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P2‐598: SUBJECTIVE AND BIOLOGICAL MARKERS OF STRESS IN MIDDLE‐AGED CAUCASIAN AND AFRICAN AMERICAN ALZHEIMER'S DISEASE FAMILIES
Author(s) -
Huang Hanfeng,
Hu William T.,
Zhao Liping,
Shin Ryan,
Verble Danielle D.,
Howell J Christina,
Pak Hannah,
Tharwani Sonum,
Kumar Veena,
Flatt Jason,
Anderson Joel G.,
Wharton Whitney
Publication year - 2019
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 - 10.1016/j.jalz.2019.06.3007
Subject(s) - medicine , depression (economics) , disease , family history , caregiver stress , gerontology , middle age , family caregivers , diabetes mellitus , clinical psychology , dementia , endocrinology , economics , macroeconomics
Background: Emerging evidence has shown that higher cognitive reserve (CR) has been linked to a lower risk of dementia. However, the effect of lifespan CR on mild cognitive impairment (MCI) remains unknow. We sought to examine whether lifespan CR may reduce the risk of MCI, and decelerate its progression to dementia. Methods: Within the Rush Memory and Aging Project (MAP), among all participants (mean age1⁄479), a cognitive intact cohort (n1⁄41137) and an MCI cohort (n1⁄4420) were identified at baseline, and followed for up to 20 years to detect incident MCI/dementia. The diagnoses of MCI and dementia were based on international criteria. Information on CR factors (education, cognitive activities at early, midand late-life, and social activities in late life) was obtained at the study entry. Based on these factors, lifespan CR was captured by a latent variable using structural equation model, which was divided into tertiles (lowest, middle and highest). Data were analysed using Cox model with adjustment for potential confounders. Results: During the follow-up period, in the cognitively intact cohort, 500 people developed MCI, and the multi-adjusted hazards ratios (HR, 95% CI) of MCI was 0.79 (0.63–0.99) (p1⁄40.045) for highest CR compared to lowest CR. In theMCI cohort, 178 subjects progressed to dementia, and the multi-adjusted HR of dementia was 0.62 (0.42–0.92) for highest CR. A highest CR delayed dementia onset by 3.73 years in people with MCI. Conclusions: Highest lifespan CRmay reduce the risk ofMCI among cognitive intact people, and delay the progression fromMCI to dementia by almost 4 years.