The role of education in a vascular pathway to episodic memory: brain maintenance or cognitive reserve?

NEUROBIOLOGY OF AGING

卷:84

Article

Zahodne, Laura B.¹  Mayeda, Elizabeth Rose²  Hohman, Timothy J.³  Fletcher, Evan⁴  Racine, Annie M.⁵  Gavett, Brandon⁶  Manly, Jennifer J.⁷  Schupf, Nicole^7,9  Mayeux, Richard^9,10,8  Brickman, Adam M.⁷  Mungas, Dan⁴ 

[1] Univ Michigan, Dept Psychol, 530 Church St, Ann Arbor, MI 48109 USA

[2] Univ Calif Los Angeles, Dept Epidemiol, Los Angeles, CA USA

[3] Vanderbilt Univ, Dept Neurol, 221 Kirkland Hall, Nashville, TN 37235 USA

[4] Univ Calif Davis, Dept Neurol, Davis, CA 95616 USA

[5] Biogen, Cambridge, MA USA

[6] Univ Western Australia, Sch Psychol Sci, Perth, WA, Australia

[7] Columbia Univ, Med Ctr, Taub Inst Res Alzheimers Dis & Aging Brain, Gertrude H Sergievsky Ctr,Dept Neurol, New York, NY USA

[8] Gertrude H Sergievsky Ctr, Taub Inst Res Alzheimers Dis & Aging Brain, Dept Epidemiol, New York, NY USA

[9] Gertrude H Sergievsky Ctr, Taub Inst Res Alzheimers Dis & Aging Brain, Dept Psychiat, New York, NY USA

[10] Gertrude H Sergievsky Ctr, Taub Inst Res Alzheimers Dis & Aging Brain, Dept Neurol, New York, NY USA

关键词: Cognitive aging;    White matter hyperintensities;    Cognitive reserve;    Brain maintenance;    Episodic memory;    Moderation;   

DOI  :  10.1016/j.neurobiolaging.2019.08.009

来源: Elsevier

【 摘 要 】

Educational attainment is associated with cognition among older adults, but this association is complex and not well understood. While associated with better cognition among healthy adults, more education predicts faster decline in older adults with cognitive impairment. Education may influence cognitive functioning through mechanisms involving brain maintenance (BM: reduced age-related pathology) or cognitive reserve (CR: altered pathology-cognition association). We examined evidence for each mechanism by quantifying main and interaction effects of education within a well-studied pathway involving systolic blood pressure, white matter hyperintensities (WMH), and episodic memory in 2 samples without dementia at the baseline (total N = 1136). There were no effects of education on systolic blood pressure or WMH, suggesting a lack of evidence for BM. In the sample less likely to progress to dementia, education attenuated the effect of WMH on memory at the baseline. In the sample more likely to progress to dementia, education exacerbated this effect at the baseline. These moderations provide evidence for a CR mechanism and are consistent with previous findings of faster decline once CR is depleted. (C) 2019 Elsevier Inc. All rights reserved.

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