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Boyle R, Townsend DL, Klinger HM, Scanlon CE, Yuan Z, Coughlan GT, Seto M, Shirzadi Z, Yau WYW, Jutten RJ, Schneider C, Farrell ME, Hanseeuw BJ, Mormino EC, Yang HS, Papp KV, Amariglio RE, Jacobs HIL, Price JC, Chhatwal JP, Schultz AP, Properzi MJ, Rentz DM, Johnson KA, Sperling RA, Hohman TJ, Donohue MC, Buckley RF. Identifying longitudinal cognitive resilience from cross-sectional amyloid, tau, and neurodegeneration. Alzheimers Res Ther 2024; 16:148. [PMID: 38961512 PMCID: PMC11220971 DOI: 10.1186/s13195-024-01510-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/20/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Leveraging Alzheimer's disease (AD) imaging biomarkers and longitudinal cognitive data may allow us to establish evidence of cognitive resilience (CR) to AD pathology in-vivo. Here, we applied latent class mixture modeling, adjusting for sex, baseline age, and neuroimaging biomarkers of amyloid, tau and neurodegeneration, to a sample of cognitively unimpaired older adults to identify longitudinal trajectories of CR. METHODS We identified 200 Harvard Aging Brain Study (HABS) participants (mean age = 71.89 years, SD = 9.41 years, 59% women) who were cognitively unimpaired at baseline with 2 or more timepoints of cognitive assessment following a single amyloid-PET, tau-PET and structural MRI. We examined latent class mixture models with longitudinal cognition as the dependent variable and time from baseline, baseline age, sex, neocortical Aβ, entorhinal tau, and adjusted hippocampal volume as independent variables. We then examined group differences in CR-related factors across the identified subgroups from a favored model. Finally, we applied our favored model to a dataset from the Alzheimer's Disease Neuroimaging Initiative (ADNI; n = 160, mean age = 73.9 years, SD = 7.6 years, 60% women). RESULTS The favored model identified 3 latent subgroups, which we labelled as Normal (71% of HABS sample), Resilient (22.5%) and Declining (6.5%) subgroups. The Resilient subgroup exhibited higher baseline cognitive performance and a stable cognitive slope. They were differentiated from other groups by higher levels of verbal intelligence and past cognitive activity. In ADNI, this model identified a larger Normal subgroup (88.1%), a smaller Resilient subgroup (6.3%) and a Declining group (5.6%) with a lower cognitive baseline. CONCLUSION These findings demonstrate the value of data-driven approaches to identify longitudinal CR groups in preclinical AD. With such an approach, we identified a CR subgroup who reflected expected characteristics based on previous literature, higher levels of verbal intelligence and past cognitive activity.
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Affiliation(s)
- Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Diana L Townsend
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hannah M Klinger
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Catherine E Scanlon
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ziwen Yuan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gillian T Coughlan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mabel Seto
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Zahra Shirzadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Wai-Ying Wendy Yau
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Roos J Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christoph Schneider
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michelle E Farrell
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bernard J Hanseeuw
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Institute of Neuroscience, Cliniques Universitaires SaintLuc, Université Catholique de Louvain, Brussels, Belgium
| | - Elizabeth C Mormino
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Wu Tsai Neuroscience Institute, Stanford, CA, USA
| | - Hyun-Sik Yang
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn V Papp
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Heidi I L Jacobs
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Julie C Price
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Timothy J Hohman
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael C Donohue
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.
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Porricelli D, Tecilla M, Pucci V, Di Rosa E, Mondini S, Cappelletti M. Cognitive reserve modulates mental health in adulthood. Aging Clin Exp Res 2024; 36:139. [PMID: 38954168 PMCID: PMC11219466 DOI: 10.1007/s40520-024-02776-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/13/2024] [Indexed: 07/04/2024]
Abstract
Cognitive Reserve (CR) reflects acquired knowledge, skills, and abilities throughout life, and it is known for modulating cognitive efficiency in healthy and clinical populations. CR, which was initially proposed to explain individual differences in the clinical presentation of dementia, has subsequently been extended to healthy ageing, showing its role in cognitive efficiency also during middle age. Recently, CR has been linked to affective processes in psychiatric conditions such as schizophrenia, major depressive and anxiety symptoms, and psychological distress, suggesting its potential role in emotional expression and regulation. Whether the role of CR in mental health extends to non-pathological adults, and whether this is only relevant in older age is not yet clear. The aim of this work was therefore to explore the relationship between CR and mental health in healthy adults, with a focus on middle adulthood (40-60). In a sample of 96 participants, we found a positive association between CR and mental health outcomes, such that a higher cognitive reserve index corresponded to fewer mental health reported symptoms. Specifically, a higher CR reflecting professional activities was associated with lower stress levels, especially in middle agers. Taken together, these data therefore suggest that engaging occupations may help maintain a robust mental health, especially by reducing stress symptoms during middle age. These results broaden previous findings suggesting that CR relates to affective components of mental health in middle aged and older adults.
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Affiliation(s)
| | | | - Veronica Pucci
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
- Human Inspired Technology Centre (HIT), University of Padua, Padua, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padua, Padua, Italy
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
- Human Inspired Technology Centre (HIT), University of Padua, Padua, Italy
- Department of Developmental Psychology and Socialization (DPSS), University of Padua, Padua, Italy
- IRCCS San Camillo Hospital, Venice, Italy
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Piro-Gambetti B, Schworer EK, Handen B, Glukhovskaya M, Hartley SL. Does Employment Complexity Promote Healthy Cognitive Aging in Down Syndrome? JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:499-513. [PMID: 37040598 PMCID: PMC10564966 DOI: 10.1177/17446295231169379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Adults with Down syndrome (DS) experience high risk for Alzheimer's disease (AD), but there is variability in the timing of transition from a cognitively stable state to prodromal AD and dementia. The present study examined the association between a modifiable lifestyle factor, employment complexity, and cognitive decline across two time points in adults with DS. Employment complexity, defined as the degree of problem-solving or critical thinking required for employment activities, was operationalized using the Dictionary of Occupational Titles, a system which classifies occupations based on three categories: Data, People, and Things. Eighty-seven adults with DS (M = 36.28 years, SD = 6.90 years) were included in analyses. Partial correlations revealed that lower employment complexity involving People and Things were associated with increased dementia symptoms. Lower employment complexity involving Things was also associated with memory decline. These findings have implications for vocational programs focused on job training and placement for adults with DS.
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Affiliation(s)
- Brianna Piro-Gambetti
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Human Development & Family Studies, University of Wisconsin-Madison, Madison, WI, USA
| | - Emily K Schworer
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Human Development & Family Studies, University of Wisconsin-Madison, Madison, WI, USA
| | - Benjamin Handen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Sigan L Hartley
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Human Development & Family Studies, University of Wisconsin-Madison, Madison, WI, USA
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Leung Y, Eramudugolla R, Cherbuin N, Peters R, Mortby ME, Kiely KM, Anstey KJ. Estimating Gender Differences in the Association between Cognitive Resilience and Mild Cognitive Impairment Incidence. Gerontology 2024; 70:776-784. [PMID: 38697040 DOI: 10.1159/000538615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/22/2024] [Indexed: 05/04/2024] Open
Abstract
INTRODUCTION Recent evidence suggests that the influence of verbal intelligence and education on the onset of subjective cognitive decline may be modulated by gender, where education contributes less to cognitive resilience (CR) in women than in men. This study aimed to examine gender differences in the association between CR and mild cognitive impairment (MCI) incidence in an Australian population-based cohort. METHODS We included 1,806 participants who had completed at least the first two waves and up to four waves of assessments in the Personality and Total Health (PATH) Through Life study (baseline: 49% female, male = 62.5, SD = 1.5, age range = 60-66 years). CR proxies included measures of educational attainment, occupation skill, verbal intelligence, and leisure activity. Discrete-time survival analyses were conducted to examine gender differences in the association between CR proxies and MCI risk, adjusting for age and apolipoprotein E4 status. RESULTS Gender differences were only found in the association between occupation and MCI risk, where lower occupation skill was more strongly associated with higher risk in men than in women (odds ratio [OR] = 1.30, 95% confidence interval [CI] [1.07, 1.57]). In both genders, after adjusting for education and occupation, one SD increase in leisure activity was associated with lower MCI risk by 32% (OR = 0.76, 95% CI [0.65, 0.89]). Higher scores in verbal intelligence assessment were associated with reduced risk of MCI by 28% (OR = 0.78, 95% CI [0.69, 0.89]). CONCLUSION Occupational experience may contribute to CR differently between genders. Life course cognitive engagement and verbal intelligence may be more protective against MCI than education and occupation for both men and women.
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Affiliation(s)
- Yvonne Leung
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Ranmalee Eramudugolla
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicolas Cherbuin
- Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Ruth Peters
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
- George Institute for Global Health, Sydney, New South Wales, Australia
| | - Moyra E Mortby
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim M Kiely
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
- School of Health and Society, and School of Mathematics and Applied Statistics, University of Wollongong, Sydney, New South Wales, Australia
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
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Pappalettera C, Carrarini C, Miraglia F, Vecchio F, Rossini PM. Cognitive resilience/reserve: Myth or reality? A review of definitions and measurement methods. Alzheimers Dement 2024; 20:3567-3586. [PMID: 38477378 PMCID: PMC11095447 DOI: 10.1002/alz.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 03/14/2024]
Abstract
INTRODUCTION This review examines the concept of cognitive reserve (CR) in relation to brain aging, particularly in the context of dementia and its early stages. CR refers to an individual's ability to maintain or regain cognitive function despite brain aging, damage, or disease. Various factors, including education, occupation complexity, leisure activities, and genetics are believed to influence CR. METHODS We revised the literature in the context of CR. A total of 842 articles were identified, then we rigorously assessed the relevance of articles based on titles and abstracts, employing a systematic approach to eliminate studies that did not align with our research objectives. RESULTS We evaluate-also in a critical way-the methods commonly used to define and measure CR, including sociobehavioral proxies, neuroimaging, and electrophysiological and genetic measures. The challenges and limitations of these measures are discussed, emphasizing the need for more targeted research to improve the understanding, definition, and measurement of CR. CONCLUSIONS The review underscores the significance of comprehending CR in the context of both normal and pathological brain aging and emphasizes the importance of further research to identify and enhance this protective factor for cognitive preservation in both healthy and neurologically impaired older individuals. HIGHLIGHTS This review examines the concept of cognitive reserve in brain aging, in the context of dementia and its early stages. We have evaluated the methods commonly used to define and measure cognitive reserve. Sociobehavioral proxies, neuroimaging, and electrophysiological and genetic measures are discussed. The review emphasizes the importance of further research to identify and enhance this protective factor for cognitive preservation.
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Affiliation(s)
- Chiara Pappalettera
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
- Department of Theoretical and Applied ScienceseCampus UniversityNovedrateItaly
| | - Claudia Carrarini
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
- Department of NeuroscienceCatholic University of Sacred HeartRomeItaly
| | - Francesca Miraglia
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
- Department of Theoretical and Applied ScienceseCampus UniversityNovedrateItaly
| | - Fabrizio Vecchio
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
- Department of Theoretical and Applied ScienceseCampus UniversityNovedrateItaly
| | - Paolo M. Rossini
- Brain Connectivity LaboratoryDepartment of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
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de Vries LE, Huitinga I, Kessels HW, Swaab DF, Verhaagen J. The concept of resilience to Alzheimer's Disease: current definitions and cellular and molecular mechanisms. Mol Neurodegener 2024; 19:33. [PMID: 38589893 PMCID: PMC11003087 DOI: 10.1186/s13024-024-00719-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/20/2024] [Indexed: 04/10/2024] Open
Abstract
Some individuals are able to maintain their cognitive abilities despite the presence of significant Alzheimer's Disease (AD) neuropathological changes. This discrepancy between cognition and pathology has been labeled as resilience and has evolved into a widely debated concept. External factors such as cognitive stimulation are associated with resilience to AD, but the exact cellular and molecular underpinnings are not completely understood. In this review, we discuss the current definitions used in the field, highlight the translational approaches used to investigate resilience to AD and summarize the underlying cellular and molecular substrates of resilience that have been derived from human and animal studies, which have received more and more attention in the last few years. From these studies the picture emerges that resilient individuals are different from AD patients in terms of specific pathological species and their cellular reaction to AD pathology, which possibly helps to maintain cognition up to a certain tipping point. Studying these rare resilient individuals can be of great importance as it could pave the way to novel therapeutic avenues for AD.
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Affiliation(s)
- Luuk E de Vries
- Department of Neuroregeneration, Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands.
| | - Inge Huitinga
- Department of Neuroimmunology, Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands
| | - Helmut W Kessels
- Swammerdam Institute for Life Sciences, Amsterdam Neuroscience, University of Amsterdam, 1098 XH, Amsterdam, the Netherlands
| | - Dick F Swaab
- Department of Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, Netherlands
| | - Joost Verhaagen
- Department of Neuroregeneration, Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
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Irani ZA, Sheridan AMC, Silk TJ, Anderson V, Weinborn M, Gavett BE. Modeling the development of cognitive reserve in children: A residual index approach. J Int Neuropsychol Soc 2024; 30:264-272. [PMID: 37667614 DOI: 10.1017/s135561772300053x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
OBJECTIVE To model cognitive reserve (CR) longitudinally in a neurodiverse pediatric sample using a residual index approach, and to test the criterion and construct validity of this index. METHOD Participants were N = 115 children aged 9.5-13 years at baseline (MAge = 10.48 years, SDAge = 0.61), and n = 43 (37.4%) met criteria for ADHD. The CR index represented variance in Matrix Reasoning scores from the WASI that was unexplained by MRI-based brain variables (bilateral hippocampal volumes, total gray matter volumes, and total white matter hypointensity volumes) or demographics (age and sex). RESULTS At baseline, the CR index predicted math computation ability (estimate = 0.50, SE = 0.07, p < .001), and word reading ability (estimate = 0.26, SE = 0.10, p = .012). Longitudinally, change in CR over time was not associated with change in math computation ability (estimate = -0.02, SE = 0.03, p < .513), but did predict change in word reading ability (estimate = 0.10, SE = 0.03, p < .001). Change in CR was also found to moderate the relationship between change in word reading ability and white matter hypointensity volume (estimate = 0.10, SE = 0.05, p = .045). CONCLUSIONS Evidence for the criterion validity of this CR index is encouraging, but somewhat mixed, while construct validity was evidenced through interaction between CR, brain, and word reading ability. Future research would benefit from optimization of the CR index through careful selection of brain variables for a pediatric sample.
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Affiliation(s)
- Zubin A Irani
- School of Psychological Science, The University of Western Australia, Crawley, WA, Australia
| | - Andrew M C Sheridan
- School of Psychological Science, The University of Western Australia, Crawley, WA, Australia
| | - Timothy J Silk
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Michael Weinborn
- School of Psychological Science, The University of Western Australia, Crawley, WA, Australia
| | - Brandon E Gavett
- School of Psychological Science, The University of Western Australia, Crawley, WA, Australia
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Kobayashi LC, O'Shea BQ, Wixom C, Jones RN, Langa KM, Weir D, Lee J, Wong R, Gross AL. Lifetime occupational skill and later-life cognitive function among older adults in the United States, Mexico, India, and South Africa. Alzheimers Dement 2024; 20:1933-1943. [PMID: 38159252 PMCID: PMC10947921 DOI: 10.1002/alz.13665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/20/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION We conducted a cross-national comparison of the association between main lifetime occupational skills and later-life cognitive function across four economically and socially distinct countries. METHODS Data were from population-based studies of aging and their Harmonized Cognitive Assessment Protocols (HCAPs) in the US, South Africa, India, and Mexico (N = 10,037; Age range: 50 to 105 years; 2016 to 2020). Main lifetime occupational skill was classified according to the International Standard Classification of Occupations. Weighted, adjusted regression models estimated pooled and country-specific associations between main lifetime occupational skill and later-life general cognitive function in men and women. RESULTS We observed positive gradients between occupational skill and later-life cognitive function for men and women in the US and Mexico, a positive gradient for women but not men in India, and no association for men or women in South Africa. DISCUSSION Main lifetime occupations may be a source of later-life cognitive reserve, with cross-national heterogeneity in this association. HIGHLIGHTS No studies have examined cross-national differences in the association of occupational skill with cognition. We used data from Harmonized Cognitive Assessment Protocols in the US, Mexico, India, and South Africa. The association of occupational skill with cognitive function varies by country and gender.
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Affiliation(s)
- Lindsay C. Kobayashi
- Center for Social Epidemiology and Population HealthDepartment of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborUSA
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborUSA
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt)University of the WitwatersrandJohannesburgSouth Africa
| | - Brendan Q. O'Shea
- Center for Social Epidemiology and Population HealthDepartment of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborUSA
| | - Caroline Wixom
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborUSA
| | - Richard N. Jones
- Department of Psychiatry and Human BehaviorAlpert Medical SchoolBrown UniversityProvidenceUSA
- Department of NeurologyAlpert Medical SchoolBrown UniversityProvidenceUSA
| | - Kenneth M. Langa
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborUSA
- Department of Internal MedicineSchool of MedicineUniversity of MichiganAnn ArborUSA
- Institute for Healthcare Policy and InnovationUniversity of MichiganAnn ArborUSA
- Veterans Affairs Ann Arbor Center for Clinical Management ResearchAnn ArborMichiganUSA
| | - David Weir
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborUSA
| | - Jinkook Lee
- Center for Economic and Social ResearchUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of EconomicsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Rebeca Wong
- Sealy Center on AgingUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Alden L. Gross
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
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Randolph JJ, Lacritz LH, Colvin MK, Espe-Pfeifer P, Carter KR, Arnett PA, Fox-Fuller J, Aduen PA, Cullum CM, Sperling SA. Integrating Lifestyle Factor Science into Neuropsychological Practice: A National Academy of Neuropsychology Education Paper. Arch Clin Neuropsychol 2024; 39:121-139. [PMID: 37873931 DOI: 10.1093/arclin/acad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to review evidence and clinical implications related to lifestyle activities associated with promoting brain and cognitive health. Our review targets four key lifestyle factors: physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets. METHOD We conducted a critical review of the lifestyle factor literature in the four domains listed earlier. We contextualize this literature review by translating findings, when possible, into evidence-based recommendations to consider when providing neuropsychological services. RESULTS There is significant current evidence supporting the role of physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets on positive brain and cognitive health outcomes. While some null findings are present in all four areas reviewed, the weight of the evidence supports the notion that engaging in these activities may promote brain and cognitive functioning. CONCLUSIONS Clinical neuropsychologists can have confidence in recommending engagement in physical activity, social activity, and cognitively stimulating activity, and adhering to a Mediterranean-style diet to promote brain and cognitive health. We discuss limitations in existing lifestyle factor research and future directions to enhance the existing evidence base, including additional research with historically underrepresented groups and individuals with neurological conditions.
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Affiliation(s)
- John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Patricia Espe-Pfeifer
- Department of Psychiatry & Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Peter A Arnett
- Psychology Department, The Pennsylvania State University, University Park, PA, USA
| | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Paula A Aduen
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Jacksonville, FL, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Scott A Sperling
- Center for Neurological Restoration, Department of Neurology, Cleveland Clinic, Cleveland, Ohio, USA
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Yu X, Kabudula CW, Wagner RG, Bassil DT, Farrell MT, Tollman SM, Kahn K, Berkman LF, Rosenberg MS, Kobayashi LC. Mid-life employment trajectories and subsequent memory function and rate of decline in rural South Africa, 2000-22. Int J Epidemiol 2024; 53:dyae022. [PMID: 38365967 PMCID: PMC10873492 DOI: 10.1093/ije/dyae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/29/2024] [Indexed: 02/18/2024] Open
Abstract
AIM To investigate mid-life employment trajectories in relation to later-life memory function and rate of decline in rural South Africa. METHODS Data from the Agincourt Health and Socio-Demographic Surveillance System were linked to the 'Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa' (HAALSI) in rural Agincourt, South Africa (N = 3133). Employment was assessed every 4 years over 2000-12 as being employed (0, 1, 2 and ≥3 time points), being employed in a higher-skill occupation (0, 1, 2 and ≥3 time points) and dynamic employment trajectories identified using sequence analysis. Latent memory z-scores were assessed over 2014-22. Mixed-effects linear regression models were fitted to examine the associations of interest. RESULTS Sustained mid-life employment from 2000-12 (β = 0.052, 95% CI: -0.028 to 0.132, 1 vs 0 time points; β = 0.163, 95% CI: 0.077 to 0.250, 2 vs 0 time points; β = 0.212, 95% CI: 0.128 to 0.296, ≥3 vs 0 time points) and greater time spent in a higher-skill occupation (β = 0.077, 95% CI: -0.020 to 0.175, 1 vs 0 time points; β = 0.241, 95% CI: 0.070 to 0.412, 2 vs 0 time points; β = 0.361, 95% CI: 0.201 to 0.520, ≥3 vs 0 time points) were associated with higher memory scores in 2014/15, but not subsequent rate of memory decline. Moving from a lower-skill to higher-skill occupation was associated with higher memory function, but a faster rate of decline over 2014-22. CONCLUSIONS Sustained mid-life employment, particularly in higher-skill occupations, may contribute to later-life memory function in this post-Apartheid South African setting.
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Affiliation(s)
- Xuexin Yu
- Centre for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Chodziwadziwa W Kabudula
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of Witwatersrand, Johannesburg, South Africa
| | - Ryan G Wagner
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of Witwatersrand, Johannesburg, South Africa
| | - Darina T Bassil
- Harvard Centre for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
| | - Meagan T Farrell
- Harvard Centre for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
| | - Stephen M Tollman
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of Witwatersrand, Johannesburg, South Africa
| | - Lisa F Berkman
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of Witwatersrand, Johannesburg, South Africa
- Harvard Centre for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
| | - Molly S Rosenberg
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Lindsay C Kobayashi
- Centre for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of Witwatersrand, Johannesburg, South Africa
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
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Šneidere K, Zdanovskis N, Mondini S, Stepens A. Relationship between lifestyle proxies of cognitive reserve and cortical regions in older adults. Front Psychol 2024; 14:1308434. [PMID: 38250107 PMCID: PMC10797127 DOI: 10.3389/fpsyg.2023.1308434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction With the rapid increase in the population over 65 years old, research on healthy aging has become one of the priorities in the research community, looking for a cost-effective method to prevent or delay symptoms of mild cognitive disorder or dementia. Studies indicate that cognitive reserve theory could be beneficial in this regard. The aim of this study was to investigate the potential relationship between lifestyle socio-behavioral proxies of cognitive reserve and cortical regions in adults with no subjective cognitive decline. Methods Overall, 58 participants, aged 65-85 years, were included in the data analysis (M = 71.83, SD = 5.02, 20.7% male). Cognitive reserve proxies were measured using the Cognitive Reserve Index questionnaire, while cortical volumes were obtained with the Siemens 1.5 T Avanto MRI scanner and further mapped using the Desikan-Killiany-Tourville (DKT) Atlas. Estimated intracranial volume and age were used as covariates. Results The results indicated that higher occupational complexity was associated with larger cortical volume in the left middle temporal gyrus, the left and right inferior temporal gyrus, and the left inferior parietal lobule, while a combined proxy (the total CRI score) showed a positive relationship with the volume of left middle temporal gyrus and inferior parietal lobule, and pars orbitalis in the right hemisphere. Discussion These results might indicate that more complex occupational activities and overall more intellectually and socially active life-style could contribute to better brain health, especially in regions known to be more vulnerable to Alzheimer's disease.
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Affiliation(s)
- Kristine Šneidere
- Department of Health Psychology and Pedagogy, Riga Stradiņš University, Riga, Latvia
- Military Medicine Research and Study Centre, Riga Stradiņš University, Riga, Latvia
| | - Nauris Zdanovskis
- Military Medicine Research and Study Centre, Riga Stradiņš University, Riga, Latvia
- Department of Radiology, Riga Stradiņš University, Riga, Latvia
- Department of Radiology, Riga East University Hospital, Riga, Latvia
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Ainars Stepens
- Military Medicine Research and Study Centre, Riga Stradiņš University, Riga, Latvia
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Bransby L, Rosenich E, Maruff P, Lim YY. How Modifiable Are Modifiable Dementia Risk Factors? A Framework for Considering the Modifiability of Dementia Risk Factors. J Prev Alzheimers Dis 2024; 11:22-37. [PMID: 38230714 PMCID: PMC10995020 DOI: 10.14283/jpad.2023.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/06/2023] [Indexed: 01/18/2024]
Abstract
Many risk factors for dementia, identified from observational studies, are potentially modifiable. This raises the possibility that targeting key modifiable dementia risk factors may reduce the prevalence of dementia, which has led to the development of dementia risk reduction and prevention strategies, such as intervention trials or dementia prevention guidelines. However, what has rarely been considered in the studies that inform these strategies is the extent to which modifiable dementia risk factors can (1) be identified by individuals, and (2) be readily modified by individuals. Characteristics of modifiable dementia risk factors such as readiness of identification and targeting, as well as when they should be targeted, can influence the design, or success of strategies for reducing dementia risk. This review aims to develop a framework for classifying the degree of modifiability of dementia risk factors for research studies. The extent to which these modifiable dementia risk factors could be modified by an individual seeking to reduce their dementia risk is determined, as well as the resources that might be needed for both risk factor identification and modification, and whether modification may be optimal in early-life (aged <45 years), midlife (aged 45-65 years) or late-life (aged >65 years). Finally, barriers that could influence the ability of an individual to engage in risk factor modification and, ultimately, dementia risk reduction are discussed.
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Affiliation(s)
- L Bransby
- Lisa Bransby, Turner Institute for Brain and Mental Health, 18 Innovation Walk, Clayton, VIC 3800, Australia;
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13
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Montine KS, Berson E, Phongpreecha T, Huang Z, Aghaeepour N, Zou JY, MacCoss MJ, Montine TJ. Understanding the molecular basis of resilience to Alzheimer's disease. Front Neurosci 2023; 17:1311157. [PMID: 38192507 PMCID: PMC10773681 DOI: 10.3389/fnins.2023.1311157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024] Open
Abstract
The cellular and molecular distinction between brain aging and neurodegenerative disease begins to blur in the oldest old. Approximately 15-25% of observations in humans do not fit predicted clinical manifestations, likely the result of suppressed damage despite usually adequate stressors and of resilience, the suppression of neurological dysfunction despite usually adequate degeneration. Factors during life may predict the clinico-pathologic state of resilience: cardiovascular health and mental health, more so than educational attainment, are predictive of a continuous measure of resilience to Alzheimer's disease (AD) and AD-related dementias (ADRDs). In resilience to AD alone (RAD), core features include synaptic and axonal processes, especially in the hippocampus. Future focus on larger and more diverse cohorts and additional regions offer emerging opportunities to understand this counterforce to neurodegeneration. The focus of this review is the molecular basis of resilience to AD.
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Affiliation(s)
| | - Eloïse Berson
- Department of Pathology, Stanford University, Stanford, CA, United States
- Department of Anesthesiology, Stanford University, Stanford, CA, United States
| | - Thanaphong Phongpreecha
- Department of Pathology, Stanford University, Stanford, CA, United States
- Department of Anesthesiology, Stanford University, Stanford, CA, United States
| | - Zhi Huang
- Department of Pathology, Stanford University, Stanford, CA, United States
- Department of Biomedical Data Science, Stanford University, Stanford, CA, United States
| | - Nima Aghaeepour
- Department of Anesthesiology, Stanford University, Stanford, CA, United States
- Department of Biomedical Data Science, Stanford University, Stanford, CA, United States
| | - James Y. Zou
- Department of Biomedical Data Science, Stanford University, Stanford, CA, United States
- Department of Computer Science, Stanford University, Stanford, CA, United States
| | - Michael J. MacCoss
- Department of Genome Sciences, University of Washington, Seattle, WA, United States
| | - Thomas J. Montine
- Department of Pathology, Stanford University, Stanford, CA, United States
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M S, E K, N TR, E C, K S, Kaminyoge MS, B M, R W, G L, W K G, S-M P, B M. The role of cognitive reserve in mediating HIV-associated neurocognitive disorders in older adults living with-treated HIV in Mbeya, Tanzania: A cross-sectional observational study. Int J Geriatr Psychiatry 2023; 38:e6042. [PMID: 38141048 DOI: 10.1002/gps.6042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION HIV-associated neurocognitive disorders (HAND) are a spectrum of cognitive impairments in chronic HIV infection. HAND is common in sub-Saharan Africa (SSA), despite combination antiretroviral therapy (cART). Older people appear to be at increased risk. It is unknown if cognitive reserve (CR), which is protective in neurodegenerative dementias, protects against HAND. OBJECTIVE To evaluate the association of CR and risk of HAND in an older cART-treated population in SSA. METHODS Cross-sectional observational study completed in hospital outpatient clinics in Southwest Tanzania. We assessed HIV-positive participants aged ≥50 years established on cART using a neuropsychological test battery, functional assessment, informant history and depression screen. Control participants were HIV-negative individuals attending chronic disease clinics. We used operationalised Frascati criteria for HAND diagnosis. CR was measured using the Cognitive Reserve Index (CRI) and other proxy measures. RESULTS The prevalence of HAND was 64.4% (n = 219/343). Lower CRI score [odds ratio (OR) = 0.971, p = 0.009] and less formal education (OR = 4.364, p = 0.026) were independent risk factors for HAND but HIV-severity measures were not. Unemployment and low-skilled manual work were associated with increased risk of HAND in bivariate analysis but not in multivariable analysis. CONCLUSIONS Higher total CRI score and more formal education appeared to be protective against HAND, in this cohort. Potentially, cognitively and socially stimulating activities and exercise could increase cognitive reserve in later life. Cognitive reserve could possibly be more important than HIV-disease severity in risk of HAND in older people with treated HIV.
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Affiliation(s)
- Sadler M
- Newcastle University, Newcastle Upon Tyne, UK
| | - Kuhoga E
- Department of Epidemiology, Bio-Statistics and Clinical Research, University of Dar es Salaam-Mbeya College of Health and Allied Sciences, UDSM-MCHAS, Mbeya, Tanzania
- Vijiji Tanzania, Rural Health Promotion, Mbeya, Tanzania
| | | | - Chuma E
- Department of Epidemiology, Bio-Statistics and Clinical Research, University of Dar es Salaam-Mbeya College of Health and Allied Sciences, UDSM-MCHAS, Mbeya, Tanzania
- Vijiji Tanzania, Rural Health Promotion, Mbeya, Tanzania
| | - Said K
- Mbeya Zonal Referral Hospital (MZRH), Mbeya, Tanzania
| | | | - Mussa B
- Vijiji Tanzania, Rural Health Promotion, Mbeya, Tanzania
| | - Walker R
- Newcastle University, Newcastle Upon Tyne, UK
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Livingston G
- Division of Psychiatry, University College London, London, UK
| | - Gray W K
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Paddick S-M
- Newcastle University, Newcastle Upon Tyne, UK
- Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - Mbwele B
- Department of Epidemiology, Bio-Statistics and Clinical Research, University of Dar es Salaam-Mbeya College of Health and Allied Sciences, UDSM-MCHAS, Mbeya, Tanzania
- Vijiji Tanzania, Rural Health Promotion, Mbeya, Tanzania
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Muhammad T, Pai M, Kumar M, Sekher T. Multiple socioeconomic risks and cognitive impairment among older men and women in India. DIALOGUES IN HEALTH 2023; 2:100119. [PMID: 38515485 PMCID: PMC10953885 DOI: 10.1016/j.dialog.2023.100119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/22/2023] [Accepted: 02/21/2023] [Indexed: 03/23/2024]
Abstract
Introduction Socioeconomic status (SES) is negatively associated with innumerable health outcomes, including cognitive functioning. Yet much remains undiscovered about SES patterns in later-life cognition in low-and middle-income countries (LMICs). The purpose of this study was to examine the association between separate and combined socioconomic risks and cognitive impairment among older adults in India. Further, given gender disparities in later life cognitive functioning and SES, the study examines the associations between socioeconomic risks and cognitive impairment separately, for older men and women. Methods Data come from the 2017-18, first wave of the Longitudinal Aging Study in India (LASI), with 31,464 older adults aged 60 years and above. Cognitive impairment was assessed using multiple broad measures of memory, orientation, arithmetic function, and visuo-spatial construction skills. We present descriptive statistics along with cross-tabulation of the outcome variable. Additionally, binary logistic regression analysis was used to test the association between outcome and explanatory variables. SES is measured using education, paid work status, and household wealth measured using monthly per-capita consumption expenditure (MPCE). Results A proportion of 7.14% of the older men and 20.03% of older women reported cognitive impairment. The odds of cognitive impairment were higher among uneducated older men and women, and older men and women in lowest wealth quintile. Surprisingly, older women without current or prior work history report lower odds of cognitive impairment compared to their peers in labor force. While odds of cognitive impairment are higher among non-working older men, this association is not statistically significant. In older men, the odds of cognitive impairment were 5.34, 7.14, and 13.05 times higher with one, two, and three risk factors, respectively, compared with those with no risk exposure. A similar trend was observed for women but with comparatively lower odds. Conclusions Our findings underscore the need to distinguish between varying elements of SES to construct "upstream" health policies and programs that redistribute resources. In particular, the findings support the use of multiple SES indicators in identifying older adults most susceptible to cognitive deficits, and planning gender-based interventions to improve cognitive health in late life.
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Affiliation(s)
- T. Muhammad
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India
| | - Manacy Pai
- Department of Sociology, Kent State University, Kent, OH 44242, USA
| | - Manish Kumar
- Population Research Centre, Dharwad, Karnataka, India
| | - T.V. Sekher
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India
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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] [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.
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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.
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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] [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.
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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
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Hill-Jarrett TG. The Black radical imagination: a space of hope and possible futures. Front Neurol 2023; 14:1241922. [PMID: 37808484 PMCID: PMC10557459 DOI: 10.3389/fneur.2023.1241922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
The radical imagination entails stepping outside the confines of the now and into the expansiveness of what could be. It has been described as the ability to dream of possible futures and bring these possibilities back to the present to drive social transformation. This perspective paper seeks to provide an overview of the radical imagination and its intersections with Afrofuturism, a framework and artistic epistemology that expresses the Black cultural experience through a space of hope where Blackness is integral. In this paper, I propose three processes that comprise the radical imagination: (1) imagining alternative Black futures, (2) radical hope, and (3) collective courage. I consider the neural networks that underlie each process and consider how the Black radical imagination is a portal through which aging Black adults experience hope and envision futures that drive social change. I conclude with considerations of what brain health and healing justice looks like for aging Black Americans- specifically, how invocation of the Black radical imagination may have positive brain health effects for a demographic group at increased risk for Alzheimer's disease and related dementias.
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Affiliation(s)
- Tanisha G. Hill-Jarrett
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, Memory and Aging Center, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
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Jester DJ, Palmer BW, Thomas ML, Brown LL, Tibiriçá L, Jeste DV, Gilmer T. Impact of educational attainment on time to cognitive decline among marginalized older adults: Cohort study of 20,311 adults. J Am Geriatr Soc 2023; 71:2913-2923. [PMID: 37073606 PMCID: PMC10523883 DOI: 10.1111/jgs.18340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/06/2023] [Accepted: 02/24/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND The effect of years of education on the maintenance of healthy cognitive functioning may differ by race and ethnicity given historical and ongoing inequities in educational quality. METHODS We examined 20,311 Black, Latinx, and White adults aged 51-100 from the Health and Retirement Study (2008-2016). Telephone Interview for Cognitive Status-27 data was used to measure cognitive functioning. Generalized additive mixed models were stratified by race and ethnicity and educational attainment (≥12 vs. <12 years). Selected social determinants of health, all-cause mortality, time-varying health and healthcare utilization characteristics, and study wave were included as covariates. RESULTS On average, Black and Latinx adults scored lower at baseline compared to White adults regardless of educational attainment (p < 0.001), with a significant overlap in the distributions of scores. The rate of cognitive decline was non-linear for Black, Latinx, and White adults (p < 0.001), and a period of stability was witnessed for those with higher educational attainment irrespective of race and ethnicity. Compared to Black, Latinx, and White adults with lower educational attainment, higher-educated White adults received the greatest protection from cognitive decline (13 years; 64 vs. 51), followed by Latinx (12 years; 67 vs. 55), and Black adults (10 years; 61 vs. 51). Latinx adults experienced cognitive decline beginning at a later age. CONCLUSIONS The extent to which higher educational attainment protects adults from cognitive decline differs by race and ethnicity, such that higher-educated White adults received a greater benefit than higher-educated Black or Latinx adults.
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Affiliation(s)
- Dylan J. Jester
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Barton W. Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
- Psychology Division, Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Michael L. Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO
| | - Lauren L. Brown
- Division of Health Management and Policy, School of Public Health, San Diego State University, San Diego, CA
| | - Lize Tibiriçá
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Todd Gilmer
- Herbert Wertheim School of Public Health, University of California San Diego, San Diego, California
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20
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Martin-Bassols N, de New SC, Johnston DW, Shields MA. Cognitive activity at work and the risk of dementia. HEALTH ECONOMICS 2023; 32:1561-1580. [PMID: 36967557 DOI: 10.1002/hec.4679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 06/04/2023]
Abstract
Dementia prevalence is projected to rise steeply in coming decades, producing tremendous burdens on families, and health and social services. Motivated by the need for further robust evidence on modifiable risk factors, we investigate the relationship between cognitive activity at work and later-life dementia. Using data from the US Health and Retirement Study matched to the O*NET occupational database, we find that a one standard deviation increase in the cognitive activity associated with one's longest held occupation is associated with a 0.9 percentage point reduction in (predicted) dementia, or a 24% reduction relative to the mean. This relationship is consistently found across model specifications and robustness tests. When controlling for individual fixed-effects we find that the association between dementia and work cognitive activity increases with age. Overall, our results provide some evidence in support of the inclusion of cognitive activity at work as a recognized modifiable risk factor for dementia.
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Affiliation(s)
| | - Sonja C de New
- Centre for Health Economics, Monash University, Clayton, Victoria, Australia
| | - David W Johnston
- Centre for Health Economics, Monash University, Clayton, Victoria, Australia
| | - Michael A Shields
- Centre for Health Economics, Monash University, Clayton, Victoria, Australia
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21
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Coleman ME, Roessler MEH, Peng S, Roth AR, Risacher SL, Saykine AJ, Apostolova LG, Perry BL. Social enrichment on the job: Complex work with people improves episodic memory, promotes brain reserve, and reduces the risk of dementia. Alzheimers Dement 2023; 19:2655-2665. [PMID: 37037592 PMCID: PMC10272079 DOI: 10.1002/alz.13035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/22/2022] [Indexed: 04/12/2023]
Abstract
Individuals with more complex jobs experience better cognitive function in old age and a lower risk of dementia, yet complexity has multiple dimensions. Drawing on the Social Networks in Alzheimer Disease study, we examine the association between occupational complexity and cognition in a sample of older adults (N = 355). A standard deviation (SD) increase in complex work with people is associated with a 9% to 12% reduction in the probability of mild cognitive impairment or dementia, a 0.14-0.19 SD increase in episodic memory, and a 0.18-0.25 SD increase in brain reserve, defined as the gap (residual) between global cognitive function and magnetic resonance imaging (MRI) indicators of brain atrophy. In contrast, complexity with data or things is rarely associated with cognitive outcomes. We discuss the clinical and methodological implications of these findings, including the need to complement data-centered activities (e.g., Sudoku puzzles) with person-centered interventions that increase social complexity.
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Affiliation(s)
- Max E. Coleman
- Department of Sociology, University of Utah, Salt Lake City, Utah, USA
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Meghan E. H. Roessler
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
- Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA
| | - Siyun Peng
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Adam R. Roth
- Department of Sociology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Shannon L. Risacher
- Stark Neurosciences Research Institute, Indiana Alzheimer's Disease Research Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Andrew J. Saykine
- Stark Neurosciences Research Institute, Indiana Alzheimer's Disease Research Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Departments of Neurology, Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Liana G. Apostolova
- Stark Neurosciences Research Institute, Indiana Alzheimer's Disease Research Center, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Departments of Neurology, Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Brea L. Perry
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
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22
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Zavecz Z, Shah VD, Murillo OG, Vallat R, Mander BA, Winer JR, Jagust WJ, Walker MP. NREM sleep as a novel protective cognitive reserve factor in the face of Alzheimer's disease pathology. BMC Med 2023; 21:156. [PMID: 37138290 PMCID: PMC10155344 DOI: 10.1186/s12916-023-02811-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/28/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) pathology impairs cognitive function. Yet some individuals with high amounts of AD pathology suffer marked memory impairment, while others with the same degree of pathology burden show little impairment. Why is this? One proposed explanation is cognitive reserve i.e., factors that confer resilience against, or compensation for the effects of AD pathology. Deep NREM slow wave sleep (SWS) is recognized to enhance functions of learning and memory in healthy older adults. However, that the quality of NREM SWS (NREM slow wave activity, SWA) represents a novel cognitive reserve factor in older adults with AD pathology, thereby providing compensation against memory dysfunction otherwise caused by high AD pathology burden, remains unknown. METHODS Here, we tested this hypothesis in cognitively normal older adults (N = 62) by combining 11C-PiB (Pittsburgh compound B) positron emission tomography (PET) scanning for the quantification of β-amyloid (Aβ) with sleep electroencephalography (EEG) recordings to quantify NREM SWA and a hippocampal-dependent face-name learning task. RESULTS We demonstrated that NREM SWA significantly moderates the effect of Aβ status on memory function. Specifically, NREM SWA selectively supported superior memory function in individuals suffering high Aβ burden, i.e., those most in need of cognitive reserve (B = 2.694, p = 0.019). In contrast, those without significant Aβ pathological burden, and thus without the same need for cognitive reserve, did not similarly benefit from the presence of NREM SWA (B = -0.115, p = 0.876). This interaction between NREM SWA and Aβ status predicting memory function was significant after correcting for age, sex, Body Mass Index, gray matter atrophy, and previously identified cognitive reserve factors, such as education and physical activity (p = 0.042). CONCLUSIONS These findings indicate that NREM SWA is a novel cognitive reserve factor providing resilience against the memory impairment otherwise caused by high AD pathology burden. Furthermore, this cognitive reserve function of NREM SWA remained significant when accounting both for covariates, and factors previously linked to resilience, suggesting that sleep might be an independent cognitive reserve resource. Beyond such mechanistic insights are potential therapeutic implications. Unlike many other cognitive reserve factors (e.g., years of education, prior job complexity), sleep is a modifiable factor. As such, it represents an intervention possibility that may aid the preservation of cognitive function in the face of AD pathology, both present moment and longitudinally.
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Affiliation(s)
- Zsófia Zavecz
- Department of Psychology, Center for Human Sleep Science, University of California Berkeley, Berkeley, CA, 94720, USA.
| | - Vyoma D Shah
- Department of Psychology, Center for Human Sleep Science, University of California Berkeley, Berkeley, CA, 94720, USA
| | - Olivia G Murillo
- Department of Psychology, Center for Human Sleep Science, University of California Berkeley, Berkeley, CA, 94720, USA
| | - Raphael Vallat
- Department of Psychology, Center for Human Sleep Science, University of California Berkeley, Berkeley, CA, 94720, USA
| | - Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, 92617, USA
| | - Joseph R Winer
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, 94304, USA
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, 94720, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - Matthew P Walker
- Department of Psychology, Center for Human Sleep Science, University of California Berkeley, Berkeley, CA, 94720, USA.
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, 94720, USA.
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Sale A, Noale M, Cintoli S, Tognoni G, Braschi C, Berardi N, Maggi S, Maffei L. Long-term beneficial impact of the randomised trial 'Train the Brain', a motor/cognitive intervention in mild cognitive impairment people: effects at the 14-month follow-up. Age Ageing 2023; 52:7160021. [PMID: 37167616 DOI: 10.1093/ageing/afad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 01/23/2023] [Indexed: 05/13/2023] Open
Abstract
No treatment options are currently available to counteract cognitive deficits and/or delay progression towards dementia in older people with mild cognitive impairment (MCI). The 'Train the Brain' programme is a combined motor and cognitive intervention previously shown to markedly improve cognitive functions in MCI individuals compared to non-trained MCI controls, as assessed at the end of the 7-month intervention. Here, we extended the previous analyses to include the long-term effects of the intervention and performed a data disaggregation by gender, education and age of the enrolled participants. We report that the beneficial impact on cognitive functions was preserved at the 14-month follow-up, with greater effects in low-educated compared to high-educated individuals, and in women than in men.
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Affiliation(s)
- Alessandro Sale
- Neuroscience Institute CNR (National Research Council), Via Moruzzi 1, Pisa 56124, Italy
| | - Marianna Noale
- Neuroscience Institute CNR (National Research Council), Via Giustiniani 2, Padua 35128, Italy
| | - Simona Cintoli
- Department of Clinical and Experimental Medicine-Neurology Unit, University of Pisa and AOU Pisa, Pisa, Italy
| | - Gloria Tognoni
- Department of Clinical and Experimental Medicine-Neurology Unit, University of Pisa and AOU Pisa, Pisa, Italy
| | - Chiara Braschi
- Neuroscience Institute CNR (National Research Council), Via Moruzzi 1, Pisa 56124, Italy
| | - Nicoletta Berardi
- Neuroscience Institute CNR (National Research Council), Via Moruzzi 1, Pisa 56124, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, Florence University, Via San Salvi, Florence 50100, Italy
| | - Stefania Maggi
- Neuroscience Institute CNR (National Research Council), Via Giustiniani 2, Padua 35128, Italy
| | - Lamberto Maffei
- Neuroscience Institute CNR (National Research Council), Via Moruzzi 1, Pisa 56124, Italy
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24
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Rydström A, Stephen R, Kåreholt I, Darin Mattsson A, Ngandu T, Lehtisalo J, Bäckman L, Kemppainen N, Rinne J, Sindi S, Soininen H, Vanninen R, Solomon A, Mangialasche F. The Role of Brain Integrity in the Association between Occupational Complexity and Cognitive Performance in Subjects with Increased Risk of Dementia. Gerontology 2023; 69:972-985. [PMID: 37071974 DOI: 10.1159/000530688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/24/2023] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION Mechanisms underlying the positive association between occupational mental demands and late-life cognition are poorly understood. The objective of this study was to assess whether the association between occupational complexity and cognition is related to and moderated by brain integrity in individuals at risk for dementia. Brain integrity was appraised throughout structural measures (magnetic resonance imaging, MRI) and amyloid accumulation (Pittsburgh compound B (PiB)-positron emission tomography, PiB-PET). METHODS Participants from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) neuroimaging sample - MRI (N = 126), PiB-PET (N = 41) - were included in a post hoc cross-sectional analysis. Neuroimaging parameters comprised the Alzheimer's disease signature (ADS) cortical thickness (FreeSurfer 5.3), medial temporal atrophy (MTA), and amyloid accumulation (PiB-PET). Cognition was assessed using the neuropsychological test battery. Occupational complexity with data, people, and substantive complexity were classified through the Dictionary of Occupational Titles. Linear regression models included cognition as dependent variable, and occupational complexity, measures of brain integrity, and their interaction terms as predictors. RESULTS Occupational complexity with data and substantive complexity were associated with better cognition (overall cognition, executive function) when adjusting for ADS and MTA (independent association). Significant interaction effects between occupational complexity and brain integrity were also found, indicating that, for some indicators of brain integrity and cognition (e.g., overall cognition, processing speed), the positive association between occupational complexity and cognition occurred only among persons with higher brain integrity (moderated association). CONCLUSIONS Among individuals at risk for dementia, occupational complexity does not seem to contribute toward resilience against neuropathology. These exploratory findings require validation in larger populations.
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Affiliation(s)
- Anders Rydström
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- Aging Research Center, Department of Neurobiology, Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Ruth Stephen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ingemar Kåreholt
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- Aging Research Center, Department of Neurobiology, Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Institute of Gerontology, School of Health and Welfare, Aging Research Network-Jönköping, Jönköping University, Jönköping, Sweden
| | - Alexander Darin Mattsson
- Aging Research Center, Department of Neurobiology, Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Tiia Ngandu
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Welfare, Population Health, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jenni Lehtisalo
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Public Health and Welfare, Population Health, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Nina Kemppainen
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Juha Rinne
- Turku PET Centre, Turku University Hospital, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Neurocenter/Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Ritva Vanninen
- Diagnostic Imaging Centre, Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
- Unit of Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- Aging Research Center, Department of Neurobiology, Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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25
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Masala C, Solla P, Loy F. Gender-Related Differences in the Correlation between Odor Threshold, Discrimination, Identification, and Cognitive Reserve Index in Healthy Subjects. BIOLOGY 2023; 12:biology12040586. [PMID: 37106786 PMCID: PMC10136322 DOI: 10.3390/biology12040586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Many studies suggested that olfactory function could be associated with semantic memory, executive function, and verbal fluency. However, the gender-related association between olfactory function and the cognitive domain is not well investigated. The aim of this study was to estimate gender-related differences in the relationship between olfactory function and each specific cognitive domain of the Cognitive Reserve Index (CRI) questionnaire, such as education, working activity, and leisure time in healthy subjects. METHODS Two hundred and sixty-nine participants were recruited (158 women and 111 men), with a mean age of 48.1 ± 18.6 years. The CRI questionnaire and Sniffin' Sticks test were used to evaluate the cognitive reserve and the olfactory function, respectively. RESULTS In all subjects, significant associations between the odor threshold versus CRI-Education, between the odor discrimina-tion and identification versus CRI-Working activity and CRI-Leisure Time, were found. In women, odor threshold, discrimination, and identification were associated with CRI-Leisure Time, while in men, only a significant association between odor threshold and CRI-Education was observed. CONCLUSIONS Our data, showing significant gender-related associations between olfactory function and CRI scores, suggested the use of olfactory evaluation and cognitive reserve as an important screening tool for the early detection of mild cognitive impairment.
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Affiliation(s)
- Carla Masala
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042 Cagliari, Italy
| | - Paolo Solla
- Department of Neurology, University of Sassari, Viale S. Pietro 10, 07100 Sassari, Italy
| | - Francesco Loy
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042 Cagliari, Italy
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26
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Ramos‐Henderson M, Soto‐Añari M, Herrera‐Pino J, Porto MF, Camargo L, Hesse H, Ferrel‐Ortega † R, Quispe‐Ayala C, García de la Cadena C, Mendoza‐Ruvalcaba N, Caldichoury N, Castellanos C, Varón C, Aguilar D, Antezana R, Martinez J, Román N, Boza C, Ducassou A, Saldías C, López N. Factors associated with cognitive impairment in Latin American older adults: A cross-sectional observational study of COVID-19 confinement. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12427. [PMID: 37063389 PMCID: PMC10102893 DOI: 10.1002/dad2.12427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/10/2023] [Accepted: 03/12/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION The effects of COVID-19 confinement have been severe, especially in older adults. Therefore, we analyzed the factors associated with cognitive impairment (CI) in Latin America (LA). METHODS We conducted a cross-sectional observational study with a total of 5245 older adults from 10 countries in LA. Measurement We used the Telephone Montreal Cognitive Assessment (T-MoCA) and the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8) scale. RESULTS We found that age, depressive symptomatology, bone fractures, being widowed, having a family member with dementia, and unemployment were associated with an increased risk of CI. In contrast, higher education, hypertension with continuous treatment, quarantine, and keeping stimulating cognitive and physical activities were associated with a lower probability of CI. No significant association was found between suffering from diabetes or being retired and CI. DISCUSSION It is essential to conduct follow-up studies on these factors, considering their relationship with CI and the duration of confinement.
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Affiliation(s)
- Miguel Ramos‐Henderson
- Centro de Investigación e Innovación en Gerontología Aplicada (CIGAP)Facultad de SaludUniversidad Santo TomásAntofagastaChile
| | - Marcio Soto‐Añari
- Departamento de PsicologíaUniversidad Católica San PabloArequipaPerú
| | | | - María F. Porto
- Neuroscience AreaL'Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
- Department of CognitionDevelopment and Educational PsychologyUniversitat de BarcelonaBarcelonaSpain
| | - Loida Camargo
- Facultad de Medicina, Departamento Médico, Grupo de investigación Neurociencia y Salud GlobalUniversidad de CartagenaCartagena de IndiasColombia
| | - Heike Hesse
- Observatorio COVID‐19Universidad Tecnológica CentroamericanaTegucigalpaHonduras
| | - Robert Ferrel‐Ortega †
- Programa de PsicologíaFacultad de Ciencias de la SaludUniversidad MagdalenaSanta MartaColombia
| | - Cesar Quispe‐Ayala
- Facultad de Derecho y Ciencias PolíticasUniversidad Nacional de HuancavelicaHuancavelicaPerú
| | - Claudia García de la Cadena
- Departamento de NeuropsicologíaFacultad de Ciencias SocialesUniversidad del Valle de GuatemalaGuatemala CityGuatema
| | - Neyda Mendoza‐Ruvalcaba
- Departamento de Ciencias de la Salud Enfermedad como Proceso IndividualUniversidad de GuadalajaraCutonalaMéxico
| | | | - Cesar Castellanos
- Dirección ejecutivaInstituto Dominicano para el Estudio de la Salud Integral y la Psicología Aplicada (IDESIP)Santo DomingoRepública Dominicana
| | - Claudia Varón
- Dirección ejecutivaFundación Acción Familiar Alzheimer Colombia‐AFACOLBogotáColombia
| | - Dolores Aguilar
- Facultad de Derecho y Ciencias PolíticasUniversidad Nacional de HuancavelicaHuancavelicaPerú
| | - Regulo Antezana
- Facultad de Derecho y Ciencias PolíticasUniversidad Nacional de HuancavelicaHuancavelicaPerú
| | - Juan Martinez
- Departmet of EducationUniversidad Ana G. MéndezSan JuanPuerto Rico
| | - Norbel Román
- Centro de Investigación en Hematología y Trastornos AfinesUniversidad de Costa RicaSan JoséCosta Rica
| | - Carolina Boza
- Centro de Investigación en Hematología y Trastornos AfinesUniversidad de Costa RicaSan JoséCosta Rica
| | - Alejandro Ducassou
- Vicerrectoría Regional y Escuela de PsicologiaFaculta de Medicina y Ciencias de la SaludUniversidad Mayor‐TemucoTemucoChile
| | - Carol Saldías
- Facultad de Ciencias de la SaludUniversidad San SebastiánValdiviaChile
| | - Norman López
- Departamento de Ciencias SocialesUniversidad de La CostaBarranquillaColombia
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27
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Orchard ER, Rutherford HJV, Holmes AJ, Jamadar SD. Matrescence: lifetime impact of motherhood on cognition and the brain. Trends Cogn Sci 2023; 27:302-316. [PMID: 36609018 PMCID: PMC9957969 DOI: 10.1016/j.tics.2022.12.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 01/06/2023]
Abstract
Profound environmental, hormonal, and neurobiological changes mark the transition to motherhood as a major biosocial life event. Despite the ubiquity of motherhood, the enduring impact of caregiving on cognition and the brain across the lifespan is not well characterized and represents a unique window of opportunity to investigate human neural and cognitive development. By integrating insights from the human and animal maternal brain literatures with theories of cognitive ageing, we outline a framework for understanding maternal neural and cognitive changes across the lifespan. We suggest that the increased cognitive load of motherhood provides an initial challenge during the peripartum period, requiring continuous adaptation; yet when these demands are sustained across the lifespan, they result in increased late-life cognitive reserve.
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Affiliation(s)
- Edwina R Orchard
- Yale Child Study Center, School of Medicine, Yale University, New Haven, CT, USA; Department of Psychology, Faculty of Arts and Sciences, Yale University, New Haven, CT, USA.
| | | | - Avram J Holmes
- Department of Psychology, Faculty of Arts and Sciences, Yale University, New Haven, CT, USA
| | - Sharna D Jamadar
- Turner Institute of Brain and Mental Health & Monash Biomedical Imaging, Monash University, Melbourne, Australia
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28
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Lv T, You S, Qin R, Hu Z, Ke Z, Yao W, Zhao H, Xu Y, Bai F. Distinct reserve capacity impacts on default-mode network in response to left angular gyrus-navigated repetitive transcranial magnetic stimulation in the prodromal Alzheimer disease. Behav Brain Res 2023; 439:114226. [PMID: 36436729 DOI: 10.1016/j.bbr.2022.114226] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/01/2022] [Accepted: 11/23/2022] [Indexed: 11/25/2022]
Abstract
Default-mode network (DMN) may be the earliest affected network and is associated with cognitive decline in Alzheimer's disease (AD). Repetitive transcranial magnetic stimulation (rTMS) may help to modulate DMN plasticity. Still, stimulation effects substantially vary across studies and individuals. Global left frontal cortex (gLFC) connectivity, a substitute for reserve capacity, may contribute to the heterogeneous physiological effects of neuro-navigated rTMS. This study investigated the effects of left angular gyrus-navigated rTMS on DMN connectivity in different reserve capacity participants. gLFC connectivity, was computed through resting-state fMRI correlations. Thirty-one prodromal AD patients were divided into low connection group (LCG) and high connection group (HCG) by the median of gLFC connectivity. Distinct reserve capacity impacts on DMN in response to rTMS were identified in these two groups. Then, brain-behavior relationships were examined. gLFC connectivity within a certain range is directly proportional to cognitive reserve ability (i.e., LCG), and the effectiveness of functional connectivity beyond this range decreases (i.e, HCG). Moreover, LCG exhibited increased DMN connectivity and significantly positive memory improvements, while HCG showed a contrary connectivity decline and maintained or slightly improved their cognitive function after neuro-navigated rTMS treatment. The prodromal AD patients with the distinct reserve capacity may benefit differently from left angular gyrus-navigated rTMS, which may lead to increasing attention in defining personalized medicine approach of AD.
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Affiliation(s)
- Tingyu Lv
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China
| | - Shengqi You
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China
| | - Ruomeng Qin
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing 210008, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing 210008, China
| | - Zheqi Hu
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China
| | - Zhihong Ke
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China
| | - Weina Yao
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China
| | - Hui Zhao
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing 210008, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing 210008, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing 210008, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing 210008, China
| | - Feng Bai
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing 210008, China; Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing 210008, China; Nanjing Neuropsychiatry Clinic Medical Center, Nanjing 210008, China.
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Boyle R, Connaughton M, McGlinchey E, Knight SP, De Looze C, Carey D, Stern Y, Robertson IH, Kenny RA, Whelan R. Connectome-based predictive modelling of cognitive reserve using task-based functional connectivity. Eur J Neurosci 2023; 57:490-510. [PMID: 36512321 PMCID: PMC10107737 DOI: 10.1111/ejn.15896] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
Cognitive reserve supports cognitive function in the presence of pathology or atrophy. Functional neuroimaging may enable direct and accurate measurement of cognitive reserve which could have considerable clinical potential. The present study aimed to develop and validate a measure of cognitive reserve using task-based fMRI data that could then be applied to independent resting-state data. Connectome-based predictive modelling with leave-one-out cross-validation was applied to predict a residual measure of cognitive reserve using task-based functional connectivity from the Cognitive Reserve/Reference Ability Neural Network studies (n = 220, mean age = 51.91 years, SD = 17.04 years). This model generated summary measures of connectivity strength that accurately predicted a residual measure of cognitive reserve in unseen participants. The theoretical validity of these measures was established via a positive correlation with a socio-behavioural proxy of cognitive reserve (verbal intelligence) and a positive correlation with global cognition, independent of brain structure. This fitted model was then applied to external test data: resting-state functional connectivity data from The Irish Longitudinal Study on Ageing (TILDA, n = 294, mean age = 68.3 years, SD = 7.18 years). The network-strength predicted measures were not positively associated with a residual measure of cognitive reserve nor with measures of verbal intelligence and global cognition. The present study demonstrated that task-based functional connectivity data can be used to generate theoretically valid measures of cognitive reserve. Further work is needed to establish if, and how, measures of cognitive reserve derived from task-based functional connectivity can be applied to independent resting-state data.
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Affiliation(s)
- Rory Boyle
- Department of NeurologyMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Trinity College Institute of NeuroscienceTrinity College DublinDublinIreland
| | - Michael Connaughton
- Trinity College Institute of NeuroscienceTrinity College DublinDublinIreland
- Department of Psychiatry, School of MedicineTrinity College DublinDublinIreland
| | - Eimear McGlinchey
- School of Nursing and MidwiferyTrinity College DublinDublinIreland
- Global Brain Health InstituteTrinity College DublinDublinIreland
| | - Silvin P. Knight
- The Irish Longitudinal Study on Aging (TILDA), School of MedicineTrinity College DublinDublinIreland
| | - Céline De Looze
- The Irish Longitudinal Study on Aging (TILDA), School of MedicineTrinity College DublinDublinIreland
| | - Daniel Carey
- The Irish Longitudinal Study on Aging (TILDA), School of MedicineTrinity College DublinDublinIreland
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of NeurologyColumbia UniversityNew York CityNew YorkUSA
| | - Ian H. Robertson
- Global Brain Health InstituteTrinity College DublinDublinIreland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Aging (TILDA), School of MedicineTrinity College DublinDublinIreland
- Mercer's Institute for Successful AgeingSt. James's HospitalDublinIreland
| | - Robert Whelan
- Trinity College Institute of NeuroscienceTrinity College DublinDublinIreland
- Global Brain Health InstituteTrinity College DublinDublinIreland
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30
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Kleineidam L, Wolfsgruber S, Weyrauch AS, Zulka LE, Forstmeier S, Roeske S, van den Bussche H, Kaduszkiewicz H, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Brettschneider C, König HH, Weeg D, Bickel H, Luppa M, Rodriguez FS, Freiesleben SD, Erdogan S, Unterfeld C, Peters O, Spruth EJ, Altenstein S, Lohse A, Priller J, Fliessbach K, Kobeleva X, Schneider A, Bartels C, Schott BH, Wiltfang J, Maier F, Glanz W, Incesoy EI, Butryn M, Düzel E, Buerger K, Janowitz D, Ewers M, Rauchmann BS, Perneczky R, Kilimann I, Görß D, Teipel S, Laske C, Munk MHJ, Spottke A, Roy N, Brosseron F, Heneka MT, Ramirez A, Yakupov R, Scherer M, Maier W, Jessen F, Riedel-Heller SG, Wagner M. Midlife occupational cognitive requirements protect cognitive function in old age by increasing cognitive reserve. Front Psychol 2022; 13:957308. [PMID: 36571008 PMCID: PMC9773841 DOI: 10.3389/fpsyg.2022.957308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them. Methods We systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the O*NET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE). Results Regarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM. Discussion Our results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology.
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Affiliation(s)
- Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,*Correspondence: Luca Kleineidam
| | | | - Anne-Sophie Weyrauch
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Linn E. Zulka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,Department of Psychology and Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
| | - Simon Forstmeier
- Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Siegen, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Medical Faculty, Institute of General Practice, University of Kiel, Kiel, Germany
| | - Birgitt Wiese
- Center for Information Management, Hannover Medical School, Hanover, Germany
| | - Siegfried Weyerer
- Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University, Heidelberg, Germany
| | - Jochen Werle
- Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University, Heidelberg, Germany
| | - Angela Fuchs
- Medical Faculty, Centre for Health and Society (CHS), Institute of General Practice (ifam), Heinrich Heine University, Düsseldorf, Germany
| | - Michael Pentzek
- Medical Faculty, Centre for Health and Society (CHS), Institute of General Practice (ifam), Heinrich Heine University, Düsseldorf, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dagmar Weeg
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Melanie Luppa
- Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Francisca S. Rodriguez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Silka Dawn Freiesleben
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
| | - Selin Erdogan
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
| | - Chantal Unterfeld
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Benjamin Franklin, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
| | - Eike J. Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea Lohse
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Josef Priller
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany,University of Edinburgh and UK DRI, Edinburgh, United Kingdom
| | - Klaus Fliessbach
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Xenia Kobeleva
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anja Schneider
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Björn H. Schott
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany,Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany,Department of Medical Sciences, Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Franziska Maier
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Enise I. Incesoy
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Michaela Butryn
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany,Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, United Kingdom,Sheeld Institute for Translational Neuroscience (SITraN), University of Sheeld, Sheeld, United Kingdom
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Doreen Görß
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Matthias H. J. Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany,Department of Biology, Technische Universität Darmstadt, Darmstadt, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Department of Neurology, University of Bonn, Bonn, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | | | - Michael T. Heneka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Alfredo Ramirez
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany,Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, United States
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany,Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Steffi G. Riedel-Heller
- Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
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31
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Gu H, Yao X, Diao C, Liu M, Kong W, Liu H, Zhao Y, Meng Z. Global cognitive function is associated with sex, educational level, occupation type, and speech recognition rate in older Chinese adults: a single-center, prospective, cross-sectional study. BMC Geriatr 2022; 22:947. [PMID: 36482356 PMCID: PMC9733133 DOI: 10.1186/s12877-022-03603-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 11/09/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The development of cognitive impairment may be delayed if its risk factors are identified and detected, if its developmental trend can be predicted, and if early intervention can be performed. This study primarily aimed to investigate the association between global cognitive function and hearing loss, educational level, and occupation type and to determine any differences in such associations according to sex among older Chinese adults. METHODS In this cross-sectional study, we prospectively recruited 219 individuals above 55 years old in an otolaryngology outpatient clinic who could write independently and had no severe vision impairment. Audiometric examinations included otoscopy, acoustic immittance, pure-tone audiometry, and speech audiometry for each ear. Cognitive function was evaluated by using the Chinese version of the Mini-Mental State Examination (MMSE). Multivariable linear regression analyses were performed to evaluate the relationship between variables and MMSE scores after adjusting for independent variables that were statistically significant in the univariable analyses. RESULTS We enrolled 219 individuals: 98 men (mean ± standard deviation age, 63.08 ± 6.64 years) and 121 women (62.64 ± 7.17 years). The overall MMSE scores of the normal hearing group and the mild, moderate, and severe-to-profound hearing loss groups were 24.00 (5.00), 24.00 (5.00), 23.00 (5.00), and 23.00 (13.00), respectively. MMSE scores were higher among participants with higher educational levels (p < 0.001) and were significantly correlated with occupation type (p < 0.001). MMSE scores were significantly higher in men than in women (p < 0.001). However, after the analysis of the five subdomains, significant differences were only observed for attention and calculation (p < 0.001) and language (p = 0.011). We further compared the distribution of educational levels between men and women by using the chi-square test; there was no significant difference in educational level between the sexes (p = 0.070). CONCLUSIONS We reported statistically significant relationships between global cognitive function and sex, educational level, and occupation type. Sex-specific strategies may be required to improve healthcare policies.
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Affiliation(s)
- Hailing Gu
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
| | - Xinyi Yao
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
| | - Cong Diao
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
| | - Min Liu
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
| | - Weili Kong
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Haotian Liu
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
| | - Yu Zhao
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaoli Meng
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
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32
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Rydström A, Darin-Mattsson A, Kåreholt I, Ngandu T, Lehtisalo J, Solomon A, Antikainen R, Bäckman L, Hänninen T, Laatikainen T, Levälahti E, Lindström J, Paajanen T, Havulinna S, Peltonen M, Sindi S, Soininen H, Neely AS, Strandberg T, Tuomilehto J, Kivipelto M, Mangialasche F. Occupational complexity and cognition in the FINGER multidomain intervention trial. Alzheimers Dement 2022; 18:2438-2447. [PMID: 35142055 DOI: 10.1002/alz.12561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/21/2021] [Accepted: 12/03/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Lifetime exposure to occupational complexity is linked to late-life cognition, and may affect benefits of preventive interventions. METHODS In the 2-year multidomain Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we investigated, through post hoc analyses (N = 1026), the association of occupational complexity with cognition. Occupational complexity with data, people, and substantive complexity were classified through the Dictionary of Occupational Titles. RESULTS Higher levels of occupational complexity were associated with better baseline cognition. Measures of occupational complexity had no association with intervention effects on cognition, except for occupational complexity with data, which was associated with the degree of intervention-related gains for executive function. DISCUSSION In older adults at increased risk for dementia, higher occupational complexity is associated with better cognition. The cognitive benefit of the FINGER intervention did not vary significantly among participants with different levels of occupational complexity. These exploratory findings require further testing in larger studies.
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Affiliation(s)
- Anders Rydström
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Alexander Darin-Mattsson
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Ingemar Kåreholt
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Institute of Gerontology, School of Health and Welfare, Aging Research Network - Jönköping (ARN-J), Jönköping University, Jönköping, Sweden
| | - Tiia Ngandu
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jenni Lehtisalo
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Riitta Antikainen
- Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and Oulu City Hospital, Oulu, Finland
| | - Lars Bäckman
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Tuomo Hänninen
- Neurocenter/Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Hospital District of North Karelia, Joensuu, Finland
| | - Esko Levälahti
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Lindström
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Paajanen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Satu Havulinna
- Department of Welfare; Ageing, Disability and Functioning Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Markku Peltonen
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Shireen Sindi
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurocenter/Neurology, Kuopio University Hospital, Kuopio, Finland
| | | | - Timo Strandberg
- Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland.,University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,South Ostrobothnia Central Hospital, Seinäjoki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland.,Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Theme Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Svenningsson AL, Stomrud E, Palmqvist S, Hansson O, Ossenkoppele R. Axonal degeneration and amyloid pathology predict cognitive decline beyond cortical atrophy. Alzheimers Res Ther 2022; 14:144. [PMID: 36192766 PMCID: PMC9531524 DOI: 10.1186/s13195-022-01081-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 09/11/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Cortical atrophy is associated with cognitive decline, but the association is not perfect. We aimed to identify factors explaining the discrepancy between the degree of cortical atrophy and cognitive decline in cognitively unimpaired elderly. METHODS The discrepancy between atrophy and cognitive decline was measured using the residuals from a linear regression analysis between change in whole brain cortical thickness over time and change in a cognitive composite measure over time in 395 cognitively unimpaired participants from the Swedish BioFINDER study. We tested for bivariate associations of this residual measure with demographic, imaging, and fluid biomarker variables using Pearson correlations and independent-samples t-tests, and for multivariate associations using linear regression models. Mediation analyses were performed to explore possible paths between the included variables. RESULTS In bivariate analyses, older age (r = -0.11, p = 0.029), male sex (t = -3.00, p = 0.003), larger intracranial volume (r = -0.17, p < 0.001), carrying an APOEe4 allele (t = -2.71, p = 0.007), larger white matter lesion volume (r = -0.16, p = 0.002), lower cerebrospinal fluid (CSF) β-amyloid (Aβ) 42/40 ratio (t = -4.05, p < 0.001), and higher CSF levels of phosphorylated tau (p-tau) 181 (r = -0.22, p < 0.001), glial fibrillary acidic protein (GFAP; r = -0.15, p = 0.003), and neurofilament light (NfL; r = -0.34, p < 0.001) were negatively associated with the residual measure, i.e., associated with worse than expected cognitive trajectory given the level of atrophy. In a multivariate analysis, only lower CSF Aβ42/40 ratio and higher CSF NfL levels explained cognition beyond brain atrophy. Mediation analyses showed that associations between the residual measure and APOEe4 allele, CSF Aβ42/40 ratio, and CSF GFAP and p-tau181 levels were mediated by levels of CSF NfL, as were the associations with the residual measure for age, sex, and WML volume. CONCLUSIONS Our results suggest that axonal degeneration and amyloid pathology independently affect the rate of cognitive decline beyond the degree of cortical atrophy. Furthermore, axonal degeneration mediated the negative effects of old age, male sex, and white matter lesions, and in part also amyloid and tau pathology, on cognition over time when accounting for cortical atrophy.
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Affiliation(s)
- Anna Linnéa Svenningsson
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE 205 02 Malmö, Sweden ,grid.411843.b0000 0004 0623 9987Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Erik Stomrud
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE 205 02 Malmö, Sweden ,grid.411843.b0000 0004 0623 9987Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Sebastian Palmqvist
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE 205 02 Malmö, Sweden ,grid.411843.b0000 0004 0623 9987Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE 205 02 Malmö, Sweden ,grid.411843.b0000 0004 0623 9987Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Rik Ossenkoppele
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE 205 02 Malmö, Sweden ,grid.484519.5Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
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Xiang X, Cho J, Sun Y, Wang X. Childhood adversity and cognitive impairment in later life. Front Psychol 2022; 13:935254. [PMID: 36051218 PMCID: PMC9424901 DOI: 10.3389/fpsyg.2022.935254] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This study examined the association between childhood adversity and cognitive impairment in later life and explored the potential moderation effect of gender and race. Methods The study sample included 15,133 participants of the Health and Retirement Study (1998-2016 surveys) who had complete data on key study measures and were more than 50. The outcome variable is a dichotomous indicator of cognitive impairment as assessed by the Telephone Interview for Cognitive Status for self-respondents and the 16-item Informant Questionnaire on Cognitive Decline in the Elderly for proxies. A total of six childhood adversity indicators included grade retention, parental substance abuse, physical abuse, trouble with the police, moving due to financial hardship, and receipt of help due to financial hardship in early life. The estimation of the association between childhood adversity and cognitive impairment involved Cox proportional hazards regression. Results: Grade retention had the largest effect on incident cognitive impairment (HR = 1.3, 95% CI = 1.23-1.38, p < 0.001), followed by physical abuse by a parent (HR = 1.10, 95% CI = 1.00-1.20, p = 0.001). The impact of grade retention was more detrimental to women than men (interaction term HR = 0.89, 95% CI = 0.80-1.00, p = 0.048, female as the reference). Parental substance abuse was associated with a lower risk of incident cognitive impairment for most racial groups (HR = 0.89, 95% CI = 0.83-0.95, p = 0.001), but this association was reversed in "non-Hispanic other" race, consisting mainly of Asians (HR = 1.54, 95% CI = 1.05-2.26, p = 0.025). Discussion Some aspects of childhood adversity continue to harm cognitive functioning in later life, while some events may have the opposite effect, with evidence of heterogeneity across gender and race.
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Affiliation(s)
- Xiaoling Xiang
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Joonyoung Cho
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Yihang Sun
- School of Social Work, Columbia University, New York, NY, United States
| | - Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, New York, NY, United States
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Voits T, DeLuca V, Abutalebi J. The Nuance of Bilingualism as a Reserve Contributor: Conveying Research to the Broader Neuroscience Community. Front Psychol 2022; 13:909266. [PMID: 35814120 PMCID: PMC9263506 DOI: 10.3389/fpsyg.2022.909266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
The neurological notion of “reserve” arises from an individually observable dissociation between brain health and cognitive status. According to the cognitive reserve hypothesis, high-reserve individuals experience functional compensation for neural atrophy and, thus, are able to maintain relatively stable cognitive functioning with no or smaller-than-expected impairment. Several lifestyle factors such as regular physical exercise, adequate and balanced nutrition, and educational attainment have been widely reported to contribute to reserve and, thus, lead to more successful trajectories of cognitive aging (CA). In recent years, it has become clear that bilingualism is also a potential reserve contributor. Yet, there is little communication between the neuroscience of bilingualism research community and researchers working in the field of CA more generally, despite compelling reasons for it. In fact, bilingualism tends to be overlooked as a contributory factor in the CA literature, or reduced to a dichotomous trait, despite it being a complex experience. Herein, we discuss issues that are preventing recognition of bilingualism as a reserve contributor across all literatures, highlight the benefits of including language experiences as a factor of interest across research disciplines, and suggest a roadmap to better integrate bilingualism and aging moving forward. We close with calls toward a model of aging that examines the contributions across lifestyle factors, including that of bilingual experience.
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Affiliation(s)
- Toms Voits
- PoLaR Lab, AcqVA Aurora Centre, UiT The Arctic University of Norway, Tromsø, Norway
- *Correspondence: Toms Voits,
| | - Vincent DeLuca
- PoLaR Lab, AcqVA Aurora Centre, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jubin Abutalebi
- PoLaR Lab, AcqVA Aurora Centre, UiT The Arctic University of Norway, Tromsø, Norway
- Centre for Neurolinguistics and Psycholinguistics (CNPL), Vita-Salute San Raffaele University, Milan, Italy
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Stebbins RC, Yang YC, Reason M, Aiello AE, Belsky DW, Harris KM, Plassman BL. Occupational cognitive stimulation, socioeconomic status, and cognitive functioning in young adulthood. SSM Popul Health 2022; 17:101024. [PMID: 35071726 PMCID: PMC8762043 DOI: 10.1016/j.ssmph.2022.101024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Occupational characteristics are associated with late-life cognition. However, little is known about the association between occupational factors and cognition in early adulthood, especially when controlling for early life socioeconomic status (SES) and cognition in childhood. Importantly, sex may shape the impact of occupational characteristics that provide cognitive stimulation given that education, occupational status, and workplace experiences differ by sex. METHODS Using data on 12,129 participants ages 24-32 from the U.S.-based National Longitudinal Study of Adolescent to Adult Health, we investigated the association between four factors of occupational cognitive stimulation (repetition, freedom, analytic skills, and social interaction) and young-adult episodic and working memory independent of childhood and young-adult SES, using linear regression. We adjusted for confounding due to sex, race/ethnicity, age, childhood cognition, and education. We further investigated effect measure modification of this association by sex in stratified regression models. RESULTS Overall, 1-unit increases in both occupational analytic skills and social interaction were significantly associated with 0.101 (95%CI: 0.28, 0.173) and 0.096 (95%CI: 0.032, 0.160) SD higher memory, respectively. However, when sex-stratified, among men, a 1-unit increase on the social interaction scale was associated with 0.16 (95%CI: 0.05, 0.27) SD higher memory, while there was no association among women. CONCLUSION Our results indicate that even in adulthood, activities that stimulate the mind can contribute to improved cognitive function, and the most beneficial forms of occupational stimulation are those that use analytic skills and involve social interaction (particularly among young men).
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Affiliation(s)
- Rebecca C. Stebbins
- Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
| | - Yang Claire Yang
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
- Department of Sociology, University of North Carolina-Chapel Hill, 155 Hamilton Hall, CB #3210, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, 450 West Drive, CB #7295, Chapel Hill, NC, 27599, USA
| | - Max Reason
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
- Department of Sociology, University of North Carolina-Chapel Hill, 155 Hamilton Hall, CB #3210, Chapel Hill, NC, 27599, USA
| | - Allison E. Aiello
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, CB #7400, Chapel Hill, NC, 27599, USA
| | - Daniel W. Belsky
- Butler Aging Center, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, NY, 10032, USA
| | - Kathleen Mullan Harris
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
- Department of Sociology, University of North Carolina-Chapel Hill, 155 Hamilton Hall, CB #3210, Chapel Hill, NC, 27599, USA
| | - Brenda L. Plassman
- Department of Psychiatry & Behavioral Science, School of Medicine, Duke University, Duke University Medical Center, Box 3950, Durham, NC, 27710, USA
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Bransby L, Buckley RF, Rosenich E, Franks KH, Yassi N, Maruff P, Pase MP, Lim YY. The relationship between cognitive engagement and better memory in midlife. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12278. [PMID: 35155733 PMCID: PMC8828986 DOI: 10.1002/dad2.12278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Engagement in cognitively stimulating work and activities may slow cognitive decline and dementia. We examined the individual and combined associations of four cognitive engagement indices (educational attainment, occupational complexity, social engagement, and cognitively stimulating leisure activities) with objective and subjective cognition. METHODS Middle-aged adults (n = 1864) enrolled in the Healthy Brain Project completed the Cogstate Brief Battery, the Cognitive Function Instrument, and self-report questionnaires of cognitive engagement. RESULTS Educational attainment and leisure activity engagement were individually associated with memory performance. Participants were classified based on whether they rated highly in zero to four cognitive engagement indices. Compared to participants with no indices, participants with two or more indices performed moderately better on memory. DISCUSSION Results suggest that greater variety of cognitive engagement across different areas of life is related to better memory in midlife. Possible explanation for this relationship may be increased opportunity for enhancing cognitive reserve, but further investigations are required.
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Affiliation(s)
- Lisa Bransby
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Rachel F Buckley
- Melbourne School of Psychological Sciences University of Melbourne Parkville Victoria Australia
- Department of Neurology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Boston Massachusetts USA
| | - Emily Rosenich
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Katherine H Franks
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
- Melbourne School of Psychological Sciences University of Melbourne Parkville Victoria Australia
| | - Nawaf Yassi
- Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia
- Population Health and Immunity Division The Walter and Eliza Hall Institute of Medical Research Parkville Victoria Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health Parkville Victoria Australia
- Cogstate Ltd. Melbourne Victoria Australia
| | - Matthew P Pase
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
- Harvard T.H. Chan School of Public Health Boston Massachusetts USA
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health School of Psychological Sciences Monash University Clayton Victoria Australia
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Lee DH, Seo SW, Roh JH, Oh M, Oh JS, Oh SJ, Kim JS, Jeong Y. Effects of Cognitive Reserve in Alzheimer's Disease and Cognitively Unimpaired Individuals. Front Aging Neurosci 2022; 13:784054. [PMID: 35197838 PMCID: PMC8859488 DOI: 10.3389/fnagi.2021.784054] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/28/2021] [Indexed: 12/16/2022] Open
Abstract
The concept of cognitive reserve (CR) has been proposed as a protective factor that modifies the effect of brain pathology on cognitive performance. It has been characterized through CR proxies; however, they have intrinsic limitations. In this study, we utilized two different datasets containing tau, amyloid PET, and T1 magnetic resonance imaging. First, 91 Alzheimer's disease (AD) continuum subjects were included from Alzheimer's Disease Neuroimaging Initiative 3. CR was conceptualized as the residual between actual cognition and estimated cognition based on amyloid, tau, and neurodegeneration. The proposed marker was tested by the correlation with CR proxy and modulation of brain pathology effects on cognitive function. Second, longitudinal data of baseline 53 AD spectrum and 34 cognitively unimpaired (CU) participants in the MEMORI dataset were analyzed. CR marker was evaluated for the association with disease conversion rate and clinical progression. Applying our multimodal CR model, this study demonstrates the differential effect of CR on clinical progression according to the disease status and the modulating effect on the relationship between brain pathology and cognition. The proposed marker was associated with years of education and modulated the effect of pathological burden on cognitive performance in the AD spectrum. Longitudinally, higher CR marker was associated with lower disease conversion rate among prodromal AD and CU individuals. Higher CR marker was related to exacerbated cognitive decline in the AD spectrum; however, it was associated with a mitigated decline in CU individuals. These results provide evidence that CR may affect the clinical progression differentially depending on the disease status.
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Affiliation(s)
- Dong Hyuk Lee
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
- College of Korean Medicine, Sangji University, Wonju, South Korea
- Research Institute of Korean Medicine, Sangji University, Wonju, South Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jee Hoon Roh
- Department of Physiology, Korea University College of Medicine, Seoul, South Korea
- Neuroscience Research Institute, Korea University College of Medicine, Seoul, South Korea
| | - Minyoung Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jungsu S. Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seung Jun Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yong Jeong
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
- KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
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Cognitive reserve proxies, Alzheimer pathologies, and cognition. Neurobiol Aging 2022; 110:88-95. [PMID: 34879329 PMCID: PMC9234822 DOI: 10.1016/j.neurobiolaging.2021.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/09/2021] [Accepted: 10/10/2021] [Indexed: 02/03/2023]
Abstract
This study aimed to explore the moderating effects of the frequently used cognitive reserve (CR) proxies [i.e., education, premorbid intelligence quotient (pIQ), occupational complexity (OC), and lifetime cognitive activity (LCA)] on the relationships between various in vivo Alzheimer's disease (AD) pathologies and cognition. In total, 351 [268 cognitively unimpaired (CU), 83 cognitive impaired (CI)] older adults underwent multi-modal brain imaging to measure AD pathologies and cognitive assessments, and information on CR proxies was obtained. For overall participants, only education moderated the relationship between Aβ deposition and cognition. Education, pIQ, and LCA, but not OC, showed moderating effect on the relationship between AD-signature cerebral hypometabolism and cognition. In contrast, only OC had a moderating effect on the relationship between cortical atrophy of the AD-signature regions and cognition. Such moderation effects of the CR proxies were similarly observed in CI individuals, but most of them were not in CU individuals. The findings suggest that the proposed CR proxies have different moderating effects on the relationships between specific AD pathologies and cognition.
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Fingerhut H, Gozdas E, Hosseini SH. Quantitative MRI Evidence for Cognitive Reserve in Healthy Elders and Prodromal Alzheimer's Disease. J Alzheimers Dis 2022; 89:849-863. [PMID: 35964179 PMCID: PMC9928487 DOI: 10.3233/jad-220197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Cognitive reserve (CR) has been postulated to contribute to the variation observed between neuropathology and clinical outcomes in Alzheimer's disease (AD). OBJECTIVE We investigated the effect of an education-occupation derived CR proxy on biological properties of white matter tracts in patients with amnestic mild cognitive impairment (aMCI) and healthy elders (HC). METHODS Educational attainment and occupational complexity ratings (complexity with data, people, and things) from thirty-five patients with aMCI and twenty-eight HC were used to generate composite CR scores. Quantitative magnetic resonance imaging (qMRI) and multi-shell diffusion MRI were used to extract macromolecular tissue volume (MTV) across major white matter tracts. RESULTS We observed significant differences in the association between CR and white matter tract MTV in aMCI versus HC when age, gender, intracranial volume, and memory ability were held constant. Particularly, in aMCI, higher CR was associated with worse tract pathology (lower MTV) in the left and right dorsal cingulum, callosum forceps major, right inferior fronto-occipital fasciculus, and right superior longitudinal fasciculus (SLF) tracts. Conversely higher CR was associated with higher MTV in the right parahippocampal cingulum and left SLF in HC. CONCLUSION Our results support compensatory CR mechanisms in aMCI and neuroprotective mechanisms in HC and suggest differential roles for CR on white matter macromolecular properties in healthy elders versus prodromal AD patients.
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Affiliation(s)
| | | | - S.M. Hadi Hosseini
- Correspondence to: S.M. Hadi Hosseini, Department of Psychiatry and Behavioral Sciences, C-BRAIN Lab, 401 Quarry Rd., Stanford, CA 94305-5795, USA. Tel.: +1 650 723 5798;
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Kim J, Kim MS. An Overview of Cognitive Reserve in Aging Based on Keyword Network Analysis. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221139374. [DOI: 10.1177/00469580221139374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Many studies have reported that Cognitive reserve is a critical mechanism affecting cognitive statuses, such as dementia. The purposes of this study were to identify the knowledge structure and the research trend on cognitive reserve by conducting keyword analysis on research papers ranging from the earliest to the most recent studies done on the topic and to suggest directions for future research. The Web of Science (WOS) database was used to search for articles on cognitive reserve in aging from 2001 to 2020. NetMiner version 4 (cyram, KOREA), a social network analysis program, was used for keyword network analysis. Data analysis showed keywords that could be categorized as cognitive reserve related keywords (cognitive reserve related concepts, cognitive reserve related factor, cognitive reserve diagnosis and measurement, cognitive reserve outcomes) and cognitive reserve research keywords (research subject/disease, research method, intervention, research field). Through trend analysis, we found that various keywords appeared, indicating that the research has gradually developed conceptually and methodically. Based on these findings, future CR studies require the development of multimodal interface-based tools by applying modern digital technology that can be used to more accurately diagnose and monitor CR; remotely, in real time. In addition, to improve CR, it is suggested that the development of cognitive stimulation interventions utilizing VR which fuses AI based interaction technology with the subjects. Finally, CR could develop further through a cooperation of multidisciplinary professionals such as psychology, medicine and nursing.
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Affiliation(s)
- Jihyun Kim
- Sahmyook University, Seoul, Republic of Korea
| | - Mi So Kim
- Shinhan University, Gyeonggi-do, Republic of Korea
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Zülke AE, Luppa M, Röhr S, Weißenborn M, Bauer A, Samos FAZ, Kühne F, Zöllinger I, Döhring J, Brettschneider C, Oey A, Czock D, Frese T, Gensichen J, Haefeli WE, Hoffmann W, Kaduszkiewicz H, König HH, Thyrian JR, Wiese B, Riedel-Heller SG. Association of mental demands in the workplace with cognitive function in older adults at increased risk for dementia. BMC Geriatr 2021; 21:688. [PMID: 34893023 PMCID: PMC8665567 DOI: 10.1186/s12877-021-02653-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/23/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives Growing evidence suggests a protective effect of high mental demands at work on cognitive function in later life. However, evidence on corresponding associations in older adults at increased risk for dementia is currently lacking. This study investigates the association between mental demands at work and cognitive functioning in the population of the AgeWell.de-trial. Methods Cross-sectional investigation of the association between global cognitive functioning (Montreal Cognitive Assessment) and mental demands at work in older individuals at increased risk for dementia (Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE)score ≥ 9; n = 941, age: 60–77 years). Occupational information was matched to Occupational Information Network (O*NET)-descriptors. Associations between cognitive function and O*NET-indices executive, verbal and novelty were investigated using generalized linear models. Results Higher values of index verbal (b = .69, p = .002) were associated with better cognitive function when adjusting for covariates. No association was observed for indices executive (b = .37, p = .062) and novelty (b = .45, p = .119). Higher education, younger age, and employment were linked to better cognitive function, while preexisting medical conditions did not change the associations. Higher levels of depressive symptomatology were associated with worse cognitive function. Conclusions Higher levels of verbal demands at work were associated with better cognitive function for older adults with increased dementia risk. This suggests an advantage for older persons in jobs with high mental demands even after retirement and despite prevalent risk factors. Longitudinal studies are warranted to confirm these results and evaluate the potential of workplaces to prevent cognitive decline through increased mental demands.
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Affiliation(s)
- Andrea E Zülke
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany.
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany.,Global Brain Health Institute (GBHI), Trinity College Dublin, D02 PN40, Dublin, Ireland
| | - Marina Weißenborn
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Alexander Bauer
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Franziska-Antonia Zora Samos
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Flora Kühne
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, 80336, Munich, Germany
| | - Isabel Zöllinger
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, 80336, Munich, Germany
| | - Juliane Döhring
- Institute of General Practice, University of Kiel, 24105, Kiel, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Service Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Anke Oey
- Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, 30625, Hannover, Germany
| | - David Czock
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Jochen Gensichen
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, 80336, Munich, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Wolfgang Hoffmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Rostock/ Greifswald, 17489, Greifswald, Germany.,Institute of Community Medicine, Dept. of Epidemiology of Health Care and Community Health, University Medicine Greifswald, 17487, Greifswald, Germany
| | | | - Hans-Helmut König
- Department of Health Economics and Health Service Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Rostock/ Greifswald, 17489, Greifswald, Germany.,Institute of Community Medicine, Dept. of Epidemiology of Health Care and Community Health, University Medicine Greifswald, 17487, Greifswald, Germany
| | - Birgitt Wiese
- Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, 30625, Hannover, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany
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43
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Zhu W, Li X, Li X, Wang H, Li M, Gao Z, Wu X, Tian Y, Zhou S, Wang K, Yu Y. The protective impact of education on brain structure and function in Alzheimer's disease. BMC Neurol 2021; 21:423. [PMID: 34717581 PMCID: PMC8557004 DOI: 10.1186/s12883-021-02445-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 10/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Cognitive Reserve (CR) theory posits that brains with higher reserve can cope with more cerebral damage to minimize clinical manifestations. The aim of this study was to examine the effect of education (CR proxy) on brain structure and function in Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) patients and in cognitively healthy elderly (HC) individuals. METHODS Fifty-seven AD patients, 57 aMCI patients and 48 HCs were included to investigate the relationships between education years and gray matter volume (GMV), regional homogeneity (ReHo) and functional connectivity (FC) in brain regions to show associations with both structure and function. Taking the severity of the disease into account, we further assessed the relationships in AD stratified analyses. RESULTS In AD group, the GMV of the dorsal anterior cingulate cortex (dACC) and ReHo in the left inferior temporal cortex (ITC) were inversely associated with education years, after adjustment for age, sex, Mini-Mental State Examination (MMSE), and total intracranial volume or head motion parameters. Seed-based FC analyses revealed that education years were negatively correlated with the FC between the left anterior ITC and left mid frontal cortex as well as right superior frontal cortex and right angular gyrus. Stratified analyses results indicated that this negative relation between education and GMV, ReHo, FC was mainly present in mild AD, which was attenuated in moderate AD and aMCI groups. CONCLUSIONS Our results support the CR theory, and suggest that CR may be protective against AD related brain pathology at the early stage of clinical dementia. These findings could provide the locus of CR-related functional brain mechanisms and a specific time-window for therapeutic interventions to help AD patients to cope better with the brain pathological damage by increasing CR.
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Affiliation(s)
- Wanqiu Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei, 230022, China
| | - Xiaoshu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei, 230022, China
| | - Xiaohu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei, 230022, China
| | - Haibao Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei, 230022, China
| | - Meiqin Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei, 230022, China
| | - Ziwen Gao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei, 230022, China
| | - Xingqi Wu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Shanshan Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei, 230022, China.
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44
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Ko H, Kim S, Kim K, Jung SH, Shim I, Cha S, Lee H, Kim B, Yoon J, Ha TH, Kwak S, Kang JM, Lee JY, Kim J, Park WY, Nho K, Kim DK, Myung W, Won HH. Genome-wide association study of occupational attainment as a proxy for cognitive reserve. Brain 2021; 145:1436-1448. [PMID: 34613391 DOI: 10.1093/brain/awab351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/22/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Occupational attainment, which represents middle-age cognitive activities, is a known proxy marker of cognitive reserve for Alzheimer's disease. Previous genome-wide association studies (GWAS) have identified numerous genetic variants and revealed the genetic architecture of educational attainment, another marker of cognitive reserve. However, the genetic architecture and heritability for occupational attainment remain elusive. We performed a large-scale GWAS of occupational attainment with 248,847 European individuals from the UK Biobank using the proportional odds logistic mixed model method. In this analysis, we defined occupational attainment using the classified job levels formulated in the UK Standard Occupational Classification system considering the individual professional skill and academic level. We identified 30 significant loci (P < 5 × 10-8); 12 were novel variants, unassociated with other traits. Among them, four lead variants were associated with genes expressed in brain tissues by expression quantitative trait loci mapping from 10 brain regions: rs13002946, rs3741368, rs11654986, and rs1627527. The single nucleotide polymorphism (SNP)-based heritability was estimated to be 8.5% (s.e. = 0.004) and partitioned heritability was enriched in the central nervous system and brain tissues. Genetic correlation analysis showed shared genetic backgrounds between occupational attainment and multiple traits, including education, intelligence, leisure activities, life satisfaction, and neuropsychiatric disorders. In two-sample Mendelian randomization (MR) analysis, we demonstrated that high occupation levels were associated with reduced risk for Alzheimer's disease (OR = 0.78, 95% CI = 0.65-0.92 in inverse variance weighted (IVW) method; OR = 0.73, 95% CI = 0.57-0.92 in the weighted median (WM) method). This causal relationship between occupational attainment and Alzheimer's disease was robust in additional sensitivity analysis that excluded potentially pleiotropic SNPs (OR = 0.72, 95% CI = 0.57-0.91 in the IVW method; OR = 0.72, 95% CI = 0.53-0.97 in the WM method). Multivariable MR confirmed that occupational attainment had an independent effect on the risk for Alzheimer's disease even after taking educational attainment into account (OR = 0.72, 95% CI = 0.54-0.95 in the IVW method; OR = 0.68, 95% CI = 0.48-0.97 in the WM method). Overall, our analyses provide insights into the genetic architecture of occupational attainment and demonstrate that occupational attainment is a potential causal protective factor for Alzheimer's disease as a proxy marker of cognitive reserve.
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Affiliation(s)
- Hyunwoong Ko
- Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, South Korea.,Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.,Dental Research Institute, Seoul National University School of Dentistry, Seoul, South Korea
| | - Soyeon Kim
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea.,Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kiwon Kim
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Sang-Hyuk Jung
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea
| | - Injeong Shim
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea
| | - Soojin Cha
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea
| | - Hyewon Lee
- Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, Asan, South Korea
| | - Beomsu Kim
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea
| | - Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seyul Kwak
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gil Medical Center, Gachon University, Incheon, South Korea
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Jinho Kim
- Precision Medicine Center, Future Innovation Research Division, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kwangsik Nho
- Department of Radiology & Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Doh Kwan Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea.,Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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45
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Kiesow H, Uddin LQ, Bernhardt BC, Kable J, Bzdok D. Dissecting the midlife crisis: disentangling social, personality and demographic determinants in social brain anatomy. Commun Biol 2021; 4:728. [PMID: 34140617 PMCID: PMC8211729 DOI: 10.1038/s42003-021-02206-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/11/2021] [Indexed: 12/11/2022] Open
Abstract
In any stage of life, humans crave connection with other people. In midlife, transitions in social networks can relate to new leadership roles at work or becoming a caregiver for aging parents. Previous neuroimaging studies have pinpointed the medial prefrontal cortex (mPFC) to undergo structural remodelling during midlife. Social behavior, personality predisposition, and demographic profile all have intimate links to the mPFC according in largely disconnected literatures. Here, we explicitly estimated their unique associations with brain structure using a fully Bayesian framework. We weighed against each other a rich collection of 40 UK Biobank traits with their interindividual variation in social brain morphology in ~10,000 middle-aged participants. Household size and daily routines showed several of the largest effects in explaining variation in social brain regions. We also revealed male-biased effects in the dorsal mPFC and amygdala for job income, and a female-biased effect in the ventral mPFC for health satisfaction. Hannah Kiesow et al. combine 40 behavioral indicators and neuroimaging data from the UK Biobank to investigate how the transitions in midlife in the domains of social, personality, and demographic determinants impact brain anatomy. Through Bayesian analyses, the authors were able to disentangle which specific traits, relative to other considered candidate traits, contributed the most to explaining differences in social brain volume.
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Affiliation(s)
- Hannah Kiesow
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Boris C Bernhardt
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montréal, QC, Canada
| | - Joseph Kable
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Danilo Bzdok
- Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute (MNI), Faculty of Medicine, McGill University, Montréal, QC, Canada. .,Mila - Quebec Artificial Intelligence Institute, Montréal, QC, Canada.
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46
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Lee YJ, Gonzales E, Andel R. Multifaceted Demands of Work and Their Associations with Cognitive Functioning: Findings From the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2021; 77:351-361. [PMID: 33979436 DOI: 10.1093/geronb/gbab087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The present study examines the associations among mental, social, and physical demands of work with cognitive functioning among older adults in the United States. METHODS Data from 3,176 respondents in the Health and Retirement Study were analyzed using growth curve modeling (2004-2014). The study investigated differences by gender, race, ethnicity, and education. RESULTS Higher mental and social demands of work were associated with higher levels of initial cognitive functioning, but not significantly associated with slower cognitive decline over time. Physical demands of work were negatively associated with initial cognitive functioning and also marginally associated with a slower rate of decline in cognitive functioning going into older adulthood. In stratified analyses, results varied by sociodemographic characteristics. DISCUSSION The results partially support the environmental complexity hypothesis and the productive aging framework in that higher mental and social demands and lower physical demands relate to better cognitive functioning at baseline, with the differences appearing stable throughout older adulthood. The stratified results shed light on addressing disparities in cognitive aging and work environments.
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Affiliation(s)
- Yeonjung Jane Lee
- University of Hawai'i at Mānoa, Thompson School of Social Work & Public Health, HI
| | | | - Ross Andel
- School of Aging Studies, University of South Florida, FL.,Department of Neurology, Motol University Hospital and Charles University, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
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47
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Mendis SB, Raymont V, Tabet N. Bilingualism: A Global Public Health Strategy for Healthy Cognitive Aging. Front Neurol 2021; 12:628368. [PMID: 33935937 PMCID: PMC8081826 DOI: 10.3389/fneur.2021.628368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/16/2021] [Indexed: 11/20/2022] Open
Abstract
Dementia is a global public health priority which cost global societies $818 billion in 2015 and is disproportionately impacting low and middle-income countries (LMICs). With limited availability of disease modifying drugs to treat Alzheimer's disease (AD), researchers have increasingly focused on preventative strategies which may promote healthy cognitive aging and mitigate the risk of cognitive impairment in aging. Lifelong bilingualism has been presented as both a highly debated and promising cognitive reserve factor which has been associated with better cognitive outcomes in aging. A recent metanalysis has suggested that bilingual individuals present on average 4.05 years later with the clinical features of AD than monolinguals. Bilinguals are also diagnosed with AD ~2.0 years later than monolingual counterparts. In this perspective piece we critically evaluate the findings of this metanalysis and consider the specific implications of these findings to LMICs. Furthermore, we appraise the major epidemiological studies conducted globally on bilingualism and the onset of dementia. We consider how both impactful and robust studies of bilingualism and cognition in older age may be conducted in LMICs. Given the limited expenditure and resources available in LMICs and minimal successes of clinical trials of disease modifying drugs we propose that bilingualism should be positioned as an important and specific public health strategy for maintaining healthy cognitive aging in LMICs. Finally, we reflect upon the scope of implementing bilingualism within the education systems of LMICs and the promotion of bilingualism as a healthy cognitive aging initiative within government policy.
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Affiliation(s)
| | - Vanessa Raymont
- Oxford Brain Health Clinical Trials Unit, Oxford, United Kingdom
| | - Naji Tabet
- Center for Dementia Studies, Brighton and Sussex Medical School, Brighton, United Kingdom
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48
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Amanollahi M, Amanollahi S, Anjomshoa A, Dolatshahi M. Mitigating the negative impacts of aging on cognitive function; modifiable factors associated with increasing cognitive reserve. Eur J Neurosci 2021; 53:3109-3124. [PMID: 33715252 DOI: 10.1111/ejn.15183] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 12/21/2022]
Abstract
Research suggests that social, physical, and cognitively challenging activities during lifetime, could mitigate the negative effects of aging on cognitive function. This effect is explained by the increased cognitive reserve (CR) resulting from such factors; in fact, such activities, by altering structural and functional properties of the human brain, equip one with more effective compensatory mechanisms to resist brain damage before the presentation of severe clinical symptoms. Therefore, applying appropriate modifications in one's lifestyle and activities may be effective in lowering the risk of developing dementia and cognitive dysfunction in old age, especially in brain areas that are susceptible to aging. In this paper, we are going to review relevant studies discussing the association between important modifiable factors, known as CR proxies (i.e., educational attainment, occupational complexity, physical activity, social engagement, bilingualism, leisure activities, and Mediterranean diet), and different domains of cognitive function, which are affected either in the process of healthy aging or neurodegenerative diseases.
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Affiliation(s)
- Mobina Amanollahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Saba Amanollahi
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Ali Anjomshoa
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Dolatshahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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49
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Rizzi L, Aventurato ÍK, Balthazar MLF. Neuroimaging Research on Dementia in Brazil in the Last Decade: Scientometric Analysis, Challenges, and Peculiarities. Front Neurol 2021; 12:640525. [PMID: 33790850 PMCID: PMC8005640 DOI: 10.3389/fneur.2021.640525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
The last years have evinced a remarkable growth in neuroimaging studies around the world. All these studies have contributed to a better understanding of the cerebral outcomes of dementia, even in the earliest phases. In low- and middle-income countries, studies involving structural and functional neuroimaging are challenging due to low investments and heterogeneous populations. Outstanding the importance of diagnosing mild cognitive impairment and dementia, the purpose of this paper is to offer an overview of neuroimaging dementia research in Brazil. The review includes a brief scientometric analysis of quantitative information about the development of this field over the past 10 years. Besides, discusses some peculiarities and challenges that have limited neuroimaging dementia research in this big and heterogeneous country of Latin America. We systematically reviewed existing neuroimaging literature with Brazilian authors that presented outcomes related to a dementia syndrome, published from 2010 to 2020. Briefly, the main neuroimaging methods used were morphometrics, followed by fMRI, and DTI. The major diseases analyzed were Alzheimer's disease, mild cognitive impairment, and vascular dementia, respectively. Moreover, research activity in Brazil has been restricted almost entirely to a few centers in the Southeast region, and funding could be the main driver for publications. There was relative stability concerning the number of publications per year, the citation impact has historically been below the world average, and the author's gender inequalities are not relevant in this specific field. Neuroimaging research in Brazil is far from being developed and widespread across the country. Fortunately, increasingly collaborations with foreign partnerships contribute to the impact of Brazil's domestic research. Although the challenges, neuroimaging researches performed in the native population regarding regional peculiarities and adversities are of pivotal importance.
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Affiliation(s)
- Liara Rizzi
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil
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50
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Gustavson DE, Panizzon MS, Kremen WS, Reynolds CA, Pahlen S, Nygaard M, Wod M, Catts VS, Lee T, Gatz M, Franz CE. Genetic and Environmental Influences on Semantic Verbal Fluency Across Midlife and Later Life. Behav Genet 2021; 51:99-109. [PMID: 33547998 DOI: 10.1007/s10519-021-10048-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/27/2021] [Indexed: 10/22/2022]
Abstract
Despite the relevance of semantic fluency measures to risk for dementia and psychiatric disorders, little is known about their genetic and environmental architecture in mid-to-late life. Participants represent 21,684 middle-aged and older adult twins (M = 60.84 years, SD = 11.21; Range 40-89) from six studies from three countries participating in the Interplay of Genes and Environment across Multiple Studies (IGEMS) consortium. All completed the same measure of semantic fluency (naming animals in 60 seconds). Results revealed small-to-moderate phenotypic associations with age and education, with education more strongly and positively associated with fluency performance in females than males. Heritability and environmental influences did not vary by age. Environmental variance was smaller with higher levels of education, but this effect was observed only in males. This is the largest study to examine the genetic and environmental architecture of semantic fluency, and the first to demonstrate that environmental influences vary based on levels of education.
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Affiliation(s)
- Daniel E Gustavson
- Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, 1420B Medical Center East, Nashville, TN, 37232, USA. .,Department of Psychiatry and Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, California, USA.
| | - Matthew S Panizzon
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, California, USA
| | - William S Kremen
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, California, USA.,VA Center of Excellence for Stress and Mental Health, La Jolla, California, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California, Riverside, California, USA
| | - Shandell Pahlen
- Department of Psychology, University of California, Riverside, California, USA
| | - Marianne Nygaard
- Department of Public Health, The Danish Twin Registry, University of Southern Denmark, Odense C, Denmark
| | - Mette Wod
- Department of Public Health, The Danish Twin Registry, University of Southern Denmark, Odense C, Denmark
| | - Vibeke S Catts
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Teresa Lee
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Margaret Gatz
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Carol E Franz
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, California, USA
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