Education and cognitive resilience: what is the role of education characteristics in shaping an ability to maintain high levels of cognitive functioning after the onset of disease

教育和认知复原力：教育特征在塑造疾病发作后维持高水平认知功能的能力方面发挥什么作用

• 批准号: 10417178
• 负责人: Chloe W Eng
• 金额: $ 1.79万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10417178
• 关键词: Acceleration; Acute; Address; Adult; Affect; Age-associated memory impairment; Cessation of life; Characteristics; Clinical; Cognition; Cognitive; Cognitive aging; Competence; Data; Data Set; Data Sources; Dementia; Diagnosis; Disease; Education; Educational Background; Elderly; Evaluation; Event; Exposure to; Fellowship; Foundations; Future Teacher; Health; Health and Retirement Study; Image; Impaired cognition; Impairment; Individual; Injury; Knowledge; Length; Life; Literature; Managed Care; Measurement; Measures; Medical History; Medical Records; Mentorship; Methodology; Methods; Mission; Modeling; Nerve Degeneration; Neurologic; Onset of illness; Outcome; Outcome Measure; Participant; Pathologic; Pathologic Processes; Patient Self-Report; Patients; Personal Satisfaction; Persons; Postdoctoral Fellow; Public Health; Quality of life; Race; Recording of previous events; Recovery; Research; Research Personnel; Respondent; Risk Factors; Role; Schools; Shapes; Stroke; Students; Subgroup; Surveys; Time; Training; Transcend; Variant; Work; age related; career; cognitive ability; cognitive function; cognitive performance; cognitive reserve; cognitive testing; dementia risk; disability; disease diagnosis; early life exposure; experience; follow-up; higher education; imaging biomarker; improved; literacy; member; mortality risk; neuroimaging; neurovascular injury; performance tests; post stroke; resilience; response; skills; social factors; statistics; stroke survivor; teacher; theories; tool; vascular injury

Project Summary Incident stroke is often accompanied by acute deficits and declines in cognitive ability as well as long- term acceleration of cognitive decline. These resulting impairments and dementia drastically affect quality of life, and patients with dementia after stroke are at increased risk of death and disability. Education has been consistently identified as a predictor of cognition after stroke, but mechanisms behind this relationship are not fully understood. One hypothesis considers cognitive resilience, suggesting that education provides individuals with cognitive tools to maintain cognitive functioning amidst a clinically meaningful amount of neurodegeneration or injury. However, studies of this relationship are hindered by a lack of universally accepted definitions of cognitive resilience. Furthermore, some studies suggest that the commonly used measure of attained education may not capture variation in cognition as well as alternative measures such as educational quality and literacy. The relationship between stroke and dementia has the potential to be used to study cognitive resilience and reserve, a critical issue in cognitive aging research. By using stroke as a well-defined and clearly diagnosed disease with a known time of event onset, studies can be conducted to assess for differences between educational subgroups and to differentiate between normal-age related decline and disease-related pathological processes. Therefore, this proposal aims to investigate the influence of educational characteristics on cognitive resilience after stroke. Cognitive resilience will be conceptualized in three distinct ways: cognitive decline in years following stroke (Aim 1), risk of dementia in patients with history of stroke (Aim 2), and cognitive testing performance in relation to imaging markers of vascular injury (Aim 3). Analyses will use existing data, with education measured as self-reported years attained from study participants and state-, year-, and race- specific measures of educational quality characteristics of average term length, student-to-teacher ratio, and attendance ratio from historical data from the National Center for Education Statistics. Aim 1 will use a nationally representative dataset to maximize variation in educational experiences with biennial follow-up surveys to assess decline after stroke, and Aims 2 and 3 will include members of a large managed care organization with detailed medical histories throughout adulthood and clinical neuropathologic imaging measures. This proposal will address the gap in understanding of mechanisms behind the influence of education on cognitive resilience after stroke. Knowledge from this research will directly address the NIA’s mission of clarifying understanding of cognitive resilience and reserve, and the priority of understanding determinants of cognitive aging. The proposed training, guided by an exemplary mentorship team of experts, will enhance the applicants research competency, content expertise, and rigorous methodological skills needed to advance her career as an independent academic researcher focused on lifecourse determinants of healthy cognitive aging.

项目摘要 突发性中风通常伴有急性缺陷和认知能力下降，以及长期- 认知能力下降的长期加速。这些导致的损伤和痴呆严重影响生活质量， 中风后痴呆患者死亡和残疾的风险增加。教育一直是 一直被认为是中风后认知的预测因子，但这种关系背后的机制并不清楚。 完全理解一个假设认为认知弹性，表明教育提供个人 使用认知工具在临床上有意义的神经退行性变中维持认知功能 或者受伤然而，对这种关系的研究受到缺乏普遍接受的定义的阻碍。 认知弹性。此外，一些研究表明，常用的衡量已获得教育的标准 可能无法反映认知方面的差异以及教育质量和识字率等替代措施。 中风和痴呆之间的关系有可能用于研究认知弹性 这是认知老化研究中的一个关键问题。通过将中风作为一种定义明确、诊断明确的 疾病与已知的事件发生时间，研究可以进行评估之间的差异 教育亚组，并区分正常年龄相关下降和疾病相关病理 流程.因此，本提案旨在调查教育特征对 中风后的认知恢复力认知弹性将以三种不同的方式概念化： 卒中后年数下降（目标1），有卒中史患者痴呆的风险（目标2），以及认知功能 测试与血管损伤的成像标记物相关的性能（目标3）。分析将使用现有数据， 受教育程度以研究参与者自我报告的年数和州、年和种族来衡量， 平均学期、学生与教师比例等教育质量特征的具体衡量标准， 入学率来自国家教育统计中心的历史数据。目标1将在全国范围内使用 代表性数据集，以最大限度地扩大教育经验的差异，并进行两年期后续调查， 目标2和3将包括一个大型管理式护理组织的成员， 整个成年期的病史和临床神经病理学成像测量。 这一建议将解决在理解教育影响机制方面存在的差距， 中风后的认知恢复力这项研究的知识将直接解决NIA的使命， 认知弹性和储备的理解，以及理解认知弹性和储备的决定因素的优先顺序 衰老拟议的培训由一个示范性的专家指导小组指导，将提高申请人的能力， 研究能力，内容专业知识和严格的方法技能，需要推进她的职业生涯， 一个独立的学术研究人员，专注于健康认知老化的生命过程决定因素。

项目成果

Temporal Trends in Stroke-Related Memory Change: Results From a US National Cohort 1998-2016.

• DOI: 10.1161/strokeaha.120.031063
• 发表时间: 2021-05
• 期刊: STROKE
• 影响因子: 8.3
• 作者: Eng, Chloe W.;Mayeda, Elizabeth R.;Gilsanz, Paola;Whitmer, Rachel A.;Kim, Anthony S.;Glymour, M. Maria
• 通讯作者: Glymour, M. Maria