P3‐585: COGNITIVE RESERVE MODULATES THE ASSOCIATION OF CEREBRAL AMYLOID PATHOLOGY WITH COGNITIVE PERFORMANCE IN PERSONS WITH ALZHEIMER'S DISEASE DEMENTIA Article Swipe

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Olin Janssen , Willemijn J. Jansen , Rik Ossenkoppele , Nancy N. Maserejian , Frans R.J. Verhey , Stephanie J. B. Vos , Pieter Jelle Visser ·

YOU? · · 2018 · Open Access · · DOI: https://doi.org/10.1016/j.jalz.2018.06.1951

The relationship between amyloid-ß deposition and the subsequent clinical expression of Alzheimer's disease (AD)-type dementia is found to be moderated by cognitive reserve. We here aim to investigate whether the protective effect of cognitive reserve on amyloid-related cognitive decline sustains in the dementia phase, and whether this potential moderating effect is influenced by age, apolipoprotein E (APOE)-ε4 carrier status and gender. We studied 1648 subjects with a clinical diagnosis of dementia of AD-type included in the Amyloid Biomarker Study. Cognitive performance was assessed by the Mini-Mental State Examination (MMSE). Amyloid-ß deposition was measured with positron emission tomography or cerebrospinal-fluid biomarkers and dichotomized as normal or abnormal according to study-specific cut-offs. Years of formal education as a proxy of cognitive reserve were divided based on tertiles in low (15 years). Generalized-estimating-equations were used to estimate the moderating effect of educational level on the cross-sectional relationship between amyloid status and low MMSE score (<24). We also examined associations with age, APOE-ε4 carrier status and gender. Average age was 69.6 years, 50.3% were female, 59.4% had a low MMSE score and 1366 (82.9%) individuals were amyloid positive. The relation between amyloid positivity and cognitive performance differed according to education group (P = .049). The effect of education on cognitive performance was different in amyloid positive and amyloid negative patients (Figure 1). In amyloid positive participants, individuals with a high educational level less often had a low MMSE score compared to individuals with intermediate or low education (mean difference 13-18%, P < .001). In amyloid negative participants, individuals with both a high and intermediate level of education performed better than those with a low education (mean difference 16-18%, P <.01). Age, APOE-ε4 carrier status and gender had moderating effects on this association. Frequencies of low Mini-Mental State Examination (MMSE) scores in AD individuals. Model with terms for age, amyloid status, and interactions between amyloid status and education groups (P = .049). Low MMSE score was defined as <24. High cognitive reserve protects against cognitive decline among individuals with dementia, regardless of amyloid status. Intermediate cognitive reserve may protect against decline in amyloid-negative persons with dementia. These results could help improve our understanding of the disease and implicate the potential of cognitive reserve to delay cognitive impairment.

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Dementia Cognitive reserve Apolipoprotein E Cognition Amyloid (mycology) Internal medicine Effects of sleep deprivation on cognitive performance Psychology Medicine Alzheimer's disease Biomarker Disease Pittsburgh compound B Mini–Mental State Examination Cognitive decline Oncology Clinical psychology Pathology Psychiatry Biology Biochemistry

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Type: article
Language: en
Landing Page: https://doi.org/10.1016/j.jalz.2018.06.1951
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DOI: https://doi.org/10.1016/j.jalz.2018.06.1951

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Title: P3‐585: COGNITIVE RESERVE MODULATES THE ASSOCIATION OF CEREBRAL AMYLOID PATHOLOGY WITH COGNITIVE PERFORMANCE IN PERSONS WITH ALZHEIMER'S DISEASE DEMENTIA

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Publication year: 2018

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Publication date: 2018-07-01

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Authors: Olin Janssen, Willemijn J. Jansen, Rik Ossenkoppele, Nancy N. Maserejian, Frans R.J. Verhey, Stephanie J. B. Vos, Pieter Jelle Visser

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Concepts: Dementia, Cognitive reserve, Apolipoprotein E, Cognition, Amyloid (mycology), Internal medicine, Effects of sleep deprivation on cognitive performance, Psychology, Medicine, Alzheimer's disease, Biomarker, Disease, Pittsburgh compound B, Mini–Mental State Examination, Cognitive decline, Oncology, Clinical psychology, Pathology, Psychiatry, Biology, Biochemistry

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