BACKGROUND
Cognitive reserve (CR) is thought to buffer against the clinical manifestation of dementia, preserving cognitive function despite accumulating pathology. However, less is known about how CR relates to the capacity to independently perform activities of daily living (ADL), particularly among cognitively unimpaired (CU) older adults. Here, we investigated this association.
METHODS
Baseline data from 1,571 CU participants (mean age: 64.7±7.6; 81.3% female) from the CAN-PROTECT study were analyzed. A composite CR score was derived from education, occupational complexity, and engagement in cognitively stimulating activities. Functional ability was measured using the Standard Assessment of Global Everyday Activities (SAGEA) scale, capturing cognitive, applied cognitive, instrumental, and basic ADL, and mobility. Negative binomial models examined associations between CR and global and domain-specific ADL, adjusting for age, sex, cognition, behaviour, and physical/sensory limitations. Additional models tested the independent contribution of CR components to functional outcomes. Mediation analyses assessed the effect of CR on quality of life (QoL) through ADL abilities.
RESULTS
Higher CR was associated with lower global ADL impairment (count ratio=0.58, 95%CI: 0.36-0.94, p = 0.027), driven by 49% less impairment in applied cognitive ADL (95%CI: 0.26-0.97, p = 0.038). Among CR domains, education showed the most consistent association with lower impairment across all ADL domains and was indirectly linked to better QoL through improved function.
CONCLUSIONS
CR, particularly education, may play an important role in supporting functional abilities and QoL among CU older adults. Enhancing CR may be a promising avenue to promote functional independence and healthy aging, even in the absence of cognitive impairment.
M. Ghahremani, D. Guan, C. Ballard et al.· The journals of gerontology....· 0 citations
BackgroundMild Cognitive Impairment (MCI) and Mild Behavioral Impairment (MBI) can be prodromal stages of neurodegenerative disease associated with plasma biomarkers of tau pathology and neuroaxonal damage. However, in psychiatric populations, the relationship between MCI, MBI and these plasma biomarkers remains unclear.ObjectiveThis study examined the association of MCI with plasma biomarkers of neurodegeneration (phosphorylated tau217 [p-tau217] and neurofilament light chain [NfL]), metabolic alterations, psychiatric disorder features, and MBI in older adults receiving psychiatric treatment.MethodsFifty-one non-demented patients ≥60 years, referred for mood or anxiety disorders, were enrolled and classified based on cognitive performance as MCI (n = 20) or non-MCI (n = 31). Assessments included psychiatric, cognitive, functional, and plasma biomarker measures.ResultsMCI patients exhibited higher p-tau217 (P = .003) and NfL (P = .042) levels, lower cognitive scores (P < .001), and a trend toward reduced functioning (P = .074). MCI was also associated with later onset of psychiatric symptoms (P = .033) and greater prevalence of MBI (P < .001). Logistic regression identified plasma NfL as a marker of MCI (P < .05) in this sample.ConclusionOur findings suggest that integrating cognitive, psychiatric, and biomarker assessments may improve early detection of dementia risk.
C. Elefante, M. F. Beatino, Daniela Marro et al.· Journal of Geriatric Psychia...· 0 citations
ABSTRACT Parkinson's disease (PD) encompasses motor and neuropsychiatric symptoms (NPS) including depression, anxiety, and apathy. Cognitive subtypes—PD with mild cognitive impairment (PD‐MCI) and PD with dementia (PDD)—and the related Dementia with Lewy Bodies (DLB) exist within the spectrum of Lewy body disease (LBD). While NPS are a major comorbidity, established imaging biomarkers are not available, nor is the neuronal basis well known. Additionally, prevalence of NPS may be linked to cognitive status. The hippocampus is implicated in the development of NPS and may undergo microstructural changes that are not reflected in volume changes. High‐resolution diffusion tensor imaging (DTI) was used to identify hippocampal changes in LBD compared to healthy controls (HC) and examine the relationship with NPS within the LBD group, both through association with DTI measures as well as comparison of cognitive subgroups. The hippocampus was manually segmented in 38 LB spectrum participants (aged 58–87 years, 32% female) and 35 HC (aged 50–83 years, 54% female) on high‐resolution (1 × 1 × 1 mm3) DTI. The LBD group (LBD‐All) was divided into LBD‐Cognitively Impaired (LBD‐CI) and LBD‐Cognitively Unimpaired (LBD‐CU). Hippocampal volume, mean diffusivity (MD), and fractional anisotropy (FA) were extracted and compared across groups. Relationships between significantly different hippocampal measures and depression, anxiety, and apathy were explored within the LBD‐All group. Hippocampal FA was lower in LBD‐All relative to HC; however, no differences in MD or volume were observed. Hippocampal FA was positively associated with depression scores within LBD‐All. There were no differences in volume, MD, or FA between LBD‐CI and LBD‐CU. Lower hippocampal fractional anisotropy in the LBD spectrum relative to HC potentially reflects microstructure alterations; however, higher hippocampal FA in LBD with more severe depression suggests more complex microstructural changes such as altered synaptic density, Lewy neurite organization, or neuroplastic changes.
Alexandra S. Budd, K. Solar, Myrlene Gee et al.· Hippocampus· 0 citations
Background Mild behavioral impairment (MBI), characterized by later-life emergence of persistent neuropsychiatric symptoms (NPS), is an early clinical indicator of dementia risk. Global MBI has been associated with Alzheimer's disease (AD) pathology; studies have also explored MBI domains. Prior work has linked MBI-apathy to AD cerebrospinal fluid (CSF) biomarkers, but whether associations are detectable using plasma-based biomarkers such as phosphorylated tau (p-tau) is unknown. Establishing such relationships is critical, as plasma biomarkers are more accessible than CSF. Objective To explore cross-sectional and longitudinal associations between MBI-apathy and plasma p-tau181 levels using Alzheimer's Disease Neuroimaging Initiative data. Methods Older adults with normal cognition or mild cognitive impairment were categorized as MBI-apathy (n = 69), non-MBI NPS (n = 112), and no-NPS (n = 215) based on Neuropsychiatric Inventory scores and symptom persistence over one year. Linear regression modelled cross-sectional associations between NPS group and plasma p-tau181, adjusting for age, sex, education, apolipoprotein E4 status, and Mini-Mental State Examination score. Hierarchical linear mixed-effects modelling assessed associations over two and three years, including time-by-NPS group interactions. Results MBI-apathy was associated with significantly higher plasma p-tau181 levels at baseline (24.05% [6.06–45.08%]; adjusted p = 0.014), and over two (26.46% [7.24–49.12%]; adjusted p = 0.012) and three years (29.28% [10.17–51.72%]; adjusted p = 0.004) compared to no-NPS. No significant associations were observed for non-MBI NPS. In sensitivity analyses, non-MBI apathy was not associated with plasma p-tau181 at baseline (−9.96% [−32.69–20.44%]; unadjusted p = 0.478). Conclusions MBI-apathy is associated with elevated plasma p-tau181 cross-sectionally and longitudinally, supporting MBI-apathy as a potential proxy marker of tau pathology for early AD detection.
Daniella Vellone, Rebeca Leon, Zahra Goodarzi et al.· Journal of Alzheimer's Disea...· 0 citations
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