease-related plasma biomarkers, and cognitive function in dementia-free older adults: A population-based study.

作者信息

Han Xiaojuan, Li Yuanjing, Wang Jiafeng, Liu Xinyu, Zhang Yu, Dong Qiwei, Song Yiming, Cong Lin, Zhang Qinghua, Tang Shi, Song Lin, Hou Tingting, Wang Yongxiang, Du Yifeng, Qiu Chengxuan

机构信息

Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China.

Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China.

出版信息

J Alzheimers Dis. 2025 Feb;103(3):821-832. doi: 10.1177/13872877241306448. Epub 2025 Jan 10.

DOI:10.1177/13872877241306448

PMID:39791378

Abstract

BACKGROUND

Cognitive reserve (CR), typically measured through socio-behavioral proxies, can partially explain better cognitive performance despite underlying brain aging or neuropathology.

OBJECTIVE

To examine the associations of CR with mild cognitive impairment (MCI) and cognitive function while considering Alzheimer's disease (AD)-related plasma biomarkers.

METHODS

This population-based cross-sectional study included 4706 dementia-free individuals from MIND-China. Data on AD-related plasma biomarkers were available for 1204 individuals. A composite CR score was generated by integrating education, occupational complexity, mental activity, and social support, using structural equation modeling. A neuropsychological test battery was used to assess the function of episodic memory, executive function, attention, and verbal fluency. MCI and subtypes of MCI were defined according to the Petersen's criteria. Data were analyzed using general linear and logistic regression models.

RESULTS

Controlling for AD-related plasma biomarkers, higher educational attainment was associated with better performance in all four examined cognitive domains (p < 0.001) and with lower likelihoods of MCI, amnestic MCI (aMCI), and non-aMCI (p < 0.05); late-life mental activity was significantly related to lower likelihoods of MCI and aMCI (p < 0.05). Midlife occupation and late-life social support were not significantly associated with MCI or subtypes (p > 0.05). Higher composite CR scores were related to better performance in all the examined cognitive domains as well as lower likelihoods of MCI, aMCI, and non-aMCI (p < 0.05).

CONCLUSIONS

Greater composite CR, derived from the CR indicators across different stages of the lifespan, is associated with better cognitive function independent of AD-related plasma biomarkers, driven mainly by early-life educational attainment.

摘要

背景

认知储备（CR）通常通过社会行为指标来衡量，尽管存在潜在的脑老化或神经病理学改变，但它可以部分解释更好的认知表现。

目的

在考虑阿尔茨海默病（AD）相关血浆生物标志物的情况下，研究CR与轻度认知障碍（MCI）及认知功能之间的关联。

方法

这项基于人群的横断面研究纳入了来自中国MIND研究的4706名无痴呆个体。1204名个体有AD相关血浆生物标志物的数据。使用结构方程模型，综合教育程度、职业复杂性、心理活动和社会支持生成一个复合CR分数。使用一套神经心理测试来评估情景记忆、执行功能、注意力和语言流畅性的功能。MCI及其亚型根据彼得森标准定义。使用一般线性和逻辑回归模型分析数据。

结果

在控制了AD相关血浆生物标志物后，较高的教育程度与所有四个被检查认知领域的更好表现相关（p < 0.001），并且与MCI、遗忘型MCI（aMCI）和非遗忘型MCI的较低可能性相关（p < 0.05）；晚年心理活动与MCI和aMCI的较低可能性显著相关（p < 0.05）。中年职业和晚年社会支持与MCI或其亚型无显著关联（p > 0.05）。较高的复合CR分数与所有被检查认知领域的更好表现以及MCI、aMCI和非遗忘型MCI的较低可能性相关（p < 0.05）。