Unraveling the Protective Effects of Cognitive Reserve on Cognition and Brain: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Population
2.2. Cognitive Reserve and Cognition
2.3. Brain Reserve and Brain Maintenance
2.4. Ethical Approval
2.5. Statistical Analysis
3. Results
Study Sample
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | No. (%) or Mean (SD) | |
---|---|---|
Age | Mean in years | 61.11 ± 9.0 |
Sex | Female | 481 (63) |
Male | 282 (37) | |
Living location | Urban | 598 (78) |
Rural | 165 (22) | |
Cognitive reserve (CR) | ||
Education level | Primary | 38 (5) |
Trade school | 78 (10) | |
Secondary/High school | 333 (44) | |
College/University | 314 (41) | |
Marital status | Common married/living with the partner | 578 (75.5) |
Divorced | 68 (9) | |
Never married | 60 (8) | |
Widowed | 56 (7) | |
Unknown | 1 (0.5) | |
Employment | Yes | 523 (79) |
No | 240 (30) | |
No date | 3 (1) | |
Leisure time physically active | Yes | 73 (14) |
No | 459 (60) | |
Unknown | 231 (26) | |
Participation in social groups | Yes | 95 (13) |
No | 668 (87) | |
Cognitive functioning | MoCA < 26 | 296 (39) |
MoCA mean score | 25.91 ± 2.7 | |
DSST mean score | 60.18 ± 14.9 | |
Brain maintenance (WMH) | Fazekas grade | |
(periventricular + subcortical) | ||
0 | 169 (22) | |
1 | 173 (23) | |
2 | 310 (41) | |
3 | 55 (7) | |
4 | 36 (4.5) | |
5 | 8 (1) | |
6 | 12 (1.5) | |
WMH volume | 1.95 ± 2.4 | |
Brain reserve | WM volume | 501.07 ± 61.3 |
GM volume | 572.72 ± 54.4 | |
Depressive symptoms | CES-d mean | 10.0 ± 8.1 |
General activity | SAGE mean score | 2.47 ± 2.9 |
Age Group | 39–49 | 50–59 | 60–69 | ≥70 | p Value * |
---|---|---|---|---|---|
No | 110 | 216 | 302 | 135 | |
MoCA mean score | 27.40 ± 2.3 | 26.29 ± 2.6 | 25.58 ± 2.4 | 24.81 ± 2.9 | <0.001 |
DSST | 74.54 ± 14.4 | 64.64 ± 13.4 | 56.63 ± 11.6 | 49.26 ± 12.5 | <0.001 |
Fazekas mean score (WMH) | 0.74 ± 0.8 | 1.22 ± 1.0 | 1.73 ± 1.1 | 2.57 ± 1.4 | <0.001 |
WMH Volume | 1.21 ± 0.8 | 1.54 ± 1.3 | 1.94 ± 1.4 | 3.23 ± 4.6 | <0.001 |
GM Volume | 622.69 ± 48.7 | 588.0 ± 49.7 | 562.9 ± 46.9 | 529.6 ±38.3 | <0.001 |
WM Volume | 542.1 ± 61.4 | 516.6 ± 61.5 | 493.9 ± 54.3 | 458.7 ± 43.7 | <0.001 |
Effect | Coefficient | SE | z-Value | p-Value | |
---|---|---|---|---|---|
CR~MoCA (through WMH vol and WM vol) | Direct effect of CR on MoCA (c) | 0.286 | 0.068 | 4.224 | <0.001 |
Direct effect of CR on WMH (a1) | −0.142 | 0.064 | −2.220 | 0.03 | |
Direct effect of CR on WM vol (a2) | 0.029 | 0.023 | 1.287 | 0.198 | |
Direct effect of WMH on MoCA (b1) | −0.187 | 0.039 | −4.841 | <0.001 | |
Direct effect of WM on MoCA (b2) | 0.420 | 0.091 | 4.628 | <0.001 | |
Indirect effect (through WMH) of CR on MoCA (a1b1) | 0.026 | 0.013 | 2.018 | 0.04 | |
Indirect effect (through WM vol) of CR on MoCA (a2b2) | 0.012 | 0.010 | 1.240 | 0.215 | |
Total effect of CR on MoCA (a1b1 + a2b2 + c) | 0.324 | 0.067 | 4.826 | <0.001 | |
CR~MoCA (through WMH vol and GM vol) | Direct effect of CR on MoCA (c) | 0.270 | 0.068 | 3.987 | <0.001 |
Direct effect of CR on WMH (a1) | −0.170 | 0.064 | −2.631 | 0.009 | |
Direct effect of CR on GM vol (a2) | 0.054 | 0.021 | 2.567 | 0.01 | |
Direct effect of WMH on MoCA (b1) | −0/161 | 0.038 | −4.207 | <0.001 | |
Direct effect of GM on MoCA (b2) | 0.549 | 0.090 | 6.086 | <0.001 | |
Indirect effect (through WMH) of CR on MoCA (a1b1) | 0.027 | 0.012 | 2.231 | 0.026 | |
Indirect effect (through GM vol) of CR on MoCA (a2b2) | 0.030 | 0.013 | 2.365 | 0.018 | |
Total effect of CR on MoCA (a1b1 + a2b2 + c) | 0.327 | 0.067 | 4.897 | <0.001 | |
CR~DSST (through WMH vol and WM vol) | Direct effect of CR on DSST (c) | 1.780 | 0.327 | 5.447 | <0.001 |
Direct effect of CR on WMH (a1) | −0.142 | 0.064 | −2.220 | 0.03 | |
Direct effect of CR on WM vol (a2) | 0.029 | 0.023 | 1.287 | 0.198 | |
Direct effect of WMH on DSST (b1) | −1.241 | 0.212 | −5.865 | <0.001 | |
Direct effect of WM on DSST (b2) | 3.042 | 0.498 | 6.107 | <0.001 | |
Indirect effect (through WMH) of CR on DSST (a1b1) | 1.176 | 0.085 | 2.076 | 0.04 | |
Indirect effect (through WM vol) of CR on DSST (a2b2) | 0.089 | 0.070 | 1.260 | 0.208 | |
Total effect of CR on DSST (a1b1 + a2b2 + c) | 2.044 | 0.317 | 6.454 | <0.001 | |
CR~DSST (through WMH vol and GM vol) | Direct effect of CR on DSST (c) | 1.649 | 0.328 | 5.032 | <0.001 |
Direct effect of CR on WMH (a1) | −0.170 | 0.064 | −2.631 | 0.009 | |
Direct effect of CR on GM vol (a2) | 0.054 | 0.021 | 2.567 | 0.01 | |
Direct effect of WMH on DSST (b1) | −1.052 | 0.208 | −5.060 | <0.001 | |
Direct effect of GM on DSST (b2) | 4.088 | 0.491 | 8.318 | <0.001 | |
Indirect effect (through WMH) of CR on DSST (a1b1) | 0.179 | 0.076 | 2.334 | 0.02 | |
Indirect effect (through GM vol) of CR on DSST (a2b2) | 0.223 | 0.091 | 2.453 | 0.01 | |
Total effect of CR on DSST (a1b1 + a2b2 + c) | 2.051 | 0.317 | 6.475 | <0.001 |
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Szcześniak, D.; Lenart-Bugla, M.; Misiak, B.; Zimny, A.; Sąsiadek, M.; Połtyn-Zaradna, K.; Zatońska, K.; Zatoński, T.; Szuba, A.; Smith, E.E.; et al. Unraveling the Protective Effects of Cognitive Reserve on Cognition and Brain: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2022, 19, 12228. https://doi.org/10.3390/ijerph191912228
Szcześniak D, Lenart-Bugla M, Misiak B, Zimny A, Sąsiadek M, Połtyn-Zaradna K, Zatońska K, Zatoński T, Szuba A, Smith EE, et al. Unraveling the Protective Effects of Cognitive Reserve on Cognition and Brain: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2022; 19(19):12228. https://doi.org/10.3390/ijerph191912228
Chicago/Turabian StyleSzcześniak, Dorota, Marta Lenart-Bugla, Błażej Misiak, Anna Zimny, Marek Sąsiadek, Katarzyna Połtyn-Zaradna, Katarzyna Zatońska, Tomasz Zatoński, Andrzej Szuba, Eric E. Smith, and et al. 2022. "Unraveling the Protective Effects of Cognitive Reserve on Cognition and Brain: A Cross-Sectional Study" International Journal of Environmental Research and Public Health 19, no. 19: 12228. https://doi.org/10.3390/ijerph191912228