从正常认知到痴呆，受教育程度与淀粉样蛋白沉积之间的关系：一项荟萃分析

IF 2.9 Q3 NEUROSCIENCES

IBRO Neuroscience Reports Pub Date : 2025-06-12 DOI:10.1016/j.ibneur.2025.05.010

Fatemeh Sedghi , Elaheh Foroughi , Farzad Sheikhzadeh , Mahya Ahmadpour Youshanlui , Ata Akhtari Kohnehshahri , Omid Karimzadeh , Sayedeh-Fatemeh Sadat-Madani , Hani Ghadri , Peyman Parhiz , Amirhesam Amirbeyk , Shaghayegh Afshari , Yegane Ebrahimnia , Mahsa Soleimanzadeh , Mahsa Asadi Anar , Parviz Aghaei Borzabad , Niloofar Deravi

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引用次数: 0

摘要

背景,目的受教育程度是影响神经退行性疾病患者认知恢复能力的关键因素。然而，在认知衰退的不同阶段，它与淀粉样蛋白沉积的关系尚不清楚。本系统综述和荟萃分析旨在调查从认知正常到诊断为阿尔茨海默病（AD）或轻度认知障碍（MCI）的个体的教育背景与淀粉样蛋白积累之间的相关性。方法于2025年1月对PubMed、Scopus和b谷歌Scholar进行了全面的文献检索，以确定教育程度与淀粉样蛋白沉积之间关系的观察性研究。如果研究报告了这种关系的相关数据，则纳入研究；综述、介入性研究和结果报告不充分的研究被排除在外。使用RStudio（版本4.3.1）分析数据，根据异质性程度采用随机效应或固定效应模型。效应量用Pearson相关系数(r)表示。在最初确定的6988份记录中，有4项队列研究符合纳入标准，包括来自加拿大和日本的288名参与者。meta分析显示，MCI患者的受教育程度与淀粉样蛋白沉积之间存在显著正相关（r = 0.34,95 % CI[0.05, 0.63]），但存在显著异质性（I²= 86 %,p <； 0.01）。相反，在AD患者中发现了负相关（r = -0.16,95 % CI[-0.28, - 0.03]），异质性最小（I²= 0.0 %,p = 0.8101）。漏斗图分析显示没有显著的发表偏倚证据。结论：这些发现提示教育程度与淀粉样蛋白积累之间存在阶段依赖关系：高等教育与MCI患者的淀粉样蛋白沉积有关，但与AD患者的淀粉样蛋白负担减少有关。这种模式支持认知储备假说，该假说认为教育可能会加强代偿性神经机制，延缓痴呆症状的临床发作。然而，存在实质性的异质性和有限的样本量需要进一步的纵向研究来阐明潜在的因果途径，并为痴呆症预防提供有针对性的策略。

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Association between educational attainment and amyloid deposition across the spectrum from normal cognition to dementia: A meta-analysis

Background & Aim

Educational attainment has been proposed as a critical factor influencing cognitive resilience in the face of neurodegenerative diseases. However, its relationship with amyloid deposition across different stages of cognitive decline remains unclear. This systematic review and meta-analysis aimed to investigate the correlation between educational background and amyloid accumulation in individuals ranging from cognitively normal to those diagnosed with Alzheimer’s disease (AD) or mild cognitive impairment (MCI).

Methods

A comprehensive literature search was conducted in January 2025 across PubMed, Scopus, and Google Scholar to identify observational studies examining the association between educational attainment and amyloid deposition. Studies were included if they reported relevant data on this relationship; reviews, interventional studies, and those with insufficient outcome reporting were excluded. Data were analyzed using RStudio (version 4.3.1), employing random-effects or fixed-effects models based on the degree of heterogeneity. Effect sizes were expressed as Pearson’s correlation coefficients (r).

Results

Out of 6988 initially identified records, four cohort studies met the inclusion criteria, comprising a total of 288 participants from Canada and Japan. Meta-analysis revealed a significant positive correlation between educational attainment and amyloid deposition among individuals with MCI (r = 0.34, 95 % CI [0.05, 0.63]), although substantial heterogeneity was observed (I² = 86 %, p < 0.01). In contrast, an inverse association was found in patients with AD (r = -0.16, 95 % CI [-0.28, −0.03]), with minimal heterogeneity (I² = 0.0 %, p = 0.8101). Funnel plot analyses indicated no significant evidence of publication bias.

Conclusion

These findings suggest a stage-dependent relationship between educational attainment and amyloid accumulation: higher education is associated with greater amyloid deposition in individuals with MCI, but with reduced amyloid burden in those with AD. This pattern supports the cognitive reserve hypothesis, which posits that education may bolster compensatory neural mechanisms, delaying the clinical onset of dementia symptoms. However, the presence of substantial heterogeneity and the limited sample size call for further longitudinal research to elucidate underlying causal pathways and inform targeted strategies for dementia prevention.

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