Better memory with literacy acquisition later in life: a randomized controlled trial

晚年读写能力提高记忆力：一项随机对照试验

• 批准号: 10263225
• 负责人: Lea Tenenholz Grinberg
• 金额: $ 15.48万
• 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: 2020-09-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10263225
• 关键词: Address; Adult; Anisotropy; Brain; Brazil; Collaborations; Communities; Cross-Sectional Studies; Cues; Dementia; Development; Diffusion Magnetic Resonance Imaging; Education; Educational Intervention; Elderly; Enrollment; Epidemic; Episodic memory; Europe; Face; Feasibility Studies; Fellowship; Future; Geography; Hand; Hippocampus (Brain); Immediate Recalls; Individual; Institution; Knowledge; Latin America; Learning; Level of Evidence; Life; Literacy Programs; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Medial; Memory; Neurologic; Participant; Placebos; Policies; Prefrontal Cortex; Public Policy; Randomized Controlled Trials; Reading; Recording of previous events; Research; Research Personnel; Resources; Rest; Risk Factors; Role; Science; Shapes; Structure; Sum; Techniques; Temporal Lobe; Testing; Training; Training and Infrastructure; Work; Writing; arm; base; cognitive reserve; comparison intervention; cost; dementia risk; frontal lobe; group intervention; illiteracy; illiterate; improved; infrastructure development; intervention cost; intervention effect; literacy; literate; low and middle-income countries; memory process; neuroimaging; placebo group; primary outcome; programs; reading ability; resilience

Abstract Dementia is epidemic with a projected cost of $1.2 trillion by 2050. Currently, 2/3 of people with dementia live in low and middle-income countries (LMIC). 30% of dementia cases are preventable by modifying risk factors such as low education. Formal education acquired early in life protects against dementia, but whether acquiring education later in life can decrease dementia risk is less clear. Our previous cross-sectional work conducted in Brazil/UFMG in partnership with the USA/UCSF suggests that even few years of education might improve brain resilience by strengthening the relationship between episodic memory and medial temporal lobe structures, including the hippocampus (HC) and its connections. Whether acquiring education in adulthood could also strengthen those relationships and increase hippocampal efficiency is unknown. We started a pilot one-arm longitudinal study to determine whether a late-life literacy improves episodic memory measured by hippocampal functional and structural connectivity. Despite the historical challenges of enrolling illiterate adults in research, we devised a successful strategy and met the target enrollment and acquired baseline structural and functional MRIs, demonstrating feasibility of our approach. This proposal will build on and expand the collaboration between UFMG and UCSF to implement a two-arm, randomized controlled trial investigating the role of adult education in improving episodic memory and enhancing hippocampal connectivity. This partnership represents a unique opportunity to test this hypothesis given the combined expertise and resources from both centers. If successful in showing a benefit of adult education into memory, brain structure and function, this proposal will be critical for developing strategies to improve brain resilience and subsequently decrease dementia risk using a low-cost intervention. Noteworthy, The proposal will also contribute to build sustainable research capacity in Brazil by transferring the knowledge on advanced longitudinal neuroimaging analysis to UFMG. The learned techniques will be applied in further studies about neurological conditions conducted not only in UFMG but other Brazilian institutions.

抽象的 痴呆症流行，预计到2050年的费用为1.2万亿美元。目前，有2/3的痴呆症患者居住 低收入和中等收入国家（LMIC）。 30％的痴呆病例可以通过修改危险因素来预防 作为低教育。在生命早期获得的正规教育可以预防痴呆症，但是否获得 以后的生活教育会降低痴呆症风险不太明显。我们以前在 巴西/UFMG与美国/UCSF合作建议，即使几年的教育也可以改善大脑 通过增强情节记忆与内侧颞叶结构之间的关系来韧性， 包括海马（HC）及其连接。在成年中获得教育是否也可以 加强这些关系并提高海马效率是未知的。我们开始了一架飞行员 纵向研究以确定晚期读写能力是否改善了海马测量的情节记忆 功能和结构连通性。尽管将文盲成年人参与研究面临的历史挑战，但 我们制定了一种成功的策略，并满足了目标入学率，并获得了基线结构和功能 MRI，证明了我们的方法的可行性。该建议将基于并扩大 UFMG和UCSF实施一项两臂，随机对照试验，调查成人教育的作用 改善情节记忆并增强海马连通性。这种伙伴关系代表了一个独特的 鉴于两个中心的综合专业知识和资源，有机会检验这一假设。如果成功 在显示成人教育对记忆，大脑结构和功能的好处时，该提案对于 制定策略以提高大脑的弹性并随后使用低成本降低痴呆症风险 干涉。值得注意的是，该提案还将有助于建立巴西的可持续研究能力 将有关晚期纵向神经影像学分析的知识转移到UFMG。学到的技术 将应用于不仅在UFMG和其他巴西进行的神经系统状况的进一步研究 机构。