Dataset Information

In vivo imaging evidence of poor cognitive resilience to Alzheimer's disease pathology in subjects with very low cognitive reserve from a low-middle income environment.

ABSTRACT:

Introduction

Reduced cognitive reserve (CR) due to very low educational (VLE) levels may influence high dementia rates in low-middle income environments, leading to decreased cognitive resilience (RES) to Alzheimer´s disease (AD) pathology. However, in vivo findings in VLE groups confirming this prediction are lacking.

Methods

Cognitively impaired patients (with clinically defined AD dementia or amnestic mild cognitive impairment) and cognitively unimpaired older adults (n = 126) were recruited for a positron emission tomography (PET) and magnetic resonance imaging (MRI) investigation in Brazil, including 37 VLE individuals (≤5 years of education). A CR score was generated combining educational attainment and vocabulary knowledge. RES indices to AD pathology were calculated using standardized residuals from linear regression models relating current cognitive performance (episodic memory or overall cognition) to amyloid beta (Aβ) burden Pittsburgh compound-B ([11C]PiB-PET).

Results

Aβ burden was lower in VLE relative to highly-educated subjects (controlling for age, sex, and Mini-Mental Status Exam [MMSE] scores) in the overall cognitively impaired sample, and in dementia subjects when the three clinically defined groups were evaluated separately. In bivariate regression analyses for the overall sample, the RES index based on a composite cognitive score was predicted by CR, socioeconomic status, and hippocampal volume (but not white matter hyperintensities or intracranial volume [ICV]); in the multivariate model, only CR retained significance (and similar results were obtained in the Aβ-positive subsample). In the multivariate model for the overall sample using the RES index based on memory performance, CR, hippocampal volume, and ICV were significant predictors, whereas only CR retained significance in Aβ-positive subjects.

Discussion

Lower CR consistently predicted less resilience to AD pathology in older adults from a low-middle income environment.

SUBMITTER: Busatto GF

PROVIDER: S-EPMC7780143 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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<i>In vivo</i> imaging evidence of poor cognitive resilience to Alzheimer's disease pathology in subjects with very low cognitive reserve from a low-middle income environment.

Busatto Geraldo F GF de Gobbi Porto Fabio Henrique FH Faria Daniele de Paula DP Squarzoni Paula P Coutinho Artur Martins AM Garcez Alexandre Teles AT Rosa Pedro Gomes Penteado PGP da Costa Naomi Antunes NA Carvalho Cleudiana Lima CL Torralbo Leticia L de Almeida Hernandes Jullie Rosana JR Ono Carla Rachel CR Brucki Sonia Maria Dozzi SMD Nitrini Ricardo R Buchpiguel Carlos Alberto CA Souza Duran Fabio Luis FL Forlenza Orestes Vicente OV

Alzheimer's & dementia (Amsterdam, Netherlands) 20201208 1

<h4>Introduction</h4>Reduced cognitive reserve (CR) due to very low educational (VLE) levels may influence high dementia rates in low-middle income environments, leading to decreased cognitive resilience (RES) to Alzheimer´s disease (AD) pathology. However, <i>in vivo</i> findings in VLE groups confirming this prediction are lacking.<h4>Methods</h4>Cognitively impaired patients (with clinically defined AD dementia or amnestic mild cognitive impairment) and cognitively unimpaired older adults (n ...[more]

PMID: 33426265

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