PDF(Pubmed)
Abstract：
BACKGROUND: Cognitive reserve (CR) is considered a protective factor for cognitive function and may explain interindividual differences of cognitive performance given similar levels of neurodegeneration, e.g., in Alzheimer´s disease. Recent evidence suggests that CR is also relevant in Parkinson\'s disease (PD).
OBJECTIVE: We aimed to explore the role of life-stage specific CR for overall cognition and specific cognitive domains cross-sectionally and longitudinally in PD.
METHODS: The cross-sectional analysis with data from the DEMPARK/LANDSCAPE study included 81 individuals without cognitive impairment (PD-N) and 87 individuals with mild cognitive impairment (PD-MCI). Longitudinal data covered 4 years with over 500 observations. CR was operationalized with the Lifetime of Experiences Questionnaire (LEQ), capturing the complexity of lifestyle activities across distinct life-stages. Cognition was assessed using a comprehensive neuropsychological test battery.
RESULTS: Higher LEQ scores, particularly from mid- and late-life, were observed in PD-N compared to PD-MCI [F(1,153) = 4.609, p = .033, ηp2 = 0.029]. They were significantly associated with better cognitive performance (0.200 ≤ β ≤ 0.292). Longitudinally, linear mixed effect models (0.236 ≤ marginal R2 ≤ 0.441) revealed that LEQ scores were positively related to cognitive performance independent of time. However, the decline in overall cognition and memory over time was slightly more pronounced with higher LEQ scores.
CONCLUSIONS: This study emphasizes the association between complex lifestyle activities and cognition in PD. Data indicate that while CR might be related to a delay of cognitive decline, individuals with high CR may experience a more pronounced drop in overall cognition and memory. Future studies will have to replicate these findings, particularly regarding domain-specific effects and considering reverse causal mechanisms.
OBJECTIVE: We aimed to explore the role of life-stage specific CR for overall cognition and specific cognitive domains cross-sectionally and longitudinally in PD.
METHODS: The cross-sectional analysis with data from the DEMPARK/LANDSCAPE study included 81 individuals without cognitive impairment (PD-N) and 87 individuals with mild cognitive impairment (PD-MCI). Longitudinal data covered 4 years with over 500 observations. CR was operationalized with the Lifetime of Experiences Questionnaire (LEQ), capturing the complexity of lifestyle activities across distinct life-stages. Cognition was assessed using a comprehensive neuropsychological test battery.
RESULTS: Higher LEQ scores, particularly from mid- and late-life, were observed in PD-N compared to PD-MCI [F(1,153) = 4.609, p = .033, ηp2 = 0.029]. They were significantly associated with better cognitive performance (0.200 ≤ β ≤ 0.292). Longitudinally, linear mixed effect models (0.236 ≤ marginal R2 ≤ 0.441) revealed that LEQ scores were positively related to cognitive performance independent of time. However, the decline in overall cognition and memory over time was slightly more pronounced with higher LEQ scores.
CONCLUSIONS: This study emphasizes the association between complex lifestyle activities and cognition in PD. Data indicate that while CR might be related to a delay of cognitive decline, individuals with high CR may experience a more pronounced drop in overall cognition and memory. Future studies will have to replicate these findings, particularly regarding domain-specific effects and considering reverse causal mechanisms.
摘要：
背景：认知储备（CR）被认为是认知功能的保护因素，并且可以解释在神经变性水平相似的情况下认知表现的个体差异，例如，在阿尔茨海默病中。最近的证据表明，CR也与帕金森病（PD）有关。
目的：我们旨在探讨生命阶段特异性CR在PD中跨截面和纵向对整体认知和特定认知领域的作用。
方法：使用DEMPARK/LANDSCAPE研究数据的横断面分析包括81名无认知障碍（PD-N）的个体和87名轻度认知障碍（PD-MCI）的个体。纵向数据涵盖4年，有500多次观察。CR使用体验寿命问卷(LEQ)进行操作，捕捉不同生命阶段生活方式活动的复杂性。使用全面的神经心理学测试电池评估认知。
结果：LEQ分数更高，尤其是中晚期,与PD-MCI相比，在PD-N中观察到[F（1,153）=4.609，p=0.033，ηp2=0.029]。它们与更好的认知表现(0.200≤β≤0.292)显著相关。纵向,线性混合效应模型(0.236≤边际R2≤0.441)显示,LEQ评分与认知表现呈正相关,而与时间无关.然而,LEQ评分越高,随着时间的推移,总体认知和记忆的下降更为明显.
结论：这项研究强调了复杂的生活方式活动与PD认知之间的关联。数据表明，虽然CR可能与认知能力下降的延迟有关，高CR患者的总体认知和记忆力可能会有更明显的下降.未来的研究将不得不复制这些发现，特别是关于特定领域的影响，并考虑反向因果机制。
目的：我们旨在探讨生命阶段特异性CR在PD中跨截面和纵向对整体认知和特定认知领域的作用。
方法：使用DEMPARK/LANDSCAPE研究数据的横断面分析包括81名无认知障碍（PD-N）的个体和87名轻度认知障碍（PD-MCI）的个体。纵向数据涵盖4年，有500多次观察。CR使用体验寿命问卷(LEQ)进行操作，捕捉不同生命阶段生活方式活动的复杂性。使用全面的神经心理学测试电池评估认知。
结果：LEQ分数更高，尤其是中晚期,与PD-MCI相比，在PD-N中观察到[F（1,153）=4.609，p=0.033，ηp2=0.029]。它们与更好的认知表现(0.200≤β≤0.292)显著相关。纵向,线性混合效应模型(0.236≤边际R2≤0.441)显示,LEQ评分与认知表现呈正相关,而与时间无关.然而,LEQ评分越高,随着时间的推移,总体认知和记忆的下降更为明显.
结论：这项研究强调了复杂的生活方式活动与PD认知之间的关联。数据表明，虽然CR可能与认知能力下降的延迟有关，高CR患者的总体认知和记忆力可能会有更明显的下降.未来的研究将不得不复制这些发现，特别是关于特定领域的影响，并考虑反向因果机制。
