Abstract:
OBJECTIVE:Examine whether cognitive reserve moderates the association of 1) vascular risk factors and 2) white matter hyperintensity burden with risk of clinical progression and longitudinal cognitive decline. METHODS:BIOCARD Study participants were cognitively normal and primarily middle-aged (M = 57 years) at baseline and have been followed with annual cognitive and clinical assessments (M = 13 years). Baseline cognitive reserve was indexed with a composite score combining education with reading and vocabulary scores. Baseline vascular risk (N = 229) was assessed with a composite risk score reflecting five vascular risk factors. Baseline white matter hyperintensity load (N = 271) was measured with FLAIR magnetic resonance imaging. Cox regression models assessed risk of progression from normal cognition to onset of clinical symptoms of Mild Cognitive Impairment. Longitudinal mixed effects models measured the relationship of these variables to cognitive decline, using a global composite score, and executive function and episodic memory sub-scores. RESULTS:Both vascular risk and white matter hyperintensities were associated with cognitive decline, particularly in executive function. Higher vascular risk, but not white matter hyperintensity burden, was associated with an increased risk of progression to Mild Cognitive Impairment. Higher cognitive reserve was associated with a reduced risk of symptom onset and higher levels of baseline cognition but did not modify the associations between the vascular risk score and white matter hyperintensities with clinical progression or cognitive decline. INTERPRETATION:Although cognitive reserve has protective effects on clinical and cognitive outcomes, it does not mitigate the negative impact of vascular risk and small vessel cerebrovascular disease on these same outcomes.
journal_name
Ann Clin Transl Neuroljournal_title
Annals of clinical and translational neurologyauthors
Soldan A,Pettigrew C,Zhu Y,Wang MC,Gottesman RF,DeCarli C,Albert M,BIOCARD Research Team.doi
10.1002/acn3.51120subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1307-1317issue
8issn
2328-9503journal_volume
7pub_type
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journal_title:Annals of clinical and translational neurology
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journal_title:Annals of clinical and translational neurology
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pub_type: 杂志文章
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更新日期:2016-04-13 00:00:00
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pub_type: 杂志文章
doi:10.1002/acn3.491
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pub_type:
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更新日期:2020-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1002/acn3.51305
更新日期:2021-01-25 00:00:00
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journal_title:Annals of clinical and translational neurology
pub_type:
doi:10.1002/acn3.51257
更新日期:2021-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1002/acn3.50959
更新日期:2020-01-01 00:00:00
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journal_title:Annals of clinical and translational neurology
pub_type: 杂志文章
doi:10.1002/acn3.330
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更新日期:2019-04-08 00:00:00
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更新日期:2019-08-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2017-05-16 00:00:00
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更新日期:2015-12-08 00:00:00
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更新日期:2019-11-01 00:00:00
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更新日期:2015-11-06 00:00:00
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更新日期:2017-11-24 00:00:00
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更新日期:2016-11-16 00:00:00
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更新日期:2018-05-01 00:00:00