In vivo imaging evidence of poor cognitive resilience to Alzheimer's disease pathology in subjects with very low cognitive reserve from a low-middle income environment

Author(s):Show less -

Busatto, Geraldo F. ^[1] ; de Gobbi Porto, Fabio Henrique ^[1] ; Faria, Daniele de Paula ^[2] ; Squarzoni, Paula ^[1] ; Coutinho, Artur Martins ^[2] ; Garcez, Alexandre Teles ^[2] ; Penteado Rosa, Pedro Gomes ^[1] ; da Costa, Naomi Antunes ^[1] ; Carvalho, Cleudiana Lima ^[1] ; Torralbo, Leticia ^[1] ; de Almeida Hernandes, Jullie Rosana ^[1] ; Ono, Carla Rachel ^[2] ; Dozzi Brucki, Sonia Maria ^[3] ; Nitrini, Ricardo ^[3] ; Buchpiguel, Carlos Alberto ^[2] ; Souza Duran, Fabio Luis ^[1] ; Forlenza, Orestes Vicente ^[4]

Affiliation

^[1] Univ Sao Paulo, Fac Med FMUSP, Dept Psychiat, Lab Psychiat Neuroimaging LIM 21, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med FMUSP, Dept Radiol & Oncol, Lab Nucl Med LIM43, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med FMUSP, Dept Neurol, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Fac Med FMUSP, Dept Psychiat, Lab Neurosci LIM 27, Sao Paulo - Brazil

• Document type: Journal article
• Source: ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING; v. 12, n. 1 2020.
• Web of Science Citations: 2

Abstract

INTRODUCTION: Reduced cognitive reserve (CR) due to very low educational (VLE) levels may influence high dementia rates in low-middle income environments, leading to decreased cognitive resilience (RES) to Alzheimers disease (AD) pathology. However, in vivo findings in VLE groups confirming this prediction are lacking. METHODS: Cognitively impaired patients (with clinically defined AD dementia or amnestic mild cognitive impairment) and cognitively unimpaired older adults (n = 126) were recruited for a positron emission tomography (PET) and magnetic resonance imaging (MRI) investigation in Brazil, including 37 VLE individuals (<= 5 years of education). A CR score was generated combining educational attainment and vocabulary knowledge. RES indices to AD pathology were calculated using standardized residuals from linear regression models relating current cognitive performance (episodic memory or overall cognition) to amyloid beta (A beta) burden Pittsburgh compound-B ({[}11C]PiB-PET). RESULTS: A beta burden was lower in VLE relative to highly-educated subjects (controlling for age, sex, and Mini-Mental Status Exam {[}MMSE] scores) in the overall cognitively impaired sample, and in dementia subjects when the three clinically defined groups were evaluated separately. In bivariate regression analyses for the overall sample, the RES index based on a composite cognitive score was predicted by CR, socioeconomic status, and hippocampal volume (but not white matter hyperintensities or intracranial volume {[}ICV]); in the multivariate model, only CR retained significance (and similar results were obtained in the A beta-positive subsample). In the multivariate model for the overall sample using the RES index based on memory performance, CR, hippocampal volume, and ICV were significant predictors, whereas only CR retained significance in A beta-positive subjects. DISCUSSION: Lower CR consistently predicted less resilience to AD pathology in older adults from a low-middle income environment. (AU)

• FAPESP's process: 18/15167-1 - Translational neuroimaging in intellectual disability: evaluation of molecular changes associated with aging in Down Syndrome
• Grantee: Daniele de Paula Faria
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 14/50873-3 - INCT 2014: National Institute of Biomarkers in Neuropsychiatry
• Grantee: Wagner Farid Gattaz
• Support Opportunities: Research Projects - Thematic Grants