Dylan X. Guan, Moyra E. Mortby, G Bruce Pike, Clive Ballard, Byron Creese, Anne Corbett, Ellie Pickering, Adam Hampshire, Pamela Roach, Eric E. Smith, Zahinoor Ismail
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引用次数: 0
摘要
导言阿尔茨海默氏症和其他与年龄相关的神经病理学引起的大脑变化可能会表现出认知和行为症状，甚至在临床前和前驱阶段也是如此。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能力下降，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障碍（MBI）之间的关系，轻度行为障碍是一种神经退行性行为前驱症状：我们分析了 "加拿大老年健康、生活质量、认知、行为、功能和护理在线研究平台"（CAN-PROTECT）研究中 1204 名参与者的横断面数据。根据教育程度、职业和个人认知储备代用指标生成了认知储备评分（CRS）。使用自我报告的 MBI 检查表对 MBI 存在（MBI+）以及 MBI 整体和领域症状严重程度进行评估。初步分析通过与客观神经心理测试成绩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的收敛有效性。此外，还拟合了模型，以评估作为 CRS 函数的 MBI 状态和严重程度：结果：较高的 CRS 与较好的神经心理测试成绩、较低的主观认知能力下降几率（OR = 0.86，95% CI：[0.76, 0.98]，p = .03）和较低的 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）、较低的总体MBI症状严重程度以及冲动控制障碍和社交不当领域的症状严重程度相关：讨论：我们提供的初步证据表明，参与已知能在衰老和疾病中保护认知功能的活动也能保护行为功能。未来的研究应厘清认知储备保护认知和行为的可能途径，探索这些症状的共同病因，并对结果进行纵向观察，以更好地理解这些关系：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障碍几率和严重程度有关。
Linking cognitive and behavioral reserve: Evidence from the CAN-PROTECT study
INTRODUCTION
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.
METHODS
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.
RESULTS
Higher CRS was associated with better neuropsychological test scores, lower odds of subjective cognitive decline (OR = 0.86, 95% CI: [0.76, 0.98], p = .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], p = .003), and lower MBI symptom severity globally, and in impulse dyscontrol and social inappropriateness domains.
DISCUSSION
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.
Highlights
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.
期刊介绍：
Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.
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