Education delays accelerated decline on a memory test in persons who develop dementia
Education delays accelerated decline on a memory test in persons who develop dementia
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DOI：
10.1212/01.wnl.0000278163.82636.30
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发表时间：
2007-10-23
期刊：
影响因子：
9.9
通讯作者：
Lipton, R. B.
中科院分区：
文献类型：
--
作者：
Hall, C. B.;Derby, C.;Lipton, R. B.
目的：为了检验认知储备假说，通过检查教育对记忆衰退的影响在临床前course.Background：低教育是阿尔茨海默病（AD）的一个众所周知的危险因素。注定要发展AD的人经历认知能力，特别是记忆力的加速下降。认知储备假说预测，受教育程度较高的人比储备较低的人在更接近诊断时间时开始开始经历认知下降的加速，但由于疾病负担增加，他们的下降速度在加速后更快。方法：我们在布朗克斯的117名痴呆患者中，通过Buschke选择性回忆测验，研究了教育对记忆衰退率的影响老化研究。受试者在入组时和年度随访访视时进行详细的认知评估。我们估计的时间在下降的速度开始加速（变点），和前和后加速下降率，从纵向数据使用变点model.Results：每增加一年的正规教育延迟的时间加速下降的Buschke选择性提醒测试0.21年。加速后，每增加一年的正规教育，记忆力衰退的速度每年增加0.10个百分点。结论：正如认知储备假说所预测的那样，高等教育可以推迟加速认知衰退的发生;一旦开始，受教育程度较高的人的记忆力衰退速度会更快。
Objective: To test the cognitive reserve hypothesis by examining the effect of education on memory decline during the preclinical course of dementia.Background: Low education is a well known risk factor for Alzheimer disease ( AD). Persons destined to develop AD experience an accelerated rate of decline in cognitive ability, particularly in memory. The cognitive reserve hypothesis predicts that persons with greater education begin to experience acceleration in cognitive decline closer to the time of diagnosis than persons with lower reserve, but that their rate of decline is more rapid after the time of acceleration due to increased disease burden.Methods: We studied the influence of education on rates of memory decline as measured by the Buschke Selective Reminding Test in 117 participants with incident dementia in the Bronx Aging Study. Subjects had detailed cognitive assessments at entry and at annual follow-up visits. We estimated the time at which the rate of decline begins to accelerate ( the change point), and the pre- and post-acceleration rates of decline, from the longitudinal data using a change point model.Results: Each additional year of formal education delayed the time of accelerated decline on the Buschke Selective Reminding Test by 0.21 years. Post-acceleration, the rate of memory decline was increased by 0.10 points per year for each year of additional formal education.Conclusions: As predicted by the cognitive reserve hypothesis, higher education delays the onset of accelerated cognitive decline; once it begins it is more rapid in persons with more education.