Association of lifetime intellectual enrichment with cognitive decline in the older population.
Association of lifetime intellectual enrichment with cognitive decline in the older population.
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DOI：
10.1001/jamaneurol.2014.963
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发表时间：
2014-08
期刊：
影响因子：
29
通讯作者：
Jack, Clifford R., Jr.
中科院分区：
文献类型：
--
作者：
Vemuri, Prashanthi;Lesnick, Timothy G.;Przybelski, Scott A.;Machulda, Mary;Knopman, David S.;Mielke, Michelle M.;Roberts, Rosebud O.;Geda, Yonas E.;Rocca, Walter A.;Petersen, Ronald C.;Jack, Clifford R., Jr.
一生中丰富的智力生活方式越来越被视为防止老年人普遍观察到的认知衰退的一种保护策略。研究非痴呆老年人群终生智力丰富与基线认知表现和认知衰退率的关系，并估计终生智力丰富与认知障碍发病的差异（以年为单位）。梅奥诊所衰老研究（MCSA）是一项在明尼苏达州奥姆斯特德县进行的以人群为基础的认知衰老纵向研究。我们研究了1995名非痴呆（1718名认知正常，277名MCI） MCSA参与者，他们在基线时完成了智力生活方式测量，并接受了至少一次随访。我们将变量分为两个不重叠的主成分：教育/职业得分和基于自述问卷的中晚期认知活动测量，研究了终身智力丰富的影响。一个全局认知z分数作为我们的总结性认知测量。我们使用线性混合效应模型来研究人口统计学和智力丰富措施与全球认知z得分轨迹的关系。老年受试者、低教育程度/职业、中晚期认知活动、载脂蛋白E4 （APOE）基因型较低的受试者和男性的基线认知表现较低。两种智力丰富措施之间的相互作用是显著的，因此中老年认知活动对基线认知表现的有益影响随着教育/职业的增加而降低。只有基线年龄、中老年认知活动和APOE4基因型与基线认知表现的纵向变化显著相关。对于终身智力富集程度高的APOE4携带者（教育/职业和中老年认知活动均为第75百分位），与终身智力富集程度低的携带者（教育/职业和中老年认知活动均为第25百分位）相比，认知功能障碍的发病时间约晚8.7年。较高的教育/职业水平与较高的认知水平相关。中老年休闲活动水平越高，认知水平也越高，但这种关系的斜率随着时间的推移略有增加。终生智力丰富可能会延迟认知障碍的发作，并被用作一种成功的预防干预措施，以减少即将到来的痴呆流行。
Intellectual lifestyle enrichment throughout life is increasingly viewed as a protective strategy against commonly observed cognitive decline in the elderly. To investigate the association of lifetime intellectual enrichment with baseline cognitive performance and rate of cognitive decline in a non-demented elderly population and to estimate difference (in years) associated with lifetime intellectual enrichment to the onset of cognitive impairment. Prospective analysis of subjects enrolled in the Mayo Clinic Study of Aging (MCSA), a longitudinal population-based study of cognitive aging in Olmsted County, Minnesota. We studied 1995 non-demented (1718 cognitively normal, 277 MCI) participants in MCSA who completed intellectual lifestyle measures at baseline and underwent at least one follow-up visit. We studied the effect of lifetime intellectual enrichment by separating the variables into two non-overlapping principal components: education/occupation-score and mid/late-life cognitive activity measure based on self-report questionnaires. A global cognitive Z-score served as our summary cognition measure. We used linear mixed-effects models to investigate the associations of demographic and intellectual enrichment measures with global cognitive Z-score trajectories. Baseline cognitive performance was lower in older subjects and in those with lower education/occupation, lower mid/late-life cognitive activity, apolipoprotein E4 (APOE) genotype, and in men. The interaction between the two intellectual enrichment measures was significant such that the beneficial effect of mid/late-life cognitive activity on baseline cognitive performance was reduced with increasing education/occupation. Only baseline age, mid/late-life cognitive activity, and APOE4 genotype were significantly associated with longitudinal change in cognitive performance from baseline. For APOE4 carriers with high lifetime intellectual enrichment (75th percentile of both education/occupation and mid/late-life cognitive activity), the onset of cognitive impairment was about 8.7 years later compared with low lifetime intellectual enrichment (25th percentile of both education/occupation and mid/late-life cognitive activity) in an 80 year old subject. Higher levels of education/occupation were associated with higher levels of cognition. Higher levels of mid/late-life leisure activity were also associated with higher levels of cognition, but the slope of this relationship slightly increased over time. Lifetime intellectual enrichment might delay the onset of cognitive impairment and be used as a successful preventive intervention to reduce the impending dementia epidemic.
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DOI：
10.1017/s1355617711000531
发表时间：
2011-11
影响因子：
2.6
作者：
James, Bryan D.;Wilson, Robert S.;Barnes, Lisa L.;Bennett, David A.
通讯作者：
Bennett, David A.
影响因子：
2.4
作者：
Salmon, David P.;Ferris, Steven H.;Thomas, Ronald G.;Sano, Mary;Cummings, Jeffery L.;Sperling, Reisa A.;Petersen, Ronald C.;Aisen, Paul S.
通讯作者：
Aisen, Paul S.
影响因子：
9.9
作者：
COBB, JL;WOLF, PA;DAGOSTINO, RB
通讯作者：
DAGOSTINO, RB
影响因子：
120.7
作者：
EVANS, DA;FUNKENSTEIN, H;TAYLOR, JO
通讯作者：
TAYLOR, JO
影响因子：
5
作者：
Karp, A;Kåreholt, I;Fratiglioni, L
通讯作者：
Fratiglioni, L