Discrepancy Between the Degree of Cognitive Impairment and Brain Imaging Abnormalities in Alzheimer's Disease Patients Is Associated with Cognitive Reserve
| Autor: | Tomohiko Sato, Hidekazu Kanetaka, Kentaro Hirao, Haruo Hanyu, Soichiro Shimizu, Toshinori Aoki, Yumi Koyama, Haruka Horita |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Disease Education Atrophy Leisure Activities Neuroimaging Cognitive Reserve Alzheimer Disease Internal medicine Medicine Humans Cognitive Dysfunction Cognitive deficit Cognitive reserve Aged Tomography Emission-Computed Single-Photon medicine.diagnostic_test business.industry General Neuroscience Brain Cognition Magnetic resonance imaging General Medicine medicine.disease Magnetic Resonance Imaging Psychiatry and Mental health Clinical Psychology Cardiology Female Geriatrics and Gerontology medicine.symptom business Emission computed tomography |
| Zdroj: | Journal of Alzheimer's disease : JAD. 84(1) |
| ISSN: | 1875-8908 |
| Popis: | Background: In Alzheimer’s disease (AD) patients, the severity of cognitive impairment is thought to correlate with the degree of brain imaging abnormalities. However, some patients show only mild cognitive deficit, despite severe brain atrophy on magnetic resonance imaging (MRI) or marked hypoperfusion in the cerebral cortices on single-photon emission computed tomography (SPECT). This suggests that cognitive reserve (CR) can compensate for the clinical manifestations of AD in patients with extensive brain pathology. Objective: We aimed to determine whether this discrepancy between cognitive and imaging findings is associated with CR. Methods: Factors associated with the discrepancy between the degree of cognitive impairment and MRI (medial temporal lobe atrophy) and SPECT (posterior cerebral hypoperfusion) findings were analyzed in 135 patients with probable AD. Factors as proxies for CR included education, occupation, leisure activity, comorbidities, frailty, and other demographics. The discrepancy index (DI) was calculated as the difference between the degree of imaging abnormalities and the degree of cognitive dysfunction. Results: Multiple regression analysis showed that leisure activity and education were significantly associated with the discrepancy between cognitive and imaging findings. When the level of CR was determined based on leisure activity and education, the high-CR group showed a significantly larger DI than the moderate- and low-CR groups. Conclusion: The discrepancy between cognitive and imaging findings in patients with AD is associated with CR, measured using a combination of two indicators, i.e., leisure activity and education. Therefore, lifestyle interventions may delay the appearance of clinical symptoms resulting from underlying AD pathology, by increasing CR. |
| Databáze: | OpenAIRE |
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