机构:[1]Shenzhen Bay Lab, Inst Neurol & Psychiat Disorders, 5 Kelian Rd, Shenzhen 518132, Peoples R China[2]Hong Kong Univ Sci & Technol, Div Life Sci, Hong Kong, Peoples R China[3]Capital Med Univ, Xuanwu Hosp, Dept Neurol, Beijing, Peoples R China首都医科大学宣武医院[4]Hainan Univ, Sch Biomed Engn, Haikou, Peoples R China[5]Harbin Inst Technol, Sch Life Sci & Technol, Harbin, Peoples R China[6]Shenzhen Guangming Dist Peoples Hosp, Dept Neurol, Shenzhen 518107, Peoples R China[7]Shenzhen Bay Lab, Inst Biomed Engn, Shenzhen, Peoples R China[8]Peking Univ, Inst Biomed Engn, Shenzhen Grad Sch, Shenzhen, Peoples R China
Introduction: Alzheimer's disease (AD) patients with higher educational attainment (EA) often exhibit better cognitive function. However, the relationship among EA status, AD pathology, structural brain reserve, and cognitive decline requires further investigation. Methods: We compared cognitive performance across different amyloid beta (A beta) positron emission tomography (A +/-) statuses and EA levels (High EA/Low EA). We examined the effects of A beta plaques, tau tangles, and gray matter volume (GMV) on the relationship between EA and domain-specific cognitive decline. Results: A+/High-EA individuals exhibited slower cognitive decline in global cognition and language domains than A+/Low-EA individuals. This cognitive benefit was independently and synergistically explained by reduced AD pathology, including lower A beta and tau burdens, as well as preserved GMV. Additionally, High-EA individuals experienced a median delay of 1.9 years in the onset of significant brain atrophy among A+ individuals. Discussion: These findings highlight the independent and synergistic contributions of EA-associated AD pathology and GMV alterations to longitudinal cognitive decline.
基金:
Guangdong Basic and Applied Basic Science Foundation for Distinguished Young Scholars; Shenzhen Science and Technology Program [RCYX20221008092935096]; National Natural Science Foundation of China [82171197]; Shenzhen Bay Laboratory; Lingang Laboratory [LG-GG-202401-ADA070600]; [2023B1515020113]