Comparison of the effects of cognitive reserve on white matter, cortical morphometric and metabolic measurements; in subjective cognitive decline, mild cognitive impairment and normal subjects; separated between high and low schooling

• Grant number: 21/01459-3
• Support Opportunities: Regular Research Grants
• Start date: August 01, 2021
• End date: July 31, 2024
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Sonia Maria Dozzi Brucki
• Grantee: Sonia Maria Dozzi Brucki
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Artur Martins Novaes Coutinho ; Carlos Alberto Buchpiguel ; Eduardo Sturzeneker Trés

Abstract

The demographic changes in Brazil produces an aging population in which, not infrequently, additional limitations arising from low schooling overlap. The combination of these factors can influence different problems throughout an individual's life, making him less functional, being cognitive complaints one of these limitations. Today, it is necessary to understand the real meaning of these complaints, in particular those that arise early and in a context of a preserved functional status. Classify them correctly, allowing better diagnoses, increasing pathophysiological knowledge and, eventually, producing more effective intervention studies; would be some of the objectives contemplated in this effort. To achieve these goals, the concept of Subjective Cognitive Decline (SCD) was created (self-perceived complaint, not yet detectable by psychometric / functional tests) and added to the already established concept of Mild Cognitive Impairment (MCI). Considered to be pre-dementia phases, both statuses may have degenerative causes or not, therefore requiring the use of biomarkers that determine the presence or absence of disease. Its characteristics, relying upon clinical and biomarker metrics, could predict a greater or lesser risk for unfavorable evolution, using measures of white matter integrity, morphometric and cortical metabolic patterns; added to the individual's economic, social, cultural and educational background. These, essentially, constitute the so-called Cognitive Reserve (CR), a protective factor that combines the educational and socioeconomic background of the person; known to modify the evolution of cognitive complaints and cognitive outcomes. An important contribution could be extracted from the improved knowledge about the behavior of these biomarkers in the SCD and MCI phases, in the light of measures of the cognitive reserve as influencing their behavior and progress in normal individuals or under the burden of eventual pathologies.OBJECTIVES: To identify white matter, morphometric and metabolic cortical patterns related to CR measures, in individuals with SCD and MCI, within the pre-dementia continuum (normal, SCD and MCI) of a Brazilian population with high and low education. METHODOLOGY: Individuals aged 60 or over, recruited from the community (lectures and electronic social media), outpatient clinics for Cognitive and Behavioral Neurology and the Center for Cognitive Disorders, of Hospital das Clínicas, Medical School, University of São Paulo, will be included, with or without complaints of cognitive decline. Then, divided into two groups, low (less than or equal to four years) and high education (greater than or equal to eight years); classified as normal, SCD or MCI depending on the result of a questionnaire of subjective complaints, neuropsychological and functional scales. White matter integrity data from specific morphometric and cortical metrics (thickness, volume and area) of magnetic resonance will be evaluated, in addition to the metabolic uptake patterns of positron emission tomography with radio labeled glucose. These standards will be compared between groups, identifying characteristics and performing analyzes of potential association between them and the measures that constitute or influence CR (years of self-reported schooling, I.Q.; PCAS-r questionnaire, work classification and socio-economic status). (AU)