1
|
Gaynor AM, Gazes Y, Haynes CR, Babukutty RS, Habeck C, Stern Y, Gu Y. Childhood engagement in cognitively stimulating activities moderates relationships between brain structure and cognitive function in adulthood. Neurobiol Aging 2024; 138:36-44. [PMID: 38522385 DOI: 10.1016/j.neurobiolaging.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/26/2024]
Abstract
Greater engagement in cognitively stimulating activities (CSA) during adulthood has been shown to protect against neurocognitive decline, but no studies have investigated whether CSA during childhood protects against effects of brain changes on cognition later in life. The current study tested the moderating role of childhood CSA in the relationships between brain structure and cognitive performance during adulthood. At baseline (N=250) and 5-year follow-up (N=204) healthy adults aged 20-80 underwent MRI to assess four structural brain measures and completed neuropsychological tests to measure three cognitive domains. Participants were categorized into low and high childhood CSA based on self-report questionnaires. Results of multivariable linear regressions analyzing interactions between CSA, brain structure, and cognition showed that higher childhood CSA was associated with a weaker relationship between cortical thickness and memory at baseline, and attenuated the effects of change in cortical thickness and brain volume on decline in processing speed over time. These findings suggest higher CSA during childhood may mitigate the effects of brain structure changes on cognitive function later in life.
Collapse
Affiliation(s)
- Alexandra M Gaynor
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Montclair State University, Department of Psychology, Montclair, NJ, United States
| | - Yunglin Gazes
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | - Caleb R Haynes
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States
| | - Reshma S Babukutty
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States
| | - Christian Habeck
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | - Yaakov Stern
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Yian Gu
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States; Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, United States.
| |
Collapse
|
2
|
Chen H, Hu J, Gui S, Li Q, Wang J, Yang X, Yang J. Longitudinal validation of cognitive reserve proxy measures: a cohort study in a rural Chinese community. Alzheimers Res Ther 2024; 16:87. [PMID: 38654379 DOI: 10.1186/s13195-024-01451-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND While evidence supports cognitive reserve (CR) in preserving cognitive function, longitudinal validation of CR proxies, including later-life factors, remains scarce. This study aims to validate CR's stability over time and its relation to cognitive function in rural Chinese older adults. METHODS Within the project on the health status of rural older adults (HSRO), the survey included baseline assessment (2019) and follow-up assessment (2022). 792 older adults (mean age: 70.23 years) were followed up. The confirmatory factor analysis (CFA) was constructed using cognitive reserve proxies that included years of formal education, social support, hobbies, and exercise. We examined the longitudinal validity of the CR factor using confirmatory factor analyses and measurement invariance and explored the association of CR with cognition using Spearman's correlation and Generalized Estimating Equations (GEE). RESULTS The results showed that CR's CFA structure was stable over time (T0, χ2/df: 3.21/2; RMSEA: 0.02, and T1, χ2/df: 7.47/2; RMSEA: 0.05) and that it accepted both configural and metric invariance (Δχ2/df = 2.28/3, P = 0.52). In addition, it was found that CR had a stable positive relationship with cognitive function across time (T0, r = 0.54; T1, r = 0.49). Furthermore, longitudinal CR were associated with MMSE (β = 2.25; 95%CI = 2.01 ~ 2.49). CONCLUSIONS This study provided valuable evidence on the stability and validity of cognitive reserve proxy measures in rural Chinese older adults. Our findings suggested that cognitive reserve is associated with cognitive function over time and highlighted the importance of accumulating cognitive reserve in later life.
Collapse
Affiliation(s)
- Hao Chen
- Department of Epidemiology and Health Statistics, School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Guizhou Medical University, Guiyang, China
- The Third People's Hospital of Guizhou Province, Guiyang, China
| | - Jin Hu
- Department of Epidemiology and Health Statistics, School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Guizhou Medical University, Guiyang, China
| | - Shiqi Gui
- Department of Epidemiology and Health Statistics, School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Guizhou Medical University, Guiyang, China
| | - Qiushuo Li
- Department of Epidemiology and Health Statistics, School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Guizhou Medical University, Guiyang, China
| | - Jing Wang
- Department of Epidemiology and Health Statistics, School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Guizhou Medical University, Guiyang, China
| | - Xing Yang
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
| | - Jingyuan Yang
- Department of Epidemiology and Health Statistics, School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Guizhou Medical University, Guiyang, China.
| |
Collapse
|
3
|
Devita M, Debiasi G, Anglani M, Ceolin C, Mazzonetto I, Begliomini C, Cauzzo S, Raffaelli C, Lazzarin A, Ravelli A, Bordignon A, De Rui M, Sergi G, Bertoldo A, Mapelli D, Coin A. The Role of Cognitive Reserve in Protecting Cerebellar Volumes of Older Adults with mild Cognitive Impairment. Cerebellum 2024:10.1007/s12311-024-01695-w. [PMID: 38639874 DOI: 10.1007/s12311-024-01695-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 04/20/2024]
Abstract
The present study aims to investigate the relationship between cerebellar volumes and cognitive reserve in individuals with Mild Cognitive Impairment (MCI). A description of proxies of cerebellar cognitive reserve in terms of different volumes across lobules is also provided. 36 individuals with MCI underwent neuropsychological (MoCA, MMSE, Clock test, CRIq) assessment and neuroimaging acquisition with magnetic resonance imaging at 3 T. Simple linear correlations were applied between cerebellar volumes and cognitive measures. Multiple linear regression models were then used to estimate standardized regression coefficients and 95% confidence intervals. Simple linear correlations between cerebellar lobules volumes and cognitive features highlighted a significant association between CRIq_Working activity and specific motor cerebellar volumes: Left_V (ρ = 0.40, p = 0.02), Right_V (r = 0.42, p = 0.002), Vermis_VIIIb (ρ = 0.47, p = 0.003), Left_X (ρ = -0.46, p = 0.002) and Vermis_X (r = 0.35, p = 0.03). Furthermore, CRIq_Working activity scores correlated with certain cerebellar lobules implicated in cognition: Left_Crus_II, Vermis VIIb, Left_IX. MMSE was associated only with the Right_VIIB volume (r = 0.35, p = 0.02), while Clock Drawing Test scores correlated with both Left_Crus_I and Right_Crus_I (r = -0.42 and r = 0.42, p = 0.02, respectively). This study suggests that a higher cognitive reserve is associated with specific cerebellar lobule volumes and that Working activity may play a predominant role in this association. These findings contribute to the understanding of the relationship between cerebellar volumes and cognitive reserve, highlighting the potential modulatory role of Working activity on cerebellum response to cognitive decline.
Collapse
Affiliation(s)
- Maria Devita
- Department of General Psychology (DPG), University of Padua, Via Venezia 8, Padua, Italy.
- Geriatrics Unit, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, Padua, Italy.
| | - Giulia Debiasi
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, Padua, Italy
- Department of Information Engineering, University of Padua, Via Gardenigo 6/B, Padua, Italy
| | - Mariagiulia Anglani
- Neuroradiology Unit, University Hospital of Padua, Via Giustiniani 2, Padua, Italy
| | - Chiara Ceolin
- Geriatrics Unit, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, Padua, Italy
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Aging Research Center, Stockholm, Sweden
| | - Ilaria Mazzonetto
- Department of Information Engineering, University of Padua, Via Gardenigo 6/B, Padua, Italy
| | - Chiara Begliomini
- Department of General Psychology (DPG), University of Padua, Via Venezia 8, Padua, Italy
| | - Simone Cauzzo
- Parkinson's Disease and Movement Disorders Unit, Center for Rare Neurological Diseases, Department of Neurosciences, University of Padova, Via Belzoni 160, Padua, Italy
| | - Cecilia Raffaelli
- Geriatrics Unit, Ospedale Fracastoro, Via Circonvallazione 1, San Bonifacio, Verona, Italy
| | - Alessandro Lazzarin
- Geriatrics Unit, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, Padua, Italy
| | - Adele Ravelli
- Geriatrics Unit, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, Padua, Italy
| | | | - Marina De Rui
- Geriatrics Unit, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, Padua, Italy
| | - Giuseppe Sergi
- Geriatrics Unit, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, Padua, Italy
| | - Alessandra Bertoldo
- Department of Information Engineering, University of Padua, Via Gardenigo 6/B, Padua, Italy
- Padova Neuroscience Center, University of Padua, Via Orus 2/B, Padua, Italy
| | - Daniela Mapelli
- Department of General Psychology (DPG), University of Padua, Via Venezia 8, Padua, Italy
| | - Alessandra Coin
- Geriatrics Unit, Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, Padua, Italy
| |
Collapse
|
4
|
Jiskoot LC, van den Berg E, Vollebergh H, de Haan R, de Boer L, Poos JM, Franzen S, van Hemmen J, Seelaar H. Occupational differences in a Dutch sample of patients with primary progressive aphasia, behavioral variant frontotemporal dementia, and Alzheimer's dementia. Appl Neuropsychol Adult 2024:1-7. [PMID: 38615690 DOI: 10.1080/23279095.2024.2339514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
BACKGROUND Cognitive reserve is a potential mechanism to cope with brain damage as a result of dementia, which can be defined by indirect proxies, including education level, leisure time activities, and occupational attainment. In this study we explored the association between dementia diagnosis and type of occupation in a retrospective Dutch outpatient memory clinic sample of patients with primary progressive aphasia (PPA), behavioral variant frontotemporal dementia (bvFTD), and Alzheimer's Dementia (AD). METHODS We included data from 427 patients (bvFTD n = 87, PPA n = 148, AD n = 192) and compared the frequency of occupations (11 categories) between patients and data from the Dutch census using Pearson Χ2 tests and we calculated odds ratios (OR) by means of multinomial logistic regression analyses. We also investigated patient group differences in age, sex, education, disease duration, and global cognition. RESULTS The frequency of teachers in patients with PPA was significantly higher than the frequency of teachers in patients with bvFTD [OR = 4.79, p = .007] and AD [OR = 2.04, p = .041]. The frequency of teachers in patients with PPA (16%) was also significantly higher than the frequency of teachers in the Dutch census [5.3%; OR = 3.27, p < .001]. The frequency of teachers in both bvFTD and AD groups were not significantly different from the frequency of teachers in the Dutch census (p = .078 and p = .513, respectively). CONCLUSIONS A potential explanation for our results is the so called "wear and tear" hypothesis, suggesting that teachers have a communication-wise demanding occupation - and therefore are at higher risk to develop PPA. Alternatively, teaching requires continuous communication, hence teachers are more sensitive to subtle changes in their speech and language abilities. Our findings broaden our understanding of the relationship between occupational activity and cognitive reserve in the development of dementia.
Collapse
Affiliation(s)
- Lize C Jiskoot
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Esther van den Berg
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Hannah Vollebergh
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Romy de Haan
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Liset de Boer
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jackie M Poos
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sanne Franzen
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Judy van Hemmen
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
5
|
Ma H, Shi Z, Kim M, Liu B, Smith PJ, Liu Y, Wu G. Disentangling sex-dependent effects of APOE on diverse trajectories of cognitive decline in Alzheimer's disease. Neuroimage 2024; 292:120609. [PMID: 38614371 DOI: 10.1016/j.neuroimage.2024.120609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/15/2024] Open
Abstract
Current diagnostic systems for Alzheimer's disease (AD) rely upon clinical signs and symptoms, despite the fact that the multiplicity of clinical symptoms renders various neuropsychological assessments inadequate to reflect the underlying pathophysiological mechanisms. Since putative neuroimaging biomarkers play a crucial role in understanding the etiology of AD, we sought to stratify the diverse relationships between AD biomarkers and cognitive decline in the aging population and uncover risk factors contributing to the diversities in AD. To do so, we capitalized on a large amount of neuroimaging data from the ADNI study to examine the inflection points along the dynamic relationship between cognitive decline trajectories and whole-brain neuroimaging biomarkers, using a state-of-the-art statistical model of change point detection. Our findings indicated that the temporal relationship between AD biomarkers and cognitive decline may differ depending on the synergistic effect of genetic risk and biological sex. Specifically, tauopathy-PET biomarkers exhibit a more dynamic and age-dependent association with Mini-Mental State Examination scores (p<0.05), with inflection points at 72, 78, and 83 years old, compared with amyloid-PET and neurodegeneration (cortical thickness from MRI) biomarkers. In the landscape of health disparities in AD, our analysis indicated that biological sex moderates the rate of cognitive decline associated with APOE4 genotype. Meanwhile, we found that higher education levels may moderate the effect of APOE4, acting as a marker of cognitive reserve.
Collapse
Affiliation(s)
- Haixu Ma
- Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Zhuoyu Shi
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Minjeong Kim
- Department of Computer Science, University of North Carolina at Greensboro, NC 27412, USA
| | - Bin Liu
- Department of Statistics and Data Science, School of Management at Fudan University, Shanghai, 200433, PR China
| | - Patrick J Smith
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Yufeng Liu
- Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, NC 27599, USA; Department of Genetics, Department of Biostatistics, University of North Carolina at Chapel Hill, NC 27599, USA.
| | - Guorong Wu
- Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, NC 27599, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, NC 27599, USA; Department of Computer Science, University of North Carolina at Chapel Hill, NC 27599, USA; UNC Neuroscience Center, University of North Carolina at Chapel Hill, NC 27599, USA.
| |
Collapse
|
6
|
Saywell I, Foreman L, Child B, Phillips-Hughes AL, Collins-Praino L, Baetu I. Influence of cognitive reserve on cognitive and motor function in α-synucleinopathies: A systematic review and multilevel meta-analysis. Neurosci Biobehav Rev 2024; 161:105672. [PMID: 38608829 DOI: 10.1016/j.neubiorev.2024.105672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
Cognitive reserve has shown promise as a justification for neuropathologically unexplainable clinical outcomes in Alzheimer's disease. Recent evidence suggests this effect may be replicated in conditions like Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy. However, the relationships between cognitive reserve and different cognitive abilities, as well as motor outcomes, are still poorly understood in these conditions. Additionally, it is unclear whether the reported effects are confounded by medication. This review analysed studies investigating the relationship between cognitive reserve and clinical outcomes in these α-synucleinopathy cohorts, identified from MEDLINE, Scopus, psycINFO, CINAHL, and Web of Science. 85 records, containing 176 cognition and 31 motor function effect sizes, were pooled using multilevel meta-analysis. There was a significant, positive association between higher cognitive reserve and both better cognition and motor function. Cognition effect sizes differed by disease subtype, cognitive reserve measure, and outcome type; however, no moderators significantly impacted motor function. Review findings highlight the clinical implications of cognitive reserve and importance of engaging in reserve-building behaviours.
Collapse
Affiliation(s)
- Isaac Saywell
- School of Psychology, University of Adelaide, Adelaide 5005, Australia.
| | - Lauren Foreman
- School of Psychology, University of Adelaide, Adelaide 5005, Australia
| | - Brittany Child
- School of Psychology, University of Adelaide, Adelaide 5005, Australia
| | | | | | - Irina Baetu
- School of Psychology, University of Adelaide, Adelaide 5005, Australia.
| |
Collapse
|
7
|
Tan CH, Tan JJX. Associations of cardiac function and arterial stiffness with cerebrovascular disease. Int J Cardiol 2024:132037. [PMID: 38604451 DOI: 10.1016/j.ijcard.2024.132037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND White matter hyperintensities (WMHs) represent diffuse small vessel disease implicating the cardiac, systemic, and cerebral vasculatures. As the brain may be the end-organ of cumulative vascular disease, and higher education is protective of both cardiovascular and brain health, we aim to clarify their intertwining relationships. METHODS We evaluated participants (mean age = 64) from the UK Biobank with neuroimaging measures of WMHs, left ventricular ejection fraction (LVEF) quantified using cardiovascular MRI, and arterial stiffness index (ASI) quantified using finger photoplethysmography. We used multiple regression to evaluate the basic, independent, and interactive relationships of LVEF status (n = 27,512) and ASI (n = 33,584) with WMHs. Moderated mediation analysis was used to determine whether the relationship between LVEF status and WMH was mediated by ASI and moderated by education. RESULTS Abnormal LVEF (β = -0.082, p < 0.001) and higher ASI (β = 0.02, p < 0.001) were associated with greater WMHs separately and independently, but not interactively. Moderated mediation analyses revealed that the relationship between abnormal LVEF and WMH was mediated by ASI, for individuals with lower education (β = -0.004, p < 0.001). Abnormal LVEF was associated with lower cortical thickness in 16 predominantly frontotemporal and select parietal regions (FDR, q < 0.05). CONCLUSIONS Cardiovascular dysfunction is associated with regional cerebral atrophy and may precipitate cerebrovascular disease via stiffening of systemic vasculatures, particularly for individuals with lower education. Integrative approaches to study biophysiological vascular systems can elucidate the complex interplay between biological and social determinants of brain and cerebrovascular health.
Collapse
Affiliation(s)
- Chin Hong Tan
- Department of Psychology, Nanyang Technological University, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
| | - Jacinth J X Tan
- School of Social Sciences, Singapore Management University, Singapore, Singapore
| |
Collapse
|
8
|
Doyle C, Andel R, Saenz J, Crowe M. Correlates of SuperAging in Two Population-Based Samples of Hispanic Older Adults. J Gerontol B Psychol Sci Soc Sci 2024:gbae058. [PMID: 38581241 DOI: 10.1093/geronb/gbae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVES 'SuperAgers' are generally defined as people 80+ years old with episodic memory performance comparable to those 20 years younger. Limited knowledge exists to describe characteristics of SuperAgers, with even less known about Hispanic SuperAgers. METHODS We examined indicators of cognitive, physical, and psychological resilience in relation to the likelihood of being a SuperAger using data from two population-based studies of Hispanic older adults [Puerto Rican Elder: Health Conditions (PREHCO) study; Health and Retirement Study (HRS)]. SuperAgers were defined as 1) ≥80 years old, 2) recall scores ≥ the median for Hispanic respondents aged 55-64, and 3) no cognitive impairment during the observation period. Overall, 640 PREHCO participants and 180 HRS participants were eligible, of whom 45 (7%) and 31 (17%) met SuperAging criteria. RESULTS Logistic regressions controlling for age and sex demonstrated that higher education (PREHCO: odds ratio[OR]=1.20, p<.001; HRS: OR=1.14, p=.044) and fewer instrumental activities of daily living (IADL) limitations (PREHCO: OR=0.79, p=.019; HRS: OR=0.58, p=.077) (cognitive resilience), fewer activities of daily living (ADL) limitations (PREHCO: OR=0.72, p=.031; HRS: OR=0.67, p=.068) (physical resilience), and fewer depressive symptoms (PREHCO: OR=0.84, p=.015; HRS: OR=0.69, p=.007) (psychological resilience) were associated with SuperAging, although not all results reached threshold for statistical significance, presumably due to low statistical power. Additionally, known indicators of physical health (e.g., chronic conditions, self-rated health) did not relate to SuperAging. DISCUSSION Increasing access to education and recognizing/treating depressive symptoms represent potential pathways to preserve episodic memory among older Hispanic adults.
Collapse
Affiliation(s)
- Cassidy Doyle
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Ross Andel
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Joseph Saenz
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Michael Crowe
- University of Alabama at Birmingham, Department of Psychology, Birmingham, Alabama
| |
Collapse
|
9
|
Dodge HH, Yu K, Wu CY, Pruitt PJ, Asgari M, Kaye JA, Hampstead BM, Struble L, Potempa K, Lichtenberg P, Croff R, Albin RL, Silbert LC. Internet-Based Conversational Engagement Randomized Controlled Clinical Trial (I-CONECT) Among Socially Isolated Adults 75+ Years Old With Normal Cognition or Mild Cognitive Impairment: Topline Results. The Gerontologist 2024; 64:gnad147. [PMID: 37935416 PMCID: PMC10943511 DOI: 10.1093/geront/gnad147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Social isolation is a risk factor for cognitive decline and dementia. We conducted a randomized controlled clinical trial (RCT) of enhanced social interactions, hypothesizing that conversational interactions can stimulate brain functions among socially isolated older adults without dementia. We report topline results of this multisite RCT (Internet-based conversational engagement clinical trial [I-CONECT]; NCT02871921). RESEARCH DESIGN AND METHODS The experimental group received cognitively stimulating semistructured conversations with trained interviewers via internet/webcam 4 times per week for 6 months (induction) and twice per week for an additional 6 months (maintenance). The experimental and control groups both received weekly 10 minutes telephone check-ins. Protocol modifications were required due to the coronavirus disease 2019 pandemic. RESULTS A total of 186 participants were randomized. After the induction period, the experimental group had higher global cognitive test scores (Montreal Cognitive Assessment [primary outcome]; 1.75 points [p = .03]) compared with the control group. After induction, experimental group participants with normal cognition had higher language-based executive function (semantic fluency test [secondary outcome]; 2.56 points [p = .03]). At the end of the maintenance period, the experimental group of mild cognitive impairment subjects had higher encoding function (Craft Story immediate recall test [secondary outcome]; 2.19 points [p = .04]). Measure of emotional well-being improved in both control and experimental groups. Resting-state functional magnetic resonance imaging showed that the experimental group had increased connectivity within the dorsal attention network relative to the control group (p = .02), but the sample size was limited. DISCUSSION AND IMPLICATIONS Providing frequent stimulating conversational interactions via the internet could be an effective home-based dementia risk-reduction strategy against social isolation and cognitive decline. CLINICAL TRIALS REGISTRATION NUMBER NCT02871921.
Collapse
Affiliation(s)
- Hiroko H Dodge
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
| | - Kexin Yu
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- Layton Aging and Alzheimer's Disease Center, Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Chao-Yi Wu
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
| | - Patrick J Pruitt
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Meysam Asgari
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - Jeffrey A Kaye
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- Layton Aging and Alzheimer's Disease Center, Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Benjamin M Hampstead
- Michigan Alzheimer's Disease Center, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- Research Program on Cognition and Neuromodulation Based Interventions, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Laura Struble
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Kathleen Potempa
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Peter Lichtenberg
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Raina Croff
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- Layton Aging and Alzheimer's Disease Center, Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Roger L Albin
- Michigan Alzheimer's Disease Center, Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- GRECC & Neurology Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Lisa C Silbert
- Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, Oregon, USA
- VA Portland Healthcare System, Portland, Oregon, USA
| |
Collapse
|
10
|
Terrier C, Greco-Vuilloud J, Cavelius M, Thevenet M, Mandairon N, Didier A, Richard M. Long-term olfactory enrichment promotes non-olfactory cognition, noradrenergic plasticity and remodeling of brain functional connectivity in older mice. Neurobiol Aging 2024; 136:133-156. [PMID: 38364691 DOI: 10.1016/j.neurobiolaging.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/18/2024]
Abstract
Brain functional and structural changes lead to cognitive decline during aging, but a high level of cognitive stimulation during life can improve cognitive performances in the older adults, forming the cognitive reserve. Noradrenaline has been proposed as a molecular link between environmental stimulation and constitution of the cognitive reserve. Taking advantage of the ability of olfactory stimulation to activate noradrenergic neurons of the locus coeruleus, we used repeated olfactory enrichment sessions over the mouse lifespan to enable the cognitive reserve buildup. Mice submitted to olfactory enrichment, whether started in early or late adulthood, displayed improved olfactory discrimination at late ages and interestingly, improved spatial memory and cognitive flexibility. Moreover, olfactory and non-olfactory cognitive performances correlated with increased noradrenergic innervation in the olfactory bulb and dorsal hippocampus. Finally, c-Fos mapping and connectivity analysis revealed task-specific remodeling of functional neural networks in enriched older mice. Long-term olfactory enrichment thus triggers structural noradrenergic plasticity and network remodeling associated with better cognitive aging and thereby forms a promising mouse model of the cognitive reserve buildup.
Collapse
Affiliation(s)
- Claire Terrier
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, NEUROPOP, F-69500, Bron, France
| | - Juliette Greco-Vuilloud
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, NEUROPOP, F-69500, Bron, France
| | - Matthias Cavelius
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, NEUROPOP, F-69500, Bron, France
| | - Marc Thevenet
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, NEUROPOP, F-69500, Bron, France
| | - Nathalie Mandairon
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, NEUROPOP, F-69500, Bron, France
| | - Anne Didier
- Institut universitaire de France (IUF), France
| | - Marion Richard
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, NEUROPOP, F-69500, Bron, France.
| |
Collapse
|
11
|
Mashinchi GM, McFarland CP, Hall S, Strongin DL, Williams GA, Cotter KA. Handicraft art leisure activities and cognitive reserve. Clin Neuropsychol 2024; 38:683-714. [PMID: 37674299 DOI: 10.1080/13854046.2023.2253993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023]
Abstract
ObjectiveOlder individuals face a higher likelihood of developing dementia. The rate of cognitive decline resulting from dementia is not equivalent for all, as some patients with dementia are able to function independently longer than others, despite having similar disease burden. The cognitive reserve (CR) theory provides one explanation for the differing rate of decline. CR suggests that there are factors-most notably, educational attainment and occupational attainment-that can protect against the cognitive decline. Although the beneficial effects of these notable CR factors are clear, not all are easily modifiable. Participation in leisure activities may represent a more easily modifiable factor. Some research hints at beneficial effects of leisure activities, although specific leisure activities have not been well examined. The present study examined the relations between handicraft art leisure activities (HALAs) and multiple cognitive domains. MethodArchival WAIS-IV and demographic data for 50 California retirement community residents were examined. ResultsHALA participation accounted for statistically significant variance in working memory performance (R2 = .40, β = .24%) over and above the established CR factors of age, depression, educational attainment, and occupational attainment. In addition, HALA participation was related to a better ability to perform abstract visual information tasks (Block Design subtest, r = .28, p = .05) and non-verbal reasoning tasks (Visual Puzzles subtest, r = .38, p = .008). ConclusionsHALA participation among older adults could contribute to the retention of cognitive function, supporting the role of HALA participation as a CR factor.
Collapse
|
12
|
Moutoussamy I, Taconnat L, Angel L, Pothier K, Toussaint L, Fay S. Protective effects of physical activity on episodic memory during aging are explained by executive functioning. Eur Rev Aging Phys Act 2024; 21:7. [PMID: 38461251 PMCID: PMC10924320 DOI: 10.1186/s11556-024-00341-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/04/2024] [Indexed: 03/11/2024] Open
Abstract
Aging is marked by a memory decline related to an executive function decline. Physical activity (PA) has beneficial effects on both executive functions and memory, especially in aging. The protective effects of PA on these two cognitive abilities have always been studied separately, despite the well-established relationship between memory and executive functions. Our objective was to explore whether the benefits of PA on memory could be explained by reduced age-related changes in executive functions.Nineteen young adults (27.16 years old) and 25 older adults (69.64 years old) performed a resource-dependent memory task, three executive tasks and completed a PA questionnaire (measuring sports and leisure PA). Age group and PA effects on memory and executive performance were analyzed with generalized linear models. Mediation analyses were calculated using method of causal steps approach with a non-parametric bootstrapping procedure.The results confirmed the effects of age and PA on memory and executive performance. A significant interaction confirmed the protective effect of PA on age-related cognitive performance. PA was positively correlated with performance in both memory and executive tasks, but only in the older adults. Although each predictor alone (age, executive functions and PA) significantly explained memory performance in older adults, only the effect of PA on memory performance remained significant when all the predictors were introduced in the analyses.PA mediates the effects of age and executive functions on memory performance. This suggests that PA protects older adults against memory decline by reducing the decline in executive functioning.
Collapse
Affiliation(s)
- Ilona Moutoussamy
- Département de Psychologie, Centre de Recherches Sur La Cognition Et L'Apprentissage (UMR-CNRS, Université de Tours Et de Poitiers, Centre National de La Recherche Scientifique, 37000, Tours, France, 3 rue des Tanneurs.
- Département de Psychologie, Psychologie Des Âges de La Vie Et Adaptation (EA 2114), Université de Tours, Tours, France.
| | - Laurence Taconnat
- Département de Psychologie, Centre de Recherches Sur La Cognition Et L'Apprentissage (UMR-CNRS, Université de Tours Et de Poitiers, Centre National de La Recherche Scientifique, 37000, Tours, France, 3 rue des Tanneurs
| | - Lucie Angel
- Département de Psychologie, Centre de Recherches Sur La Cognition Et L'Apprentissage (UMR-CNRS, Université de Tours Et de Poitiers, Centre National de La Recherche Scientifique, 37000, Tours, France, 3 rue des Tanneurs
| | - Kristell Pothier
- Département de Psychologie, Psychologie Des Âges de La Vie Et Adaptation (EA 2114), Université de Tours, Tours, France
| | - Lucette Toussaint
- Département Des Sciences du Sport, Centre de Recherches Sur La Cognition Et L'Apprentissage (UMR-CNRS 7295), Université de Tours Et de Poitiers, Centre National de La Recherche Scientifique, Poitiers, France
| | - Séverine Fay
- Département de Psychologie, Centre de Recherches Sur La Cognition Et L'Apprentissage (UMR-CNRS, Université de Tours Et de Poitiers, Centre National de La Recherche Scientifique, 37000, Tours, France, 3 rue des Tanneurs
| |
Collapse
|
13
|
Zhang H, Cao P, Mak HKF, Hui ES. The structural-functional-connectivity coupling of the aging brain. GeroScience 2024:10.1007/s11357-024-01106-2. [PMID: 38443539 DOI: 10.1007/s11357-024-01106-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/30/2024] [Indexed: 03/07/2024] Open
Abstract
Aging primarily affects memory and executive functions, a relationship that may be underpinned by the fact that almost all adults over 60 years old develop small vessel disease (SVD). The fact that a wide range of neuropathologies could only explain up to 43% of the variation in age-related cognitive impairment suggests that other factors, such as cognitive reserve, may play a role in the brain's resilience against aging-related cognitive decline. This study aims to examine the relationship between structural-functional-connectivity coupling (SFC), and aging, cognitive abilities and reserve, and SVD-related neuropathologies using a cohort of n = 176 healthy elders from the Harvard Aging Brain Study. The SFC is a recently proposed biomarker that reflects the extent to which anatomical brain connections can predict coordinated neural activity. After controlling for the effect of age, sex, and years of education, global SFC, as well as the intra-network SFC of the dorsolateral somatomotor and dorsal attention networks, and the inter-network SFC between dorsolateral somatomotor and frontoparietal networks decreased with age. The global SFC decreased with total cognitive score. There were significant interaction effects between years of education versus white matter hyperintensities and between years of education versus cerebral microbleeds on inter-network SFC. Enlarged perivascular space in basal ganglia was associated with higher inter-network SFC. Our results suggest that cognitive ability is associated with brain coupling at the global level and cognitive reserve with brain coupling at the inter-functional-brain-cluster level with interaction effect from white matter hyperintensities and cerebral microbleed in a cohort of healthy elderlies.
Collapse
Affiliation(s)
- Hui Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute for Intelligent Wearable Systems, The Hong Kong Polytechnic University, Hong Kong, China
| | - Peng Cao
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
| | - Henry K F Mak
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
- Alzheimer's Disease Research Network, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Edward S Hui
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China.
- CU Lab for AI in Radiology (CLAIR), The Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
14
|
Levin F, Grothe MJ, Dyrba M, Franzmeier N, Teipel SJ. Longitudinal trajectories of cognitive reserve in hypometabolic subtypes of Alzheimer's disease. Neurobiol Aging 2024; 135:26-38. [PMID: 38157587 DOI: 10.1016/j.neurobiolaging.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/16/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
Previous studies have demonstrated resilience to AD-related neuropathology in a form of cognitive reserve (CR). In this study we investigated a relationship between CR and hypometabolic subtypes of AD, specifically the typical and the limbic-predominant subtypes. We analyzed data from 59 Aβ-positive cognitively normal (CN), 221 prodromal Alzheimer's disease (AD) and 174 AD dementia participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) from ADNI and ADNIGO/2 phases. For replication, we analyzed data from 5 Aβ-positive CN, 89 prodromal AD and 43 AD dementia participants from ADNI3. CR was estimated as standardized residuals in a model predicting cognition from temporoparietal grey matter volumes and covariates. Higher CR estimates predicted slower cognitive decline. Typical and limbic-predominant hypometabolic subtypes demonstrated similar baseline CR, but the results suggested a faster decline of CR in the typical subtype. These findings support the relationship between subtypes and CR, specifically longitudinal trajectories of CR. Results also underline the importance of longitudinal analyses in research on CR.
Collapse
Affiliation(s)
- Fedor Levin
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany.
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Martin Dyrba
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Stefan J Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| |
Collapse
|
15
|
Stöffel T, Vaqué-Alcázar L, Bartrés-Faz D, Peró-Cebollero M, Cañete-Massé C, Guàrdia-Olmos J. Reduced default mode network effective connectivity in healthy aging is modulated by years of education. Neuroimage 2024; 288:120532. [PMID: 38331332 DOI: 10.1016/j.neuroimage.2024.120532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/20/2024] [Accepted: 02/06/2024] [Indexed: 02/10/2024] Open
Abstract
Aging is a major risk factor for neurodegenerative diseases like dementia and Alzheimer's disease. Even in non-pathological aging, decline in cognitive functioning is observed in the majority of the elderly population, necessitating the importance of studying the processes involved in healthy aging in order to identify brain biomarkers that promote the conservation of functioning. The default mode network (DMN) has been of special interest to aging research due to its vulnerability to atrophy and functional decline over the course of aging. Prior work has focused almost exclusively on functional (i.e. undirected) connectivity, yet converging findings are scarce. Therefore, we set out to use spectral dynamic causal modeling to investigate changes in the effective (i.e. directed) connectivity within the DMN and to discover changes in information flow in a sample of cognitively normal adults spanning from 48 to 89 years (n = 63). Age was associated to reduced verbal memory performance. Modeling of effective connectivity revealed a pattern of age-related downregulation of posterior DMN regions driven by inhibitory connections from the hippocampus and middle temporal gyrus. Additionally, there was an observed decline in the hippocampus' susceptibility to network inputs with age, effectively disconnecting itself from other regions. The estimated effective connectivity parameters were robust and able to predict the age in out of sample estimates in a leave-one-out cross-validation. Attained education moderated the effects of aging, largely reversing the observed pattern of inhibitory connectivity. Thus, medial prefrontal cortex, hippocampus and posterior DMN regions formed an excitatory cycle of extrinsic connections related to the interaction of age and education. This suggests a compensatory role of years of education in effective connectivity, stressing a possible target for interventions. Our findings suggest a connection to the concept of cognitive reserve, which attributes a protective effect of educational level on cognitive decline in aging (Stern, 2009).
Collapse
Affiliation(s)
- Tibor Stöffel
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona 08035, Spain; Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2 (UZA II), Vienna 1090, Austria.
| | - Lídia Vaqué-Alcázar
- Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona 08036, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona 08036, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
| | - Maribel Peró-Cebollero
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona 08035, Spain; UB Institute of Complex Systems, Universitat de Barcelona, Barcelona 08028, Spain; Institute of Neurosciences, Universitat de Barcelona, Barcelona 08035, Spain
| | - Cristina Cañete-Massé
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona 08035, Spain; Institute of Neurosciences, Universitat de Barcelona, Barcelona 08035, Spain
| | - Joan Guàrdia-Olmos
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona 08035, Spain; UB Institute of Complex Systems, Universitat de Barcelona, Barcelona 08028, Spain; Institute of Neurosciences, Universitat de Barcelona, Barcelona 08035, Spain
| |
Collapse
|
16
|
Jiménez-Morales RM, Broche-Pérez Y, Macías-Delgado Y, Sebrango C, Díaz-Díaz S, Castiñeira-Rodriguez R, Pérez-González FJ, Forn C. Cognitive rehabilitation program in patients with multiple sclerosis: A pilot study. Neurologia 2024; 39:135-146. [PMID: 38460992 DOI: 10.1016/j.nrleng.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/24/2021] [Indexed: 03/11/2024] Open
Abstract
INTRODUCTION In recent years, there has been an increase of studies dedicated to cognitive rehabilitation in patients with multiple sclerosis (MS); however, few of these analyze the impact on such variables as cognitive reserve. The study aims to explore the effects of a cognitive rehabilitation program comprising a combination of cognitive and physical exercises, as well as group sessions to improve cognitive performance, emotional state, and cognitive reserve index. METHOD Fifty patients with MS were subdivided into 2 groups: the control group, which performed aerobic exercise (n=25), and the experimental group (n=25), which participated in the integrated cognitive rehabilitation program (ICRP). All participants were evaluated 3 times (baseline, post-treatment, and long-term) with the Brief Repeatable Battery of Neuropsychological Tests, Cognitive Reserve Scale, Beck Depression Inventory, and a scale evaluating trait and state anxiety. RESULTS Compared with the control group, patients in the experimental group showed improvements in cognitive function, with significant changes in measures of information processing speed, attention, memory, cognitive reserve index, and long-term mood. CONCLUSIONS The ICRP was effective in improving cognitive and emotional function in MS, and increased the cognitive reserve index.
Collapse
Affiliation(s)
- R M Jiménez-Morales
- Physical Medicine and Rehabilitation Department, Rehabilitation Hospital Dr. Faustino Pérez Hernández, Sancti Spíritus, Cuba; Center for Studies in Educational Sciences, José Martí University of Sancti Spíritus, Cuba.
| | - Y Broche-Pérez
- Psychology Department, Universidad Central "Marta Abreu" de Las Villas, Cuba
| | - Y Macías-Delgado
- Psychology Department, University of Medical Sciences Dr. Fustino Pérez Hernández, de Sancti Spíritus, Cuba
| | - C Sebrango
- Center for Studies Energy and Industrial, José Martí University of Sancti Spíritus, Cuba
| | - S Díaz-Díaz
- Physical Medicine and Rehabilitation Department, Rehabilitation Hospital Dr. Faustino Pérez Hernández, Sancti Spíritus, Cuba
| | - R Castiñeira-Rodriguez
- Physical Medicine and Rehabilitation Department, Rehabilitation Hospital Dr. Faustino Pérez Hernández, Sancti Spíritus, Cuba
| | - F J Pérez-González
- Center for Studies in Educational Sciences, José Martí University of Sancti Spíritus, Cuba
| | - C Forn
- Psicología Bàsica, Clínica i Psicobiología Depatment, Universitat Jaume I, Spain
| |
Collapse
|
17
|
Maggi G, Altieri M, Risi M, Rippa V, Borgo RM, Sacco R, Buonanno D, D'Ambrosio A, Bisecco A, Santangelo G, Gallo A. Vocabulary knowledge as a reliable proxy of cognitive reserve in multiple sclerosis: a validation study. Neurol Sci 2024:10.1007/s10072-024-07388-w. [PMID: 38418663 DOI: 10.1007/s10072-024-07388-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/04/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION The present study aimed to explore the suitability of the vocabulary knowledge (VOC) test as an accurate and reliable proxy of cognitive reserve (CR) by evaluating its psychometric properties and discrimination accuracy compared with other CR measures in multiple sclerosis (MS). METHODS Sixty-eight consecutive people with multiple sclerosis (pwMS), followed at our MS outpatient clinic, completed a clinical evaluation and neuropsychological assessment including: VOC, Brief Repeatable Battery of Neuropsychological Tests (BRB-N), Cognitive Reserve Index Questionnaire (CRIq), Beck Depression Inventory-II, and State-Trait Anxiety Inventory. Reliability, convergent and divergent validity, and discrimination accuracy of the VOC were assessed using educational level as reference standard. The possible effects of sociodemographic and clinical factors on VOC and their role in predicting global cognitive status were also explored. RESULTS VOC demonstrated good internal consistency (Cronbach's α = 0.894) and adequate construct validity. It showed an acceptable level of discrimination between pwMS with high and low CR, comparable to the CRIq score. Education strongly affected VOC scores, which in turn were independent of MS features. VOC emerged as an independent predictor of global cognitive status together with MS-related disability. CONCLUSION We demonstrated the validity of VOC as a reliable CR measure in pwMS. Thus, CR may also be estimated using fixed objective measures, independent of brain pathology and clinical features. Early CR estimation may help clinicians identify pwMS at a higher risk of cognitive decline and plan strict neuropsychological monitoring and cognitive interventions.
Collapse
Affiliation(s)
- Gianpaolo Maggi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Manuela Altieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
| | - Mario Risi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valentina Rippa
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Riccardo Maria Borgo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rosaria Sacco
- Department of Neurology, Neurocenter of Southern Switzerland (NSI), Regional Hospital of Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Daniela Buonanno
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro D'Ambrosio
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alvino Bisecco
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Antonio Gallo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
18
|
Megari K, Kosmidis MH. Protecting the Brain While Healing Hearts: The Protective Role of Cognitive Reserve in Cardiac Surgery. Am J Geriatr Psychiatry 2024; 32:195-204. [PMID: 37926673 DOI: 10.1016/j.jagp.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/23/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE One of the most significant complications following coronary artery bypass grafting (CABG) is postoperative cognitive decline (POCD). CABG patients frequently experience considerable postoperative cognitive dysfunction (POCD), including decline in attention, orientation, memory, judgment, and social functioning. DESIGN These negative effects may potentially be resolved by a protective factor, cognitive reserve (CR) that has been considered to function as a buffer against the consequences of neuropathology. SETTING We explored the frequency of POCD and CR in coronary artery disease patients undergoing CABG. We hypothesized that high levels of CR would protect against POCD after cardiac surgery. PARTICIPANTS We assessed 101 patients before surgery, and 4 months after cardiopulmonary bypass surgery with the use of extracorporeal circulation. MEASUREMENTS Measures of cognitive functions, CR, anxiety, and depression were included in the assessment. RESULTS Each patient was placed in the high (n = 50) or low CR (n = 51) group, based on median split. Chi-square tests effect showed that patients with low CR were more likely to a great extend to demonstrate postsurgical cognitive decline in attention, memory, visuospatial perception and executive functions than patients with high CR upon postsurgery neuropsychological assessment. CONCLUSIONS Our results suggest that CR can forecast neuropsychological outcomes of cardiac surgery, recognizing the patients with low CR and help them to participate to interventions programs that could slow cognitive aging or reduce the risk of dementia and enhance their overall postsurgical functional outcome.
Collapse
Affiliation(s)
- Kalliopi Megari
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| |
Collapse
|
19
|
Aravena JM, Lee J, Schwartz AE, Nyhan K, Wang SY, Levy BR. Beneficial Effect of Societal Factors on APOE-ε2 and ε4 Carriers' Brain Health: A Systematic Review. J Gerontol A Biol Sci Med Sci 2024; 79:glad237. [PMID: 37792627 PMCID: PMC10803122 DOI: 10.1093/gerona/glad237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Apolipoprotein-E (APOE) ε4 and ε2 are the most prevalent risk-increasing and risk-reducing genetic predictors of Alzheimer's disease, respectively. However, the extent to which societal factors can reduce the harmful impact of APOE-ε4 and enhance the beneficial impact of APOE-ε2 on brain health has not yet been examined systematically. METHODS To fill this gap, we conducted a systematic review searching for studies in MEDLINE, Embase, PsycINFO, and Scopus until June 2023, that included: (a) 1 of 5 social determinants of health (SDH) identified by Healthy People 2030, (b) APOE-ε2 or APOE-ε4 allele carriers, (c) cognitive or brain-biomarker outcomes, and (d) studies with an analysis of how APOE-ε2 and/ or APOE-ε4 carriers differ on outcomes when exposed to SDH. RESULTS From 14 076 articles retrieved, 124 met the inclusion criteria. In most of the studies, exposure to favorable SDH reduced APOE-ε4's detrimental effect and enhanced APOE-ε2's beneficial effect on cognitive and brain-biomarker outcomes (cognition: 70.5%, n: 74/105; brain-biomarkers: 71.4%, n: 20/28). A similar pattern of results emerged in each of the 5 Healthy People 2030 SDH categories, where finishing high school, having resources to satisfy basic needs, less air pollution, less negative external stimuli that can generate stress (eg, negative age stereotypes), and exposure to multiple favorable SDH were associated with better cognitive and brain health among APOE-ε4 and APOE-ε2 carriers. CONCLUSIONS Societal factors can reduce the harmful impact of APOE-ε4 and enhance the beneficial impact of APOE-ε2 on cognitive outcomes. This suggests that plans to reduce dementia should include community-level policies promoting favorable SDH.
Collapse
Affiliation(s)
- José M Aravena
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Jakyung Lee
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of South Korea
| | - Anna E Schwartz
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Kate Nyhan
- Cushing/Whitney Medical Library, Department of Environmental Health Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Shi-Yi Wang
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Becca R Levy
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| |
Collapse
|
20
|
da Silva SP, de Castro CCM, Rabelo LN, Engelberth RC, Fernández-Calvo B, Fiuza FP. Neuropathological and sociodemographic factors associated with the cortical amyloid load in aging and Alzheimer's disease. GeroScience 2024; 46:621-643. [PMID: 37870702 PMCID: PMC10828279 DOI: 10.1007/s11357-023-00982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia and is characterized by a progressive decline in cognitive abilities. A pathological hallmark of AD is a region-specific accumulation of the amyloid-beta protein (Aβ). Here, we explored the association between regional Aβ deposition, sociodemographic, and local biochemical factors. We quantified the Aβ burden in postmortem cortical samples from parietal (PCx) and temporal (TCx) regions of 27 cognitively unimpaired (CU) and 15 AD donors, aged 78-100 + years. Histological images of Aβ immunohistochemistry and local concentrations of pathological and inflammatory proteins were obtained at the "Aging, Dementia and TBI Study" open database. We used the area fraction fractionator stereological methodology to quantify the Aβ burden in the gray and white matter within each cortical region. We found higher Aβ burdens in the TCx of AD octogenarians compared to CU ones. We also found higher Aβ loads in the PCx of AD nonagenarians than in AD octogenarians. Moreover, AD women exhibited increased Aβ deposition compared to CU women. Interestingly, we observed a negative correlation between education years and Aβ burden in the white matter of both cortices in CU samples. In AD brains, the Aβ40, Aβ42, and pTau181 isoforms of Aβ and Tau proteins were positively correlated with the Aβ burden. Additionally, in the TCx of AD donors, the proinflammatory cytokine TNFα showed a positive correlation with the Aβ load. These novel findings contribute to understanding the interplay between sociodemographic characteristics, local inflammatory signaling, and the development of AD-related pathology in the cerebral cortex.
Collapse
Affiliation(s)
- Sayonara P da Silva
- Graduate Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, RN, 59280-000, Brazil
| | - Carla C M de Castro
- Graduate Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, RN, 59280-000, Brazil
| | - Lívia N Rabelo
- Graduate Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, RN, 59280-000, Brazil
- Laboratory of Neurochemical Studies, Department of Physiology and Behavior, Biosciences Center, Federal University of Rio Grande Do Norte, Natal, Brazil
| | - Rovena C Engelberth
- Laboratory of Neurochemical Studies, Department of Physiology and Behavior, Biosciences Center, Federal University of Rio Grande Do Norte, Natal, Brazil
| | - Bernardino Fernández-Calvo
- Department of Psychology, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil
| | - Felipe P Fiuza
- Graduate Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, RN, 59280-000, Brazil.
| |
Collapse
|
21
|
Amoretti S, Anmella G, Bernardo M, Alfonso M, Hernandez C, García-Portilla MP, González-Blanco L, Safont G, Garrido I, Sanchez-Autet M, Arranz B. Impact of cognitive reserve in clinical, neurocognitive and lifestyle factors in chronic schizophrenia and early stages of schizophrenia. Span J Psychiatry Ment Health 2024:S2950-2853(24)00010-3. [PMID: 38218376 DOI: 10.1016/j.sjpmh.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/20/2023] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Although there is evidence that higher cognitive reserve (CR) is a protective factor and it has been related to better prognosis, there have been no studies to date that have explored the CR level and its impact in clinical, neurocognitive and lifestyle outcomes according to the stage of the disease: early stage of psychosis (ESP) or chronic schizophrenia (SCZ). MATERIAL AND METHODS A total of 60 patients in the ESP and 225 patients with SCZ were enrolled in the study. To test the predictive capacity of CR for each diagnostic group, a logistic regression analysis was conducted. Hierarchical linear regression analyses were performed to explore the associations between CR and different outcomes. The mediation analyses were performed according to the principles of Baron and Kenny. RESULTS Patients with SCZ showed lower CR than those in the ESP (p<0.001). CR correctly classified 79.6% of the cases (p<0.001; Exp(B)=1.062). In ESP group, CR was related to working memory (p=0.030) and negative symptoms (p=0.027). CR (t=3.925, p<0.001) and cannabis use (t=2.023, p=0.048) explained 26.7% of the variance on functioning (p=0.003). In patients with SCZ, CR predicted all cognitive domains, negative symptoms (R2=0.091, p=0.001) and functioning (R2=0.074, p=0.005). In both ESP and SCZ groups, higher CR was associated with lower body mass index and circumference. In ESP group, the effect of adherence to Mediterranean diet on functioning (p=0.037) was mediated by CR level (p=0.003). CONCLUSIONS The implications of CR depend on the stage of the disease (ESP vs. SCZ), with a greater effect on neurocognition and negative symptoms in patients with chronic SCZ.
Collapse
Affiliation(s)
- Silvia Amoretti
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Biomedical Research Networking Center for Mental Health Network (CIBERSAM), ISCIII, Barcelona, Catalonia, Spain; Departament de Medicina, Institut de Neurociències (UBNeuro), Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Universitat de Barcelona (UB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Gerard Anmella
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Universitat de Barcelona (UB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Miquel Bernardo
- Departament de Medicina, Institut de Neurociències (UBNeuro), Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain.
| | - Miqueu Alfonso
- Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain
| | | | - María Paz García-Portilla
- Department of Psychiatry, Universidad de Oviedo, Spain; CIBERSAM, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Leticia González-Blanco
- Department of Psychiatry, Universidad de Oviedo, Spain; CIBERSAM, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Gemma Safont
- Hospital Universitari Mútua Terrassa, CIBERSAM, Spain
| | | | | | - Belén Arranz
- Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain
| |
Collapse
|
22
|
Ayton A, Hicks AJ, Spitz G, Ponsford J. The utility of the Cognitive Reserve Index questionnaire in chronic traumatic brain injury. Clin Neuropsychol 2024; 38:182-201. [PMID: 37035985 DOI: 10.1080/13854046.2023.2196441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 03/23/2023] [Indexed: 04/11/2023]
Abstract
Objective: This study examined the relationship between cognitive reserve measured with the Cognitive Reserve Index questionnaire (CRIq) and cognitive and functional outcomes in a chronic traumatic brain injury (TBI) cohort compared to a non-TBI cohort. The utility of the CRIq was compared to common proxies of cognitive reserve (premorbid IQ and years of education) in TBI and non-TBI cohorts. Method: Participants were 105 individuals with moderate-severe TBI (10-33 years post injury) and 91 participants without TBI. Cognitive outcome was examined across four cognitive factors; verbal memory, visual ability and memory, executive attention, and episodic memory. Functional outcome was measured using the Glasgow Outcome Scale Extended. The CRIq total score and three subscale scores (education, work, leisure) were examined. Results: In the TBI cohort, associations were identified between two CRIq subscales and cognitive factors (CRIq education and verbal memory; CRIq work and executive attention). There were no associations between CRIq leisure and cognitive outcomes, or between CRIq and functional outcome. Model selection statistics suggested premorbid IQ and years of education provided a better fit than the CRIq for the relationship between cognitive reserve with two cognitive factors and functional outcome, with neither model providing an improved fit for the remaining two cognitive factors. This finding was broadly consistent in the non-TBI cohort. Conclusion: Cognitive reserve contributes significantly to long-term clinical outcomes following moderate-severe TBI. The relationship between cognitive reserve and long-term cognitive and functional outcomes following TBI is best characterised with traditional proxies of cognitive reserve, mainly premorbid IQ, rather than the CRIq.
Collapse
Affiliation(s)
- Amber Ayton
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Amelia J Hicks
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Gershon Spitz
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
23
|
Gomes LR, Damasceno BP, de Campos BM, Damasceno A. Impairment of daily occupations in multiple sclerosis: analysis of neuroimaging, general and social cognition, and reserve. Mult Scler Relat Disord 2024; 81:105140. [PMID: 37988860 DOI: 10.1016/j.msard.2023.105140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Multiple Sclerosis (MS) can impact performance of daily occupations in both relapsing-remitting (RRMS) and secondary-progressive (SPMS) clinical courses. Work force participation decreases with advancing physical disability but the influence of non-motor factors, neuroimaging, and reserve have been scarcely investigated. We aimed to evaluate MRI, clinical, and cognitive (social and general) factors associated with impairment in different daily occupations and address whether cognitive and brain reserve have a positive impact on the ability to maintain these activities. METHODS We prospectively enrolled persons with MS (PwMS) who underwent clinical examination (Expanded Disability Status Scale - EDSS; Timed 25-Foot Walk Test - T25FW; and the Nine Hole Peg Test - 9HPT), general neuropsychological assessment (Brief Repeatable Battery of Neuropsychological Tests - BRBN, including the Symbol Digit Modalities Test - SDMT), social cognition evaluation (Reading the Mind in the Eyes Test), cognitive reserve questionnaire, and MRI (FreeSurfer). We also enrolled healthy subjects for comparison as a control group. Daily occupations (employment, money management, and driving abilities) were assessed in all individuals with questionnaires. RESULTS We included 62 PwMS (32 RRMS and 30 SPMS; mean age 42.8 years; median educational time 12.75 years) and 67 controls (mean age 39.7; median educational time 12.0 years) which were similar regarding demographics, education, and socioeconomic status (p > 0.1). Most PwMS (67.7%) had work-restrictions. They also reported fewer money management and driving abilities than controls (p < 0.001). Work-restriction was associated with physical disability (p = 0.006), SDMT and BRBN performance (p = 0.035 and p = 0.031, respectively), and T2-lesion volume (p = 0.022), with large effect sizes (d > 0.75). After hierarchical linear regression, money management was associated with hand dexterity, general and social cognition, and cognitive reserve (p < 0.03). Variables associated with driving abilities included fatigue, verbal fluency, striatum volume, and brain reserve (p < 0.05). CONCLUSIONS PwMS have more frequent work-restrictions and impairment in money management and driving abilities compared to controls. Cognitive function, physical disability, and MS-lesion burden are strongly associated with work-restriction. Social cognition can also influence financial capacity. Cognitive and brain reserve can help retain some of these daily occupations.
Collapse
Affiliation(s)
| | | | | | - Alfredo Damasceno
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil; Neuroimaging Laboratory, University of Campinas (UNICAMP), Campinas, Brazil.
| |
Collapse
|
24
|
Pinto JO, Peixoto B, Dores AR, Barbosa F. Measures of cognitive reserve: An umbrella review. Clin Neuropsychol 2024; 38:42-115. [PMID: 37073431 DOI: 10.1080/13854046.2023.2200978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/04/2023] [Indexed: 04/20/2023]
Abstract
Objective: Recently, there has been a growing interest in operationalizing and measuring cognitive reserve (CR) for clinical and research purposes. This umbrella review aims to summarize the existing systematic and meta-analytic reviews about measures of CR. Method: A literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the guidelines of Aromataris et al. (2015) to identify the systematic reviews and meta-analysis involving the assessment of CR. The methodological quality of the papers included in this umbrella review was assessed with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) and Specialist Unit for Review Evidence (SURE). Results: Thirty-one reviews were identified, sixteen of which were systematic reviews, and fifteen were meta-analyses. Most of the reviews had a critically low quality, according to AMSTAR-2. The reviews included between two and 135 studies. Most of the papers focused on older adults, mainly those with dementia. CR was measured using one to six proxies, but most considered each proxy separately. The most assessed proxies of CR were education on its own, combined with occupation and/or engagement in activities or combined with parental education, bilingualism, and engagement in activities when four CR proxies were studied. Most of the studies included in higher quality reviews focused on three proxies, with education and engagement in activities being the most evaluated using CR questionnaires. Conclusion: Despite the growing interest in measuring CR, its operationalization did not improve since the last umbrella review in this field.
Collapse
Affiliation(s)
- Joana O Pinto
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- CESPU, University Institute of Health Sciences, Gandra, Portugal
| | - Bruno Peixoto
- CESPU, University Institute of Health Sciences, Gandra, Portugal
- NeuroGen - Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Artemisa R Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| |
Collapse
|
25
|
Morrow SA, Balusha AAK, Rosehart H, Casserly C, Racosta JM. Does multilingualism act as a protective factor ( cognitive reserve) against cognitive impairment in multiple sclerosis?: A retrospective cohort study. Mult Scler Relat Disord 2023; 80:105060. [PMID: 37866025 DOI: 10.1016/j.msard.2023.105060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 09/09/2023] [Accepted: 10/07/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Cognitive impairment (CI) is common in multiple sclerosis (MS), affecting half of persons with MS (PwMS). Cognitive reserve has been associated with delaying the onset and slowing the progression of CI in PwMS. Multilingualism has been demonstrated to be a protective factor against CI in Alzheimer's disease (AD) but has never been studied in PwMS. OBJECTIVE To explore if multilingualism is a protective factor against CI in PwMS. METHODS This is a retrospective cohort study of PwMS aged 18-59, with a confirmed diagnosis of relapsing MS, fluent in English, who completed the Minimal Assessment of Cognitive Function in MS (MACFIMS) at the London (ON) MS Clinic. Any PwMS with a history of dementia or developmental delay, daily marijuana use, a major psychiatric disorder, or less than grade 9 education was excluded. We focused on the Brief Visuospatial Memory Test (BVMTR), immediate recall (-IR) and delayed recall (-DR) as it would be the least affected by language, as well as the Symbol Digit Modalities Test (SDMT), as information processing speed is the most commonly affected domain in PwMS. One-way ANOVA was used to compare raw scores on the BVMTR and SDMT between groups (uni- vs. multillingual), while chi-square was used to compare impairment on BVMTR and SDMT between groups. RESULTS The cohort consisted of 678 subjects. The mean age was 39.7 (± 9.6) years with 501 (73.9 %) females (sex at birth), the mean duration of disease of 5.9 (± 6.9) years, and mean years of education was 13.9 (±2.2). The majority of subjects (563, 83 %) were unilingual and (115, 17 %) were multilingual; 102 subjects were bilingual and 13 subjects fluent in ≥ three languages. English was the first language was in most of subjects (614, 90.6 %). There was no significant difference on the BVMTR-IR scores (p = 0.189) or BVMTR-DR (p = 0.096) between groups. Similarly, there was no difference in the number of subjects impaired on the BVMTR-IR (X2 (1, N = 678) = 3.167, p = 0.057) or BVMT-DR between groups (X2 (1, N = 678) = 2.996, p = 0.083). Further, there was no significant difference on the SDMT (p = 0.506) between groups, or in number of subjects impaired on the SDMT between groups (X2 (1, N = 678) = 1.023, p = 0.312). CONCLUSION This study shows that multilingualism does not have a protective effect against CI in PwMS and does not play a role in enriching the cognitive reserve, in contrast to studies in AD. This difference may be explained by a different underlying pathological mechanism in these diseases and warrants further study.
Collapse
Affiliation(s)
- Sarah A Morrow
- Department of Clinical Neurological Sciences, London Health Sciences Centre, University of Western Ontario (Western), London, ON Canada..
| | - Abedallah A K Balusha
- Department of Clinical Neurological Sciences, London Health Sciences Centre, University of Western Ontario (Western), London, ON Canada
| | - Heather Rosehart
- Department of Clinical Neurological Sciences, London Health Sciences Centre, University of Western Ontario (Western), London, ON Canada
| | - Courtney Casserly
- Department of Clinical Neurological Sciences, London Health Sciences Centre, University of Western Ontario (Western), London, ON Canada
| | - Juan M Racosta
- Department of Clinical Neurological Sciences, London Health Sciences Centre, University of Western Ontario (Western), London, ON Canada
| |
Collapse
|
26
|
Prosperini L, Alcamisi I, Quartuccio ME, Rossi I, Fortuna D, Ruggieri S. Brain and cognitive reserve mitigate balance dysfunction in multiple sclerosis. Neurol Sci 2023; 44:4411-4420. [PMID: 37464205 DOI: 10.1007/s10072-023-06951-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Approximately two-thirds of patients with multiple sclerosis (MS) complain different degrees of balance dysfunction, but some of them are able to withstand considerable disease burden without an overt balance impairment. Here, we tested the hypothesis that brain and cognitive reserve lessen the effect of MS-related tissue damage on balance control. METHODS We measured the postural sway of 148 patients and 74 sex- and age-matched healthy controls by force platform under different conditions reflecting diverse neuro-pathological substrates of balance dysfunction: eyes opened (EO), eyes closed (EC), and while performing the Stroop test, i.e., dual-task (DT). Lesion volumes on T2-hyperintense and T1-hypointense sequences, and normalized brain volume provided estimations of MS-related tissue damage in patients with MS. Hierarchical linear regressions explored the protective effect against the MS-related tissue damage of intracranial volume and educational attainment (proxies for brain and cognitive reserve, respectively) on balance. RESULTS Larger intracranial volume and high educational attainment mitigated the detrimental effect of MS-related tissue damage on postural sway under EO (adjusted-R2=0.20 and 0.27, respectively, p<0.01) and DT (adjusted-R2=0.22 and 0.30, respectively, p<0.06) conditions. Neither educational level nor brain size was associated with postural sway under EC condition. CONCLUSION Our findings suggest a protective role of brain and cognitive reserve even on balance, an outcome that relies on both motor control and higher order processing resources. The lack of a protective effect on postural sway under EC condition confirms that this latter outcome is closer associated with spinal cord rather than brain damage.
Collapse
Affiliation(s)
- Luca Prosperini
- Department of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy.
| | - Irene Alcamisi
- Department of Rehabilitation Sciences and Health Professions, Sapienza University, Via Cardarelli s.n.c, 01100, Viterbo, Italy
| | | | - Ilaria Rossi
- Department of Neurosciences, S. Camillo-Forlanini Hospital, C.ne Gianicolense 87, 00152, Rome, Italy
| | - Deborah Fortuna
- Azienda Sanitaria Locale di Rieti, Via del Terminillo 42, 02100, Rieti, Italy
| | - Serena Ruggieri
- Department of Human Neurosciences, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy
- Neuroimmunology Unit, Santa Lucia Foundation, Via del Fosso di Fiorano 64/65, 00143, Rome, Italy
| |
Collapse
|
27
|
Fastame MC, Brandas B, Pau M. Is Cognitive Reserve a Determinant of Functional and Mental Health in Older People of the Sardinian Blue Zone? A Mediational Approach. Psychiatr Q 2023; 94:617-632. [PMID: 37642822 PMCID: PMC10638121 DOI: 10.1007/s11126-023-10047-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
The main purpose of this study was to examine the mediating role of cognitive reserve in the relationship between functional health (expressed through the amount and intensity of performed physical activity objectively assessed using wearable accelerometers) and psychological well-being (i.e., assessed in terms of self-reported depressive signs) of older people living in an area of exceptional longevity, the so-called Sardinian Blue Zone. A further goal was to investigate the impact of gender on the cognitive reserve and physical health of our participants, using global cognitive functioning as a covariate. A battery of tests assessing motor efficiency, cognitive reserve, global cognitive functioning, and self-reported depressive symptoms was individually presented to 120 community dwellers (Mage = 82 years, SD = 8.4 years) of the Sardinian Blue Zone. Significant associations were found between cognitive reserve, motor efficiency, and self-reported depressive signs. Moreover, three mediation analyses documented that distinct indexes of cognitive reserve and motor efficiency explain 27.2-31% of the variance in the self-reported depression condition. Following this, it was also found that people with scarce cognitive reserve tended to exhibit significant signs of depression and showed worse motor abilities. In addition, after controlling for the effect of global cognitive functioning, motor efficiency, and cognitive reserve were generally more preserved in males than in females. Overall, these findings suggest that cognitive reserve is a compensatory resource that contributes significantly to the enhancement of health-related quality of life in the last decades of life.
Collapse
Affiliation(s)
- Maria Chiara Fastame
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Via Is Mirrionis 1, Cagliari, 09123, Italy.
| | - Benedetta Brandas
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Via Is Mirrionis 1, Cagliari, 09123, Italy
| | - Massimiliano Pau
- Department of Mechanical, Chemical, and Materials Engineering, University of Cagliari, Via Marengo 2, Cagliari, 09123, Italy
| |
Collapse
|
28
|
Sánchez Cabaco A, De La Torre L, Alvarez Núñez DN, Mejía Ramírez MA, Wöbbeking Sánchez M. Tele neuropsychological exploratory assessment of indicators of mild cognitive impairment and autonomy level in Mexican population over 60 years old. PEC Innov 2023; 2:100107. [PMID: 37214529 PMCID: PMC10194319 DOI: 10.1016/j.pecinn.2022.100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/07/2022] [Accepted: 11/21/2022] [Indexed: 05/24/2023]
Abstract
Due to the cognitive decline associated with aging, it is necessary to determine the variables involved in this process to implement preventive actions to avoid or help slow the progression of cognitive decline to dementia in older adults. This is a priority in the current pandemic situation, due to the consequences of periods of confinement due to COVID-19. To address these challenges, this study was conducted through Information and Communication Technologies (ICTs), by adapting an in-person assessment protocol into an online Tele neuropsychological consultation. The correlation between autonomy and cognitive performance variables is analyzed in 47 Mexican subjects over 60 years of age. The results of the statistical analyses suggest a moderate correlation between the level of autonomy and cognitive performance (with MOCA and Clock Drawing Test), significant correlation values are outlined in some of the variables reviewed, and interesting data were found in the correlation of cognitive reserve with cognitive decline and the educational level from the participants. Finally, future analysis is proposed of the sensitivity of screening tests (CDT) to find indicators of Mild Cognitive Impairment (MCI) in this population that is not detected in classical tests (MOCA). Developing ICT-based screening protocols for the elderly may be a key tool in these coronavirus times or under any given circumstances.
Collapse
|
29
|
Fisher A, Moore DJ, Levine AJ, Masliah E, Gouaux B, Soontornniyomkij V, Letendre S, Sundermann EE. The relationship between synaptodendritic neuropathology and HIV-associated neurocognitive disorders is moderated by cognitive reserve. J Neurovirol 2023; 29:713-722. [PMID: 37943478 DOI: 10.1007/s13365-023-01177-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/23/2023] [Accepted: 09/21/2023] [Indexed: 11/10/2023]
Abstract
We examined whether cognitive reserve moderated the relationship between neurodegeneration and cognition in 67 postmortem persons with HIV (PWH) who were cognitively assessed within 1 year of death. Cognitive reserve was measured via the Wide Range Achievement Test-4 reading subtest (WRAT4). Synaptodendritic neurodegeneration was based on densities of synaptophysin and microtubule-associated protein 2 immunohistochemical reactivity in frontal cortex, and categorized as minimal, moderate, or severe (tertile-split). T-Scores from 15 cognitive tests were averaged into a global cognitive T-score. Among those with low cognitive reserve (based on WRAT4 median split), the moderate neurodegeneration group showed cognition that was poorer than the minimal neurodegeneration group and comparable to the severe neurodegeneration group. Among those with high cognitive reserve, the moderate neurodegeneration group showed cognition comparable to the minimal neurodegeneration group and better than the severe neurodegeneration group. High cognitive reserve may buffer against cognitive impairment among PWH with moderate, but not severe, neurodegeneration.
Collapse
Affiliation(s)
- Arin Fisher
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92037, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92037, USA
| | - Andrew J Levine
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Ben Gouaux
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92037, USA
| | | | - Scott Letendre
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Erin E Sundermann
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92037, USA.
| |
Collapse
|
30
|
Loughrey DG, Jordan C, Ibanez A, Parra MA, Lawlor BA, Reilly RB. Age-related hearing loss associated with differences in the neural correlates of feature binding in visual working memory. Neurobiol Aging 2023; 132:233-245. [PMID: 37866083 DOI: 10.1016/j.neurobiolaging.2023.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/09/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023]
Abstract
The underlying neural mechanisms underpinning the association between age-related hearing loss (ARHL) and dementia remain unclear. A limitation has been the lack of functional neuroimaging studies in ARHL cohorts to help clarify this relationship. In the present study, we investigated the neural correlates of feature binding in visual working memory with ARHL (controls = 14, mild HL = 21, and moderate or greater HL = 23). Participants completed a visual change detection task assessing feature binding while their neural activity was synchronously recorded via high-density electroencephalography. There was no difference in accuracy scores for ARHL groups compared to controls. There was increased electrophysiological activity in those with ARHL, particularly in components indexing the earlier stages of visual cognitive processing. This activity was more pronounced with more severe ARHL and was associated with maintained feature binding. Source space (sLORETA) analyses indicated greater activity in networks modulated by frontoparietal and temporal regions. Our results demonstrate there may be increased involvement of neurocognitive control networks to maintain lower-order neurocognitive processing disrupted by ARHL.
Collapse
Affiliation(s)
- David G Loughrey
- Global Brain Health Institute, Trinity College, The University of Dublin, Ireland; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Trinity College Institute of Neuroscience, Trinity College, The University of Dublin, Ireland.
| | - Catherine Jordan
- Global Brain Health Institute, Trinity College, The University of Dublin, Ireland; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
| | - Agustin Ibanez
- Global Brain Health Institute, Trinity College, The University of Dublin, Ireland; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Cognitive Neuroscience Center, University of San Andrés, Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Brian A Lawlor
- Global Brain Health Institute, Trinity College, The University of Dublin, Ireland; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
| | - Richard B Reilly
- Trinity College Institute of Neuroscience, Trinity College, The University of Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity College, The University of Dublin, Ireland; School of Engineering, Trinity College, The University of Dublin, Ireland; School of Medicine, Trinity College, The University of Dublin, Ireland
| |
Collapse
|
31
|
Phongpreecha T, Godrich D, Berson E, Espinosa C, Kim Y, Cholerton B, Chang AL, Mataraso S, Bukhari SA, Perna A, Yakabi K, Montine KS, Poston KL, Mormino E, White L, Beecham G, Aghaeepour N, Montine TJ. Quantitative estimate of cognitive resilience and its medical and genetic associations. Alzheimers Res Ther 2023; 15:192. [PMID: 37926851 PMCID: PMC10626669 DOI: 10.1186/s13195-023-01329-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND We have proposed that cognitive resilience (CR) counteracts brain damage from Alzheimer's disease (AD) or AD-related dementias such that older individuals who harbor neurodegenerative disease burden sufficient to cause dementia remain cognitively normal. However, CR traditionally is considered a binary trait, capturing only the most extreme examples, and is often inconsistently defined. METHODS This study addressed existing discrepancies and shortcomings of the current CR definition by proposing a framework for defining CR as a continuous variable for each neuropsychological test. The linear equations clarified CR's relationship to closely related terms, including cognitive function, reserve, compensation, and damage. Primarily, resilience is defined as a function of cognitive performance and damage from neuropathologic damage. As such, the study utilized data from 844 individuals (age = 79 ± 12, 44% female) in the National Alzheimer's Coordinating Center cohort that met our inclusion criteria of comprehensive lesion rankings for 17 neuropathologic features and complete neuropsychological test results. Machine learning models and GWAS then were used to identify medical and genetic factors that are associated with CR. RESULTS CR varied across five cognitive assessments and was greater in female participants, associated with longer survival, and weakly associated with educational attainment or APOE ε4 allele. In contrast, damage was strongly associated with APOE ε4 allele (P value < 0.0001). Major predictors of CR were cardiovascular health and social interactions, as well as the absence of behavioral symptoms. CONCLUSIONS Our framework explicitly decoupled the effects of CR from neuropathologic damage. Characterizations and genetic association study of these two components suggest that the underlying CR mechanism has minimal overlap with the disease mechanism. Moreover, the identified medical features associated with CR suggest modifiable features to counteract clinical expression of damage and maintain cognitive function in older individuals.
Collapse
Affiliation(s)
- Thanaphong Phongpreecha
- Department of Pathology, Stanford University, Stanford, CA, USA
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, 300 Pasteur Dr Rm L216, Stanford, CA, 94305, USA
| | - Dana Godrich
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, FL, USA
| | - Eloise Berson
- Department of Pathology, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, 300 Pasteur Dr Rm L216, Stanford, CA, 94305, USA
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Camilo Espinosa
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, 300 Pasteur Dr Rm L216, Stanford, CA, 94305, USA
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Yeasul Kim
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, 300 Pasteur Dr Rm L216, Stanford, CA, 94305, USA
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | | | - Alan L Chang
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, 300 Pasteur Dr Rm L216, Stanford, CA, 94305, USA
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Samson Mataraso
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, 300 Pasteur Dr Rm L216, Stanford, CA, 94305, USA
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Syed A Bukhari
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Amalia Perna
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Koya Yakabi
- Department of Pathology, Stanford University, Stanford, CA, USA
| | | | - Kathleen L Poston
- Department of Neurology Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Elizabeth Mormino
- Department of Neurology Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Lon White
- Pacific Health Research and Education Institute, Honolulu, HI, USA
| | - Gary Beecham
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, FL, USA
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, 300 Pasteur Dr Rm L216, Stanford, CA, 94305, USA
- Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Thomas J Montine
- Department of Pathology, Stanford University, Stanford, CA, USA.
| |
Collapse
|
32
|
Prete M, Cellini N, Ronconi L, Di Rosa E. Cognitive reserve moderates the relationship between sleep difficulties and executive functions in patients with Parkinson's disease. Sleep Med 2023; 111:82-85. [PMID: 37738789 DOI: 10.1016/j.sleep.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/02/2023] [Accepted: 09/10/2023] [Indexed: 09/24/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor disturbances as well as non-motor symptoms, such as sleep and cognitive difficulties. Recent evidence has shown that, in patients with PD, sleep disturbances selectively correlate with specific cognitive functions, such as non-verbal reasoning, attention and executive functions, and language abilities. The present study aimed to test the hypothesis of Cognitive Reserve (CR) as a potential moderator in the relationship between sleep difficulties and cognitive performance in PD patients. Participants were asked to attend two sessions in which they were assessed for cognitive functions and reserve, as well as subjective sleep quality, excessive sleepiness, and symptoms of REM sleep behavior disorder (RBD) and insomnia. The results of preliminary correlations confirmed the presence of a significant negative correlation between sleep quality and cognitive performance. The results of the moderation analysis revealed a significant role for CR as a moderator of the negative association between RBD and executive functions. Specifically, a significant negative correlation was observed between sleep difficulties and executive performance only in patients with low CR. Overall, our results suggest that patients with PD with low to average CR levels could be considered to be more at risk of developing cognitive deficits in the presence of sleep difficulties.
Collapse
Affiliation(s)
- Michela Prete
- Department of General Psychology, University of Padova, Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy
| | - Lucia Ronconi
- Computer and Statistical Services, Multifunctional Pole of Psychology, University of Padova, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padova, Italy.
| |
Collapse
|
33
|
Stevens WD, Khan N, Anderson JAE, Grady CL, Bialystok E. A neural mechanism of cognitive reserve: The case of bilingualism. Neuroimage 2023; 281:120365. [PMID: 37683809 DOI: 10.1016/j.neuroimage.2023.120365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023] Open
Abstract
Cognitive Reserve (CR) refers to the preservation of cognitive function in the face of age- or disease-related neuroanatomical decline. While bilingualism has been shown to contribute to CR, the extent to which, and what particular aspect of, second language experience contributes to CR are debated, and the underlying neural mechanism(s) unknown. Intrinsic functional connectivity reflects experience-dependent neuroplasticity that occurs across timescales ranging from minutes to decades, and may be a neural mechanism underlying CR. To test this hypothesis, we used voxel-based morphometry and resting-state functional connectivity analyses of MRI data to compare structural and functional brain integrity between monolingual and bilingual older adults, matched on cognitive performance, and across levels of second language proficiency measured as a continuous variable. Bilingualism, and degree of second language proficiency specifically, were associated with lower gray matter integrity in a hub of the default mode network - a region that is particularly vulnerable to decline in aging and dementia - but preserved intrinsic functional network organization. Bilingualism moderated the association between neuroanatomical differences and cognitive decline, such that lower gray matter integrity was associated with lower executive function in monolinguals, but not bilinguals. Intrinsic functional network integrity predicted executive function when controlling for group differences in gray matter integrity and language status. Our findings confirm that lifelong bilingualism is a CR factor, as bilingual older adults performed just as well as their monolingual peers on tasks of executive function, despite showing signs of more advanced neuroanatomical aging, and that this is a consequence of preserved intrinsic functional network organization.
Collapse
Affiliation(s)
- W Dale Stevens
- Department of Psychology, York University, Toronto, Canada.
| | - Naail Khan
- Department of Psychology, York University, Toronto, Canada
| | - John A E Anderson
- Department of Cognitive Science, Carleton University, Ottawa, Canada
| | - Cheryl L Grady
- Rotman Research Institute at Baycrest Hospital, Toronto, Canada; Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | - Ellen Bialystok
- Department of Psychology, York University, Toronto, Canada; Rotman Research Institute at Baycrest Hospital, Toronto, Canada
| |
Collapse
|
34
|
Sato K, Matsui M, Ono Y, Miyagishi Y, Tsubomoto M, Naito N, Kikuchi M. The relationship between cognitive reserve focused on leisure experiences and cognitive functions in bipolar patients. Heliyon 2023; 9:e21661. [PMID: 38027814 PMCID: PMC10661430 DOI: 10.1016/j.heliyon.2023.e21661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/01/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Bipolar disorder (BP) is characterized by cognitive decline. Individual differences exist in maintaining cognitive function due to daily physical activity and sleep. We examined the relationship between leisure experiences as proxies for cognitive reserve (CR) and cognitive function in patients with bipolar disorder after adjusting for daily physical activity and sleep. The CR of patients with BP (n = 24) and healthy study controls (HC) (n = 24) was assessed using premorbid IQ, years of education, and leisure activity history. Performance-based neuropsychological tests were performed to evaluate cognitive function. A self-reported scale was used to assess resilience. Physical activity and sleep were measured using an activity meter. Verbal fluency, story memory, and verbal memory were significantly positively correlated with the kinds of leisure experiences in patients with BP. A hierarchical regression analysis accounting for confounding factors showed that verbal fluency and memory were associated with the kinds of leisure experiences. Neither years of education nor resilience were significantly associated with neuropsychological scores. Various leisure experiences in patients with BP are associated with higher language-related cognitive functioning. Engaging in various leisure experiences may affect higher cognitive functions related to language.
Collapse
Affiliation(s)
- Kuniko Sato
- Laboratory of Clinical Cognitive Neuroscience, Graduate School of Medical Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
| | - Mie Matsui
- Laboratory of Clinical Cognitive Neuroscience, Graduate School of Medical Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
- Laboratory of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
| | - Yasuki Ono
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, 1 Bunkyocyo, Hirosaki, Aomori 036-8224, Japan
| | - Yoshiaki Miyagishi
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| | - Makoto Tsubomoto
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| | - Nobushige Naito
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| | - Mitsuru Kikuchi
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| |
Collapse
|
35
|
Stein C, O'Keeffe F, Strahan O, McGuigan C, Bramham J. Systematic review of cognitive reserve in multiple sclerosis: Accounting for physical disability, fatigue, depression, and anxiety. Mult Scler Relat Disord 2023; 79:105017. [PMID: 37806233 DOI: 10.1016/j.msard.2023.105017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/03/2023] [Accepted: 09/17/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Cognitive reserve (CR) describes an individual's ability to adapt cognitive processes in response to brain atrophy, and has been reported to explain some of the discrepancy between brain atrophy and cognitive functioning outcomes in multiple sclerosis (MS). CR in MS is typically investigated by assessing an individual's pre- and/or post-diagnosis enrichment, which includes premorbid intellectual abilities, educational level, occupational attainment, and engagement in cognitively enriching leisure activities. Common MS symptoms (e.g., physical disability, fatigue, depression, anxiety) may impact an individual's ability to engage in various CR-enhancing activities post-diagnosis. It is unknown to what extent these MS symptoms have been taken into account in MS research on CR. As such, we identified whether studies assessed CR using measures of premorbid or continuous (including post-diagnosis) enrichment. For studies investigating continuous enrichment, we identified whether studies accounted for MS-impact, which MS symptoms were accounted for, and how, and whether studies acknowledged MS symptoms as potential CR-confounds. METHODS Three electronic databases (PsycINFO, PubMed, Scopus) were searched. Eligible studies investigated CR proxies (e.g., estimated premorbid intellectual abilities, vocabulary knowledge, educational level, occupational attainment, cognitively enriching leisure activities, or a combination thereof) in relation to cognitive, brain atrophy or connectivity, or daily functioning outcomes in adult participants with MS. We extracted data on methods and measures used, including any MS symptoms taken into account. Objectives were addressed using frequency analyses and narrative synthesis. RESULTS 115 studies were included in this review. 47.8% of all studies investigated continuous enrichment. Approximately half of the studies investigating continuous enrichment accounted for potential MS-impact in their analyses, with only 31.0% clearly identifying that they treated MS symptoms as potential confounds for CR-enhancement. A narrative synthesis of studies which investigated CR with and without controlling statistically for MS-impact indicated that accounting for MS symptoms may impact findings concerning the protective nature of CR. CONCLUSION Fewer than half of the studies investigating CR proxies in MS involved continuous enrichment. Just over half of these studies accounted for potential MS-impact in their analyses. To achieve a more complete and accurate understanding of CR in MS, future research should investigate both pre-MS and continuous enrichment. In doing so, MS symptoms and their potential impact should be considered. Establishing greater consistency and rigour across CR research in MS will be crucial to produce an evidence base for the development of interventions aimed at improving quality of care and life for pwMS.
Collapse
Affiliation(s)
- Clara Stein
- University College Dublin, Belfield, Dublin 4, Ireland.
| | - Fiadhnait O'Keeffe
- University College Dublin, Belfield, Dublin 4, Ireland; St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Orla Strahan
- University College Dublin, Belfield, Dublin 4, Ireland
| | - Christopher McGuigan
- University College Dublin, Belfield, Dublin 4, Ireland; St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Jessica Bramham
- University College Dublin, Belfield, Dublin 4, Ireland; St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| |
Collapse
|
36
|
Karanth S, Braithwaite D, Katsumata Y, Duara R, Norrod P, Aukhil I, Abner E. Association of Physical Frailty and Cognitive Function in a Population-Based Cross-Sectional Study of American Older Adults. Gerontology 2023; 70:48-58. [PMID: 37903474 PMCID: PMC10961850 DOI: 10.1159/000533919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/28/2023] [Indexed: 11/01/2023] Open
Abstract
INTRODUCTION Cognitive impairment and frailty are prevalent in older persons. Physical frailty is associated with cognitive decline; however, the role of effect modifiers such as age, sex, race/ethnicity, and cognitive reserve is not well understood. METHODS Cross-sectional data from the National Health and Nutrition Examination Survey (2011-2014) were obtained for participants aged ≥60 years. Complete availability of cognitive scores was an inclusion criterion. Physical frailty was defined by the presence of exhaustion, weakness, low body mass, and/or low physical activity, and categorized into three groups: robust (0 present), pre-frail (1-2 present), or frail (3-4 present). Four cognitive test scores were converted to z-scores, and global cognition (composite z-score) was calculated by averaging the four-individual z-scores. Multivariable linear regression models were fit to estimate the associations between frailty and cognitive function. Frailty was also evaluated as a risk factor for self-reported subjective memory complaint (SMC) using logistic regression. All models were adjusted for age, sex, race/ethnicity, education, alcohol use, income, marital status, diabetes, hypertension, and history of stroke. Effect measure modification analyses were conducted by age, sex, race/ethnicity, education, and occupational cognitive demand. RESULTS The study population comprised 2,863 participants aged ≥60 years. 50.6% of the participants were categorized into robust, 43.2% pre-frail, and 6.2% frail. After adjusting for covariates, compared to robust participants, frail and prefrail participants had lower adjusted mean global cognitive z-scores, β^ = -0.61, 95% CI: -0.83, -0.38 and β^ = -0.21, 95% CI: -0.30, -0.12, respectively. Both prefrail and frail participants had higher odds of SMC compared to the robust participants. We did not see strong evidence that the association between frailty and cognition was modified by the factors we studied. DISCUSSION/CONCLUSION Both pre-frailty and frailty were associated with lower cognitive performance and were more likely to report subjective memory complaints relative to persons without frailty. These findings provide additional evidence that physical frailty may serve as a prognostic factor for cognitive deterioration or dementia, and prevention of frailty may be an important public health strategy.
Collapse
Affiliation(s)
- Shama Karanth
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA
- University of Florida Health Cancer Center, Gainesville, Florida, USA
| | - Dejana Braithwaite
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA
- University of Florida Health Cancer Center, Gainesville, Florida, USA
- Department of Epidemiology, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Yuriko Katsumata
- Department of Biostatistics, University of Kentucky, Lexington, Kentucky, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
| | - Ranjan Duara
- Florida Alzheimer's Disease Research Center, University of Florida, Gainesville, Florida, USA
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center¸, Miami Beach, Florida, USA
| | - Paul Norrod
- Department of Population Health, College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ikramuddin Aukhil
- Department of Surgical Sciences, School of Dental Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Erin Abner
- Department of Biostatistics, University of Kentucky, Lexington, Kentucky, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
37
|
Lewis NA, Yoneda T, Melis RJF, Mroczek DK, Hofer SM, Muniz-Terrera G. Availability of Cognitive Resources in Early Life Predicts Transitions Between Cognitive States in Middle and Older Adults From Europe. Innov Aging 2023; 7:igad124. [PMID: 38034934 PMCID: PMC10682867 DOI: 10.1093/geroni/igad124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Indexed: 12/02/2023] Open
Abstract
Background and Objectives The existing literature highlights the importance of reading books in middle-to-older adulthood for cognitive functioning; very few studies, however, have examined the importance of childhood cognitive resources for cognitive outcomes later in life. Research Design and Methods Using data from 11 countries included in the Survey of Health, Ageing, and Retirement in Europe (SHARE) data set (N = 32,783), multistate survival models (MSMs) were fit to examine the importance of access to reading material in childhood on transitions through cognitive status categories (no cognitive impairment and impaired cognitive functioning) and death. Additionally, using the transition probabilities estimated by the MSMs, we estimated the remaining years of life without cognitive impairment and total longevity. All models were fit individually in each country, as well as within the pooled SHARE sample. Results Adjusting for age, sex, education, and childhood socioeconomic status, the overall pooled estimate indicated that access to more books at age 10 was associated with a decreased risk of developing cognitive impairment (adjusted hazard ratio = 0.79, confidence interval: 0.76-0.82). Access to childhood books was not associated with risk of transitioning from normal cognitive functioning to death, or from cognitive impairment to death. Total longevity was similar between participants reporting high (+1 standard deviation [SD]) and low (-1 SD) number of books in the childhood home; however, individuals with more access to childhood books lived a greater proportion of this time without cognitive impairment. Discussion and Implications Findings suggest that access to cognitive resources in childhood is protective for cognitive aging processes in older adulthood.
Collapse
Affiliation(s)
- Nathan A Lewis
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, British Columbia, Canada
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tomiko Yoneda
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Psychology, University of California, Davis, California, USA
| | - René J F Melis
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Scott M Hofer
- Pacific Health Research and Education Institute, Honolulu, Hawaii, USA
- Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Graciela Muniz-Terrera
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
38
|
Pacifico D, Sabatini S, Fiordelli M, Annoni AM, Frei A, Puhan M, Graf G, Albanese E. Associations of multilingualism and language proficiency with cognitive functioning: epidemiological evidence from the SwissDEM study in community dwelling older adults and long-term care residents. BMC Geriatr 2023; 23:629. [PMID: 37803260 PMCID: PMC10559505 DOI: 10.1186/s12877-023-04311-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 09/12/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND We explored whether number of languages spoken and language proficiency are associated with cognitive performance among older adults living in the community and in long-term care (LTC) in Switzerland. METHODS Among study participants, 664 lived in the community in the Canton of Zurich (Mean age = 72.97 years; SD = 6.08), 386 lived in the community in Ticino (Mean age = 76.24 years; SD = 6.66), and 176 resided in LTC in Ticino (Mean age = 87.61 years; SD = 6.45). We recorded sociodemographic variables, number of languages spoken, language proficiency, and assessed overall cognitive performance, immediate and delayed memory, and verbal fluency with standardized tests. We used adjusted regression models. RESULTS A higher number of spoken languages was positively associated with overall cognitive performance, verbal fluency and immediate and delayed memory performance in community-dwelling older adults in the Cantons of Ticino and Zurich, (all p values ≤ 0.012;), but not in in older adults living in LTC homes (all p values ≥ 0.35). Higher language proficiency was associated with better memory performance among individuals living in the community in Ticino (p value = 0.003), and to better performance in verbal fluency and memory tasks in Zurich (p values ≤ 0.002). Among LTC residents, proficiency levels were not associated with cognitive performance. CONCLUSIONS Multilingualism and greater language proficiency were associated with better cognitive functioning in community-dwelling but not in institutionalized older adults. Multilingualism may contribute to cognitive reserve, as well as protect and delay cognitive decline in late life.
Collapse
Affiliation(s)
- Deborah Pacifico
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
| | - Serena Sabatini
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Maddalena Fiordelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Anna Maria Annoni
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Anja Frei
- Epidemiology Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo Puhan
- Epidemiology Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Gwendolyn Graf
- Epidemiology Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| |
Collapse
|
39
|
Montemurro S, Mondini S, Pucci V, Durante G, Riccardi A, Maffezzini S, Scialpi G, Signorini M, Arcara G. Tele-Global Examination of Mental State (Tele-GEMS): an open tool for the remote neuropsychological screening. Neurol Sci 2023; 44:3499-3508. [PMID: 37248426 PMCID: PMC10226870 DOI: 10.1007/s10072-023-06862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/15/2023] [Indexed: 05/31/2023]
Abstract
Tele-neuropsychology, i.e., the application of remote audio-visual technologies to neuropsychological evaluation or rehabilitation, has become increasingly popular and widespread during and after the COVID-19 pandemic. New tools with updated normative data and appropriate methodological developments are necessary. We present Tele-GEMS, a telephone-based cognitive screening developed on N = 601 Italian participants. It yields a global score tapping on orientation, memory, spatial representation, language, and pragmatic abilities. Its administration lasts about 10 min. Clinical cut-offs are provided, accounting for demographic variables (age, education, and sex) and also for a comprehensive index taking into account cognitively stimulating life experiences that can build up a cognitive reserve. Tele-GEMS shows good internal consistency and a good inter-rater agreement. The test includes the thresholds for estimating a significant change after repeated measurements. Tele-GEMS has a good construct validity as assessed with MoCA and a suitable criterion validity assessed with its in-person version (GEMS). All the materials and the instructions, including scripts and an online Application for the automatic calculation of cut-offs, are accessible on OSF at https://osf.io/t3bma/ under a Creative Commons license.
Collapse
Affiliation(s)
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), Università di Padova, Padova, Italy
- Centro di Ateneo Servizi Clinici Universitari Psicologici (SCUP), Università di Padova, Padova, Italy
- Human Inspired Technology Research Centre HIT, University of Padova, Padova, Italy
| | - Veronica Pucci
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), Università di Padova, Padova, Italy
- Human Inspired Technology Research Centre HIT, University of Padova, Padova, Italy
| | - Giorgia Durante
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), Università di Padova, Padova, Italy
| | - Alice Riccardi
- Multiple Sclerosis Centre, Department of Neurosciences-DNS, Università di Padova, Padova, Italy
| | - Sabrina Maffezzini
- Multiple Sclerosis Centre, Department of Neurosciences-DNS, Università di Padova, Padova, Italy
| | - Graziana Scialpi
- Multiple Sclerosis Centre, Department of Neurosciences-DNS, Università di Padova, Padova, Italy
| | | | | |
Collapse
|
40
|
Grant JG, Rapport LJ, Darling R, Waldron-Perrine B, Lumley MA, Whitfield KE, Bernitsas E. Cognitive enrichment and education quality moderate cognitive dysfunction in black and white adults with multiple sclerosis. Mult Scler Relat Disord 2023; 78:104916. [PMID: 37552903 DOI: 10.1016/j.msard.2023.104916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/30/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE To examine the extent to which three sociobehavioral proxies of cognitive reserve-years of education, education quality, and cognitive enrichment-differ in their prediction of cognitive performance among Black and White people with MS (PwMS). METHODS 82 PwMS (Black n = 41, White n = 41) underwent a neurological examination and a neuropsychological evaluation that included tests of word recognition (Wechsler Test of Adult Reading) as well as measures of verbal memory, visuospatial memory, and processing speed (the Brief International Cognitive Assessment for MS; BICAMS). Participants rated their lifetime engagement in various cognitively-enriching activities (Cognitive Reserve Scale). RESULTS For the full sample, education quality and cognitive enrichment were more strongly associated with cognitive performance than were years of education. Cognitive enrichment was not associated with cognitive performance among participants with high education quality. In contrast, among participants with low education quality, cognitive enrichment was strongly associated with cognitive performance, suggesting that high engagement in cognitively-enriching activities provided similar protection to high education quality. Furthermore, among Black participants, cognitive enrichment and educational quality moderated the relationship between disability level and cognitive performance. In contrast, among White participants, cognitive enrichment did not provide additional protection beyond the buffering effect of education quality. CONCLUSIONS PwMS can successfully build reserve through multiple routes, including formal education or informal cognitive enrichment. Treatment for MS should incorporate cognitively-enriching activities to build resilience against cognitive decline, particularly for members of marginalized racial/ethnic groups, who are at greatest risk for poor health outcomes, and for whom years of education may not best reflect education quality.
Collapse
Affiliation(s)
- Jeremy G Grant
- Department of Psychology, Wayne State University, 5057 Woodward Ave., Detroit, MI 48202, USA.
| | - Lisa J Rapport
- Department of Psychology, Wayne State University, 5057 Woodward Ave., Detroit, MI 48202, USA
| | - Rachel Darling
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Brigid Waldron-Perrine
- Department of Physical Medicine & Rehabilitation, Wayne State University School of Medicine, Detroit, MI, USA
| | - Mark A Lumley
- Department of Psychology, Wayne State University, 5057 Woodward Ave., Detroit, MI 48202, USA
| | - Keith E Whitfield
- Department of Psychology and Department of Brain Health, University of Nevada, Las Vegas, NV, USA
| | - Evanthia Bernitsas
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| |
Collapse
|
41
|
Cespón J, Chupina I, Carreiras M. Cognitive reserve counteracts typical neural activity changes related to ageing. Neuropsychologia 2023; 188:108625. [PMID: 37364777 DOI: 10.1016/j.neuropsychologia.2023.108625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/13/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023]
Abstract
Studies have shown that older adults with high Cognitive Reserve (HCR) exhibit better executive functioning than their low CR (LCR) counterparts. However, the neural processes linked to those differences are unclear. This study investigates (1) the neural processes underlying executive functions in older adults with HCR compared to older adults with LCR and (2) how executive control differences between HCR and LCR groups are modulated by increased task difficulty. We recruited 74 participants (37 in each group) with diverse CR levels, as determined by a standardised CR questionnaire. Participants performed two executive control tasks with lower and higher difficulty levels (i.e., Simon and spatial Stroop tasks, respectively) while recording the electroencephalogram. The accuracy on both tasks requiring inhibition of irrelevant information was better in the HCR than the LCR group. Also, in the task with higher difficulty level (i.e., the spatial Stroop task), event-related potential (ERP) latencies associated with inhibition (i.e., frontal N200) and updating of working memory (i.e., P300) were earlier in HCR than LCR. Moreover, the HCR, but not the LCR group, showed larger P300 amplitude in parietal than frontal regions and in the left than right hemisphere, suggesting a posterior to anterior shift of activity and loss of inter-hemispheric asymmetries in LCR participants. These results suggest that high CR counteracts neural activity changes related to ageing. Thus, high levels of CR may be related to maintenance of neural activity patterns typically observed in young adults rather than to deployment of neural compensatory mechanisms.
Collapse
Affiliation(s)
- Jesús Cespón
- BCBL Basque Center on Cognition, Brain, and Language, Mikeletegi Pasealekua, 69, Donostia/San Sebastián, 20009, Spain.
| | - Irina Chupina
- Radboud University, Donders Centre for Cognition, Thomas van Aquinostraat 4, 6525 GD, Nijmegen, the Netherlands
| | - Manuel Carreiras
- BCBL Basque Center on Cognition, Brain, and Language, Mikeletegi Pasealekua, 69, Donostia/San Sebastián, 20009, Spain; Ikerbasque. Basque Foundation for Science, Bilbao, Spain; University of the Basque Country (UPV/EHU). Bilbao, Spain
| |
Collapse
|
42
|
Montoliu T, Zapater-Fajarí M, Hidalgo V, Salvador A. Openness to experience and cognitive functioning and decline in older adults: The mediating role of cognitive reserve. Neuropsychologia 2023; 188:108655. [PMID: 37507065 DOI: 10.1016/j.neuropsychologia.2023.108655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/13/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVE Openness to experience has been consistently associated with better cognitive functioning in older people, but its association with cognitive decline is less clear. Cognitive reserve has been proposed as a mechanism underlying this relationship, but previous studies have reported mixed findings, possibly due to the different ways of conceptualizing cognitive reserve. We aimed to analyze the potential mediating role of cognitive reserve in the association between openness and cognitive functioning and decline in healthy older people. METHOD In Wave 1 and at the four-year follow-up (Wave 2), 87 healthy older people (49.4% women; M age = 65.08, SD = 4.54) completed a neuropsychological battery to assess cognitive functioning and a questionnaire to assess cognitive reserve. Openness was measured with the NEO- Five-Factor Inventory. Mediation models were proposed to investigate the relationship between openness and cognitive function or decline through cognitive reserve or its change. RESULTS Cognitive reserve mediated the openness-cognitive functioning association. Thus, individuals with higher openness showed greater cognitive reserve, and this greater cognitive reserve was associated with better cognitive functioning. Moreover, greater cognitive reserve at baseline also mediated the association between higher openness and slower cognitive decline. However, change in cognitive reserve did not mediate the association between openness and change in cognitive functioning. CONCLUSIONS Cognitive reserve is a mechanism underlying the association between openness and cognitive functioning and decline. These findings support the differential preservation hypothesis, suggesting that healthy older adults who engage in more cognitively stimulating activities would show less age-related cognitive decline.
Collapse
Affiliation(s)
- Teresa Montoliu
- Department Psychobiology-IDOCAL, University of Valencia, Valencia, Spain
| | | | - Vanesa Hidalgo
- Department Psychobiology-IDOCAL, University of Valencia, Valencia, Spain; Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain.
| | - Alicia Salvador
- Department Psychobiology-IDOCAL, University of Valencia, Valencia, Spain; Spanish National Network for Research in Mental Health CIBERSAM, 28029, Spain
| |
Collapse
|
43
|
Harahap HS, Ferdiana A, Mahardika A, Hunaifi I, Putri SA. Higher education level as a protective factor against executive dysfunction in patients with epilepsy in Mataram, Indonesia. Clin Neurol Neurosurg 2023; 232:107886. [PMID: 37451091 DOI: 10.1016/j.clineuro.2023.107886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Since the concept of cognitive reserve is applicable in epilepsy-associated cognitive impairment, the role of cognitive reserve components as a protective factor against epilepsy-associated executive dysfunction needs further investigation. This study aimed at investigating the association between cognitive reserve components and the frequency of epilepsy-associated executive dysfunction in Mataram, Indonesia. METHODS This case-control study involved both epilepsy outpatient and healthy participants recruited consecutively in 5 hospitals in Mataram, between October 2021 and September 2022. Data on sociodemographic, cognitive reserve components, and executive function status were collected from both groups, while data on seizure were collected only from epilepsy participants. The association between cognitive reserve components and the frequency of epilepsy-associated executive dysfunction was tested using logistic regression. RESULTS A total of 119 epilepsy patients and 93 healthy participants were recruited. The frequency of epilepsy-associated executive dysfunction was 50.4%. Multivariate logistic regression analysis showed that higher education level was the only cognitive reserve component protective against epilepsy-associated executive dysfunction (odds ratio [OR]: 3.36; 95% confidence interval [CI]: 1.33 - 8.50). CONCLUSION A high frequency of epilepsy-associated executive dysfunction was observed in Mataram. Higher education level was a cognitive reserve component protective against executive dysfunction in these patients.
Collapse
Affiliation(s)
| | - Astri Ferdiana
- Department of Public Health, Faculty of Medicine, University of Mataram, Indonesia
| | - Agustine Mahardika
- Department of Psychiatry, Faculty of Medicine, University of Mataram, Indonesia
| | - Ilsa Hunaifi
- Department of Neurology, Faculty of Medicine, University of Mataram, Indonesia
| | | |
Collapse
|
44
|
Guerrini S, Hunter EM, Papagno C, MacPherson SE. Cognitive reserve and emotion recognition in the context of normal aging. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2023; 30:759-777. [PMID: 35634692 DOI: 10.1080/13825585.2022.2079603] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
The Cognitive Reserve (CR) hypothesis accounts for individual differences in vulnerability to age- or pathological-related brain changes. It suggests lifetime influences (e.g., education) increase the effectiveness of cognitive processing in later life. While evidence suggests CR proxies predict cognitive performance in older age, it is less clear whether CR proxies attenuate age-related decline on social cognitive tasks. This study investigated the effect of CR proxies on unimodal and cross-modal emotion identification. Sixty-six older adults aged 60-78 years were assessed on CR proxies (Cognitive Reserve Index Questionnaire, NART), unimodal(faces only, voices only), and cross-modal (faces and voices combined) emotion recognition and executive function (Stroop Test). No CR proxy predicted performance on emotion recognition. However, NART IQ predicted performance on the Stroop test; higher NART IQ was associated with better performance. The current study suggests CR proxies do not predict performance on social cognition tests but do predict performance on cognitive tasks.
Collapse
Affiliation(s)
- Sofia Guerrini
- Dipartimento di Psicologia, Università degli studi di Milano-Bicocca, Milano, Italy
| | | | - Costanza Papagno
- CeRiN, Centro di Riabilitazione Neurocognitiva, CIMeC, Università di Trento, Rovereto, Italy
| | - Sarah E MacPherson
- Human Cognitive Neuroscience, Department of Psychology, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
45
|
Klinedinst BS, Kharate MK, Mohammadiarvejeh P, Fili M, Pollpeter A, Larsen BA, Moody S, Wang Q, Allenspach K, Mochel JP, Willette AA. Exploring the secrets of super-aging: a UK Biobank study on brain health and cognitive function. GeroScience 2023; 45:2471-2480. [PMID: 36947307 PMCID: PMC10651574 DOI: 10.1007/s11357-023-00765-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/27/2023] [Indexed: 03/23/2023] Open
Abstract
Communities across the globe are faced with a rapidly aging society, where age is the main risk factor for cognitive decline and development of Alzheimer's and related diseases. Despite extensive research, there have been no successful treatments yet. A rare group of individuals called "super-agers" have been noted to thrive with their exceptional ability to maintain a healthy brain and normal cognitive function even in old age. Studying their traits, lifestyles, and environments may provide valuable insight. This study used a data-driven approach to identify potential super-agers among 7121 UK Biobank participants and found that these individuals have the highest total brain volume, best cognitive performance, and lowest functional connectivity. The researchers suggest a novel hypothesis that these super-agers possess enhanced neural processing efficiency that increases with age and introduce a definition of the "neural efficiency index." Furthermore, several other types of aging were identified and significant structural-functional differences were observed between them, highlighting the benefit of research efforts in personalized medicine and precision nutrition.
Collapse
Affiliation(s)
- Brandon S Klinedinst
- Department of Medicine, University of Washington, Box 359, 325 9th Avenue, WA, 98104, Seattle, USA.
| | - Mihir K Kharate
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA
| | - Parvin Mohammadiarvejeh
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
| | - Mohammad Fili
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
| | - Amy Pollpeter
- Interdepartmental Bioinformatics and Computational Program, Iowa State University, Ames, IA, USA
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Brittany A Larsen
- Neuroscience Graduate Program, Iowa State University, Ames, IA, USA
- Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Shannin Moody
- Health Sciences Center, Louisiana State University, New Orleans, LA, USA
| | - Qian Wang
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Karin Allenspach
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA
| | - Jonathan P Mochel
- Department of Biomedical Sciences, Iowa State University, Ames, IA, USA
| | - Auriel A Willette
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
- Neuroscience Graduate Program, Iowa State University, Ames, IA, USA
- Department of Neurology, University of Iowa, Iowa City, IA, USA
| |
Collapse
|
46
|
Li Y, Ren Y, Cong L, Hou T, Song L, Wang M, Wang X, Han X, Tang S, Zhang Q, Dekhtyar S, Wang Y, Du Y, Qiu C. Association of Lifelong Cognitive Reserve with Dementia and Mild Cognitive Impairment among Older Adults with Limited Formal Education: A Population-Based Cohort Study. Dement Geriatr Cogn Disord 2023; 52:258-266. [PMID: 37517389 PMCID: PMC10614281 DOI: 10.1159/000532131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Early-life educational attainment contributes to cognitive reserve (CR). We investigated the associations of lifelong CR with dementia and mild cognitive impairment (MCI) among older people with limited formal education. METHODS This population-based cohort study included 2,127 dementia-free participants (≥60 years; 59.4% women; 81.5% with no or elementary school) who were examined at baseline (August-December 2014) and follow-up (March-September 2018). Lifelong CR score at baseline was generated from six lifespan intellectual factors. Dementia, MCI, and their subtypes were defined according to the international criteria. Data were analyzed using Cox proportional-hazards models. RESULTS During the total of 8,330.6 person-years of follow-up, 101 persons were diagnosed with dementia, including 74 with Alzheimer's disease (AD) and 26 with vascular dementia (VaD). The high (vs. low) tertile of lifelong CR score was associated with multivariable-adjusted hazards ratios (95% confidence interval) of 0.28 (0.14-0.55) for dementia and 0.18 (0.07-0.48) for AD. The association between higher CR and reduced AD risk was significant in people aged 60-74 but not in those aged ≥75 years (p for interaction = 0.011). Similarly, among MCI-free people at baseline (n = 1,635), the high (vs. low) tertile of lifelong CR score was associated with multivariable-adjusted hazard ratios of 0.51 (0.38-0.69) for MCI and 0.46 (0.33-0.64) for amnestic MCI. Lifelong CR was not related to VaD or non-amnestic MCI. DISCUSSION High lifelong CR is associated with reduced risks of dementia and MCI, especially AD and amnestic MCI. It highlights the importance of lifelong CR in maintaining late-life cognitive health even among people with no or limited education.
Collapse
Affiliation(s)
- Yuanjing Li
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Yifei Ren
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
- Cheeloo College of Medicine, Shandong University, Jinan, PR China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Mingqi Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Xiang Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Xiaojuan Han
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Qinghua Zhang
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Serhiy Dekhtyar
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
- Cheeloo College of Medicine, Shandong University, Jinan, PR China
| | - Chengxuan Qiu
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Department of Neurology, Shandong Provincial Hospital, Jinan, PR China
| |
Collapse
|
47
|
Jury-Garfe N, You Y, Martínez P, Redding-Ochoa J, Karahan H, Johnson TS, Zhang J, Kim J, Troncoso JC, Lasagna-Reeves CA. Enhanced microglial dynamics and paucity of tau seeding in the amyloid plaque microenvironment contributes to cognitive resilience in Alzheimer's disease. bioRxiv 2023:2023.07.27.550884. [PMID: 37546928 PMCID: PMC10402121 DOI: 10.1101/2023.07.27.550884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Asymptomatic Alzheimer's disease (AsymAD) describes the status of subjects with preserved cognition but with identifiable Alzheimer's disease (AD) brain pathology (i.e. Aβ-amyloid deposits, neuritic plaques, and neurofibrillary tangles) at autopsy. In this study, we investigated the postmortem brains of a cohort of AsymAD cases to gain insight into the underlying mechanisms of resilience to AD pathology and cognitive decline. Our results showed that AsymAD cases exhibit an enrichment of core plaques and decreased filamentous plaque accumulation, as well as an increase in microglia surrounding this last type. In AsymAD cases we found less pathological tau aggregation in dystrophic neurites compared to AD and tau seeding activity comparable to healthy control subjects. We used spatial transcriptomics to further characterize the plaque niche and found autophagy, endocytosis, and phagocytosis within the top upregulated pathways in the AsymAD plaque niche, but not in AD. Furthermore, we found ARP2, an actin-based motility protein crucial to initiate the formation of new actin filaments, increased within microglia in the proximity of amyloid plaques in AsymAD. Our findings support that the amyloid-plaque microenvironment in AsymAD cases is characterized by microglia with highly efficient actin-based cell motility mechanisms and decreased tau seeding compared to AD. These two mechanisms can potentially provide protection against the toxic cascade initiated by Aβ that preserves brain health and slows down the progression of AD pathology.
Collapse
Affiliation(s)
- Nur Jury-Garfe
- Stark Neuroscience Research Institute, Indiana University, Indianapolis, USA
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yanwen You
- Stark Neuroscience Research Institute, Indiana University, Indianapolis, USA
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Pablo Martínez
- Stark Neuroscience Research Institute, Indiana University, Indianapolis, USA
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Javier Redding-Ochoa
- Departments of Pathology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Hande Karahan
- Stark Neuroscience Research Institute, Indiana University, Indianapolis, USA
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, USA
| | - Travis S. Johnson
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, USA
| | - Jie Zhang
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, USA
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jungsu Kim
- Stark Neuroscience Research Institute, Indiana University, Indianapolis, USA
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, USA
| | - Juan C. Troncoso
- Departments of Pathology, Johns Hopkins University School of Medicine, Baltimore, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Cristian A. Lasagna-Reeves
- Stark Neuroscience Research Institute, Indiana University, Indianapolis, USA
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
48
|
Bücker J, Amoretti S, Vieta E, Czepielewsk L, Scheibe D, Montezano BB, Goularte J, Rosa A. Validity and Reliability of the Brazilian Version of the Cognitive Reserve Assessment Scale in Health (CRASH). Braz J Psychiatry 2023. [PMID: 37400362 DOI: 110.47626/1516-4446-2023-3198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 06/08/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE As the elderly population increases, it is important to identify factors that may reduce risks of dementia in the general population. One such factor is the concept of cognitive reserve (CR). The present study analyzed the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH) in the Brazilian population, which was originally developed to measure CR in individuals with severe mental illness. We also investigated the relationship between the CRASH and clinical or sociodemographic variables. METHODS This study was conducted with 398 individuals. We assessed sociodemographic variables and depression, anxiety and stress symptoms (DASS-21), using a web-based survey. We constructed a confirmatory factor analysis (CFA) model in order to test the goodness of fit of the factor structure proposed in the original CRASH study. RESULTS The McDonald's hierarchical ω for CRASH using CFA parameters was 0.61 and Cronbach's alpha coefficient indicated good internal consistency when considering all items (∝ = 0.7). CONCLUSIONS Our results suggest that CRASH can be used to assess CR in the general population in Brazil.
Collapse
Affiliation(s)
- Joana Bücker
- Programa de Pós-Graduação em Ciências Médicas, Universidade do Vale do Taquari - Univates, Lajeado, RS, Brazil
| | - Silvia Amoretti
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR); Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain. Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain. Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain. Biomedical Research Networking Center for Mental Health Network (CIBERSAM), ISCIII, Barcelona, Spain
| | - Eduard Vieta
- Bipolar and Depressive disorders Unit, Hospital Clinic de Barcelona, Institute of Neurosciences (UBNeuro), Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain. CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - Leticia Czepielewsk
- Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Universidade Federal do Rio Grande do Sul (UFRGS) - Porto Alegre, RS, Brazil
| | - Denise Scheibe
- Programa de Pós-Graduação em Ciências Médicas, Universidade do Vale do Taquari - Univates, Lajeado, RS, Brazil
| | - Bruno Braga Montezano
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, RS, Brazil
| | - Jeferson Goularte
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Adriane Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Department of Pharmacology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
49
|
Magdaleno Herrero R, Ortiz-García de la Foz V, Murillo-García N, Vázquez-Bourgon J, Setién-Suero E, Crespo-Facorro B, Ayesa-Arriola R. Sex differences in cognitive reserve among first episode of psychosis patients. Span J Psychiatry Ment Health 2023; 16:143-150. [PMID: 38520113 DOI: 10.1016/j.rpsm.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/09/2021] [Accepted: 11/27/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cognitive reserve (CR) has recently been considered a key factor in the onset of a first episode of psychosis (FEP). However, the differences in CR in FEP patients according to sex have not yet been investigated. MATERIAL AND METHODS CR was estimated among 443 FEP patients (246 men and 197 women) and 156 healthy controls (96 men and 60 women) by using the proxies premorbid IQ, years of education and employment status. A neuropsychological battery was administrated to measure neurocognitive specific domains. Analyses of variance were used to make comparisons between groups. RESULTS FEP women had greater CR than FEP men. This circumstance was not observed in healthy controls. Among the group of patients with low CR, FEP women outperformed FEP men in the cognitive domains verbal memory and processing speed. Meanwhile, among the FEP patients with high CR, men showed better performance in attention than women. CONCLUSIONS Differences in CR observed between FEP men and women could be related to a number of specific factors, such as, age at illness onset, education level, and variability in performance in verbal memory, processing speed, and attention domains. These results provide background information about CR in FEP patients that will be useful in the design of sex specific cognitive remediation interventions.
Collapse
Affiliation(s)
- Rebeca Magdaleno Herrero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Nancy Murillo-García
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Esther Setién-Suero
- Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain; Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain; Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain; Instituto de Investigación Sanitaria de Sevilla, IBiS, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain.
| |
Collapse
|
50
|
Turrini S, Wong B, Eldaief M, Press DZ, Sinclair DA, Koch G, Avenanti A, Santarnecchi E. The multifactorial nature of healthy brain ageing: Brain changes, functional decline and protective factors. Ageing Res Rev 2023; 88:101939. [PMID: 37116664 DOI: 10.1016/j.arr.2023.101939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023]
Abstract
As the global population faces a progressive shift towards a higher median age, understanding the mechanisms underlying healthy brain ageing has become of paramount importance for the preservation of cognitive abilities. The first part of the present review aims to provide a comprehensive look at the anatomical changes the healthy brain endures with advanced age, while also summarizing up to date findings on modifiable risk factors to support a healthy ageing process. Subsequently, we describe the typical cognitive profile displayed by healthy older adults, conceptualizing the well-established age-related decline as an impairment of four main cognitive factors and relating them to their neural substrate previously described; different cognitive trajectories displayed by typical Alzheimer's Disease patients and successful agers with a high cognitive reserve are discussed. Finally, potential effective interventions and protective strategies to promote cognitive reserve and defer cognitive decline are reviewed and proposed.
Collapse
Affiliation(s)
- Sonia Turrini
- Precision Neuroscience & Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Centro studi e ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia "Renzo Canestrari", Alma Mater Studiorum Università di Bologna, Campus di Cesena, Cesena, Italy
| | - Bonnie Wong
- Neuropsychology Program, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA , USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark Eldaief
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel Z Press
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - David A Sinclair
- Blavatnik Institute, Department of Genetics, Paul F. Glenn Center for Biology of ageing Research, Harvard Medical School, Boston, MA, USA
| | - Giacomo Koch
- Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Rome, Italy; Department of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Alessio Avenanti
- Centro studi e ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia "Renzo Canestrari", Alma Mater Studiorum Università di Bologna, Campus di Cesena, Cesena, Italy; Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Universidad Católica del Maule, Talca, Chile
| | - Emiliano Santarnecchi
- Precision Neuroscience & Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|