The levels of β-amyloid (Aβ) and phosphorylated tau (p-tau), as measured in cerebrospinal fluid, have been associated with the risk of progressing from normal cognition to onset of clinical symptoms during preclinical Alzheimer's disease. We examined whether cognitive reserve (CR) modifies this association. Cerebrospinal fluid was obtained at baseline from 239 participants (mean age, 57.2 years) who had been followed for up to 17 years with clinical and cognitive assessments (mean follow-up, 8 years). A composite score based on the National Adult Reading Test, vocabulary, and years of education at baseline was used as an index of CR. Cox regression models showed that the increased risk of progressing from normal cognition to symptom onset was associated with lower CR, lower baseline Aβ, and higher baseline p-tau. There was no interaction between CR and Aβ, suggesting that the protective effects of higher CR are equivalent across the observed range of amyloid levels. In contrast, both tau and p-tau interacted with CR, indicating that CR was more protective at lower levels of tau and p-tau.

译文

在脑脊液中测得的 β-淀粉样蛋白 (a β) 和磷酸化tau (p-tau) 的水平与临床前阿尔茨海默氏病从正常认知发展为临床症状发作的风险有关。我们检查了认知储备 (CR) 是否改变了这种关联。在基线时从239名参与者 (平均年龄,57.2岁) 获得脑脊液,这些参与者接受了长达17年的临床和认知评估 (平均随访,8年)。使用基于全国成人阅读测试,词汇和基线受教育年限的综合分数作为CR的指标。Cox回归模型显示,从正常认知到症状发作的风险增加与较低的CR,较低的基线a β 和较高的基线p-tau相关。CR和a β 之间没有相互作用,这表明在观察到的淀粉样蛋白水平范围内,较高的CR的保护作用是等效的。相反,tau和p-tau均与CR相互作用,表明CR在较低的tau和p-tau含量下具有更大的保护性。

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