{"title":"认知储备在白质高信号中的作用：从认知老化到阿尔茨海默氏症。","authors":"Yu-Ruei Lin, Wei-Lu Lee, Jong-Ling Fuh","doi":"10.1002/dad2.70167","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>White matter hyperintensities (WMHs) are characteristic of Alzheimer's disease (AD), and cognitive reserve (CR) protects cognitive function. However, whether WMHs mediate the CR-cognition relationship remains unclear.</p><p><strong>Methods: </strong>Brain imaging, clinical features, and neuropsychological assessments were performed, and CR was measured using the Cognitive Reserve Index questionnaire. Bootstrap mediation analysis examined CR's role in specific cognitive functions, controlling for covariates.</p><p><strong>Results: </strong>Participants who were cognitively unimpaired (CU; <i>n</i> = 85, mean age = 68.6 ± 5.7) and who had mild cognitive impairment (MCI; <i>n</i> = 43, mean age = 71.8 ± 6.5) or AD (<i>n</i> = 61, mean age = 72.8 ± 6.2) were included. CR was positively associated with global and non-memory cognitive functions in the CU and MCI groups. In the CU group, WMHs served as a mediator between CR and global cognitive ability.</p><p><strong>Discussion: </strong>CR may maintain the optimal cognitive function by mitigating the WMH burden independently of AD-related brain changes.</p><p><strong>Highlights: </strong>Cognitive reserve (CR) positively links to non-memory cognition.Cognitive reserve mitigates white matter hyperintensities to preserve cognition.Cognitive reserve primarily protects cognition in pre-Alzheimer's stages.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70167"},"PeriodicalIF":4.4000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373489/pdf/","citationCount":"0","resultStr":"{\"title\":\"The role of cognitive reserve in white matter hyperintensities: from cognitive aging to Alzheimer's spectrum.\",\"authors\":\"Yu-Ruei Lin, Wei-Lu Lee, Jong-Ling Fuh\",\"doi\":\"10.1002/dad2.70167\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>White matter hyperintensities (WMHs) are characteristic of Alzheimer's disease (AD), and cognitive reserve (CR) protects cognitive function. However, whether WMHs mediate the CR-cognition relationship remains unclear.</p><p><strong>Methods: </strong>Brain imaging, clinical features, and neuropsychological assessments were performed, and CR was measured using the Cognitive Reserve Index questionnaire. Bootstrap mediation analysis examined CR's role in specific cognitive functions, controlling for covariates.</p><p><strong>Results: </strong>Participants who were cognitively unimpaired (CU; <i>n</i> = 85, mean age = 68.6 ± 5.7) and who had mild cognitive impairment (MCI; <i>n</i> = 43, mean age = 71.8 ± 6.5) or AD (<i>n</i> = 61, mean age = 72.8 ± 6.2) were included. CR was positively associated with global and non-memory cognitive functions in the CU and MCI groups. In the CU group, WMHs served as a mediator between CR and global cognitive ability.</p><p><strong>Discussion: </strong>CR may maintain the optimal cognitive function by mitigating the WMH burden independently of AD-related brain changes.</p><p><strong>Highlights: </strong>Cognitive reserve (CR) positively links to non-memory cognition.Cognitive reserve mitigates white matter hyperintensities to preserve cognition.Cognitive reserve primarily protects cognition in pre-Alzheimer's stages.</p>\",\"PeriodicalId\":53226,\"journal\":{\"name\":\"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring\",\"volume\":\"17 3\",\"pages\":\"e70167\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2025-08-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373489/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/dad2.70167\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/dad2.70167","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
白质高强度（WMHs）是阿尔茨海默病（AD）的特征，认知储备（CR）保护认知功能。然而，WMHs是否介导cr -认知关系尚不清楚。方法：采用脑成像、临床特征和神经心理评估，并采用认知储备指数问卷测量CR。Bootstrap中介分析检验了CR在特定认知功能中的作用，控制了协变量。结果：纳入了认知功能未受损（CU; n = 85，平均年龄= 68.6±5.7）和轻度认知功能受损（MCI; n = 43，平均年龄= 71.8±6.5）或AD （n = 61，平均年龄= 72.8±6.2）的参与者。在CU和MCI组中，CR与整体和非记忆认知功能呈正相关。在CU组中，WMHs在CR和整体认知能力之间起中介作用。讨论：CR可能通过减轻WMH负担而独立于ad相关的大脑变化来维持最佳认知功能。重点：认知储备（CR）与非记忆认知呈正相关。认知储备减轻白质高强度以保持认知。认知储备主要保护阿尔茨海默病前期的认知能力。
The role of cognitive reserve in white matter hyperintensities: from cognitive aging to Alzheimer's spectrum.
Introduction: White matter hyperintensities (WMHs) are characteristic of Alzheimer's disease (AD), and cognitive reserve (CR) protects cognitive function. However, whether WMHs mediate the CR-cognition relationship remains unclear.
Methods: Brain imaging, clinical features, and neuropsychological assessments were performed, and CR was measured using the Cognitive Reserve Index questionnaire. Bootstrap mediation analysis examined CR's role in specific cognitive functions, controlling for covariates.
Results: Participants who were cognitively unimpaired (CU; n = 85, mean age = 68.6 ± 5.7) and who had mild cognitive impairment (MCI; n = 43, mean age = 71.8 ± 6.5) or AD (n = 61, mean age = 72.8 ± 6.2) were included. CR was positively associated with global and non-memory cognitive functions in the CU and MCI groups. In the CU group, WMHs served as a mediator between CR and global cognitive ability.
Discussion: CR may maintain the optimal cognitive function by mitigating the WMH burden independently of AD-related brain changes.
Highlights: Cognitive reserve (CR) positively links to non-memory cognition.Cognitive reserve mitigates white matter hyperintensities to preserve cognition.Cognitive reserve primarily protects cognition in pre-Alzheimer's stages.
期刊介绍：
Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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