In:
Alzheimer's & Dementia, Wiley, Vol. 18, No. S7 ( 2022-12)
Abstract:
Prevention of Alzheimer’s dementia may encompass both avoiding the AD pathological processes (resistance) and coping with AD pathology (resilience). Increasing evidence implicates resistance/resilience factors (e.g., level of education, socio‐economic status [SES], physical activity [PA] ) occurring through life as potential modifiers of age at symptom onset (AAO) and rate of cognitive decline to dementia. The extent to which life course factors may influence disease progression in Dominantly Inherited Alzheimer’s Disease (DIAD) remains unknown. Methods We aimed to examine the influence of life‐course factors on clinical‐cognitive decline and MRI hippocampal volume in individuals with DIAD enrolled in the Dominantly Inherited Alzheimer Network. A total of 310 mutations carriers (195 asymptomatic and 111 symptomatic [CDR 〉 0]) self‐reported education, work complexity, SES, and PA at baseline and completed longitudinal clinical‐cognitive measures, CSF biomarker studies (Aβ‐42, p‐tau‐181, t‐tau), structural MRI and Aβ‐PET imaging. The influence of life‐course risk factors on AAO, cognitive performances, and hippocampal volume were analyzed using linear mixed models. Result In mutation carriers (MC), adjusting for age, PiB‐PET SUVR, and sex, lower clinical disease severity as measured by CDR‐SB was associated with higher levels of education (p = 0.04), PA (p = 0.01) and SES (0.002). Similarly, MC with higher educational levels (p = 0.02) and SES levels (p = 0.001) exhibited larger hippocampal volume despite no differences in PiB‐PET SUVR. Longitudinally, MC with higher levels of education, PA, and SES showed better performance and slower cognitive decline in memory and executive function prior to symptom onset (CDR 〉 0), but a similar decline rate after symptom onset. Conclusion Life‐course factors, like higher education, PA, and SES may promote brain resistance and clinical resilience to AD pathology in DIAD. A model of cognitive reserve in DIAD may help to identify how social and behavioral factors influence the progression of AD pathophysiology and explain how a variety of factors may enhance resistance to pathology, delay AAO, and cognitive decline rate.
Type of Medium:
Online Resource
ISSN:
1552-5260
,
1552-5279
Language:
English
Publisher:
Wiley
Publication Date:
2022
detail.hit.zdb_id:
2201940-6
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