Static and Dynamic Cognitive Reserve Proxy Measures: Interactions with Alzheimer’s Disease Neuropathology and Cognition
Received Date: Oct 06, 2017 / Accepted Date: Oct 18, 2017 / Published Date: Oct 25, 2017
Abstract
Objective: Years of education are the most common proxy for measuring cognitive reserve (CR) when assessing the relationship between Alzheimer’s disease (AD) neuropathology and cognition. However, years of education may be limited as a CR proxy given that it represents a specific timeframe in early life and is static. Studies suggest that measures of intellectual function provide a dynamic estimate of CR that is superior to years of education since it captures the effect of continued learning over time. The present study determined whether dynamic measures of CR were better predictors of episodic memory and executive function in the presence of AD pathology than a static measure of CR.
Methods: Subjects examined died with a pre-mortem clinical diagnosis of no cognitive impaired, mild cognitive impairment and mild to moderate AD. CERAD and Braak stage were used to stratify the sample by AD pathology severity. Linear regression analyses using CR by CERAD and CR by Braak stage interaction terms were used to determine whether Extended Range Vocabulary Test (ERVT) scores or years of education were significantly associated with episodic memory composite (EMC) and executive function composite (EFC) performance. All models were adjusted for clinical diagnosis, age at death, gender, APOE e4 carrier status and Braak stage.
Results: For episodic memory, years of education by CERAD interaction were not statistically significant (β=- 0.01, SE=0.01, p=0.53). By contrast, ERVT interaction with CERAD diagnosis was statistically significant (β=- 0.03, SE=0.01, p=0.004). Among the models using Braak stages, none of the CR by pathology interactions were associated with EMC or EFC.
Conclusion: Results suggest that a dynamic rather than a static measure is a better indicator of CR and that the relationship between CR and cognition is dependent upon the severity of select AD criteria.
Keywords: No cognitive impairment; Mild cognitive impairment; Episodic memory; Executive function; Plaque; Tangle; Education; Intellectual function
Citation: Malek-Ahmadi M, Lu S, Chan Y, Perez SE, Chen K, et al. (2017) Static and Dynamic Cognitive Reserve Proxy Measures: Interactions with Alzheimer’s Disease Neuropathology and Cognition. J Alzheimers Dis Parkinsonism 7: 390. Doi: 10.4172/2161-0460.1000390
Copyright: © 2017 Malek-Ahmadi M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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