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Association of an index of lifespan cognitive reserve with the risk of mild cognitive impairment and its progression to dementia
Author(s) -
Xu Hui,
Yang Rongrong,
Dintica Christina S,
Qi Xiuying,
Song Ruixue,
Bennett David A,
Xu Weili
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.041427
Subject(s) - dementia , cognitive reserve , medicine , cohort , cognition , cognitive decline , cognitive impairment , gerontology , disease , psychology , psychiatry
Background The effect of lifespan cognitive reserve (CR) on mild cognitive impairment (MCI) and its progression to dementia remains controversial. Method Within the Rush Memory and Aging Project, a community‐based cohort study (mean age, 79 years) with annual follow‐up (median, 5.16 years; maximum, 20 years), a cognitively intact group (n=1182) and an MCI group (n=420) were identified at baseline. During the follow‐up, 611 participants died and underwent autopsies. Neuropathologic evaluations for Alzheimer’s disease (AD) and infarcts were performed in autopsied participants. CR indicator encompassing education, early‐ to late‐life cognitive and social activities was obtained and tertiled. Result Compared to the lowest CR, the multi‐adjusted hazards ratios (HRs, 95% CI) of the highest CR was 0.78 (0.63–0.98) for incident MCI in the cognitively intact group, and 0.66 (0.45–0.97) for dementia in the MCI group. Among MCI participants with high brain pathologies (including global AD pathology or gross infarcts), the adjusted incident rate of dementia was about 50‐65% lower in people with highest CR compared to lowest CR. Conclusion High lifespan CR indicator reduces risk of MCI, and delays its progression to dementia, in the presence of brain pathologies.