Cognitive activities delay onset of memory decline in persons who develop dementia
Cognitive activities delay onset of memory decline in persons who develop dementia
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DOI：
10.1212/wnl.0b013e3181b04ae3
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发表时间：
2009-08-01
期刊：
影响因子：
9.9
通讯作者：
Verghese, J.
中科院分区：
文献类型：
--
作者：
Hall, C. B.;Lipton, R. B.;Verghese, J.
背景：注定会患痴呆症的人认知能力下降速度加快，尤其是记忆力。早年教育以及晚年参与认知刺激性休闲活动是被认为反映认知储备的两个因素，这可能会延缓痴呆临床前阶段记忆力下降的发生。
方法：在布朗克斯衰老研究中，我们对488名最初认知完好的社区居民进行了流行病学、临床和认知评估，每12到18个月一次。我们使用变化点模型评估了自我报告的参与认知刺激性休闲活动对101名发生痴呆的个体中由布施克选择性提醒测试所测量的加速记忆力下降发生的影响。
结果：基线时自我报告的每多一天认知活动会使加速记忆力下降的发生延迟0.18年。基线时较高的认知活动水平与发生后更快的记忆力下降相关。纳入教育因素并没有在认知活动的影响之外显著改善模型的拟合度。
结论：我们的研究结果表明，晚年的认知活动独立于教育影响认知储备。早年教育对认知储备的影响可能由晚年的认知活动所介导。或者，早年教育可能是认知储备的一个决定因素，受过更多教育的人可能会选择参与认知活动而不影响储备。未来的研究应该检验增加参与认知活动对预防或延缓痴呆的功效。《神经病学》2009年；73卷：356 - 361页
Background: Persons destined to develop dementia experience an accelerated rate of decline in cognitive ability, particularly in memory. Early life education and participation in cognitively stimulating leisure activities later in life are 2 factors thought to reflect cognitive reserve, which may delay the onset of the memory decline in the preclinical stages of dementia.Methods: We followed 488 initially cognitively intact community residing individuals with epidemiologic, clinical, and cognitive assessments every 12 to 18 months in the Bronx Aging Study. We assessed the influence of self-reported participation in cognitively stimulating leisure activities on the onset of accelerated memory decline as measured by the Buschke Selective Reminding Test in 101 individuals who developed incident dementia using a change point model.Results: Each additional self-reported day of cognitive activity at baseline delayed the onset of accelerated memory decline by 0.18 years. Higher baseline levels of cognitive activity were associated with more rapid memory decline after that onset. Inclusion of education did not significantly add to the fit of the model beyond the effect of cognitive activities.Conclusions: Our findings show that late life cognitive activities influence cognitive reserve independently of education. The effect of early life education on cognitive reserve may be mediated by cognitive activity later in life. Alternatively, early life education may be a determinant of cognitive reserve, and individuals with more education may choose to participate in cognitive activities without influencing reserve. Future studies should examine the efficacy of increasing participation in cognitive activities to prevent or delay dementia. Neurology (R) 2009; 73: 356-361