title: Cognitive reserve and the risk for Alzheimer's disease: a longitudinal study.
abstract: This study investigates how cognitive reserve (CR) interacts with neurodegeneration (quantified by medial temporal atrophy, MTA) and macroscopic white matter lesions (WMLs) in delaying the conversion from amnestic mild cognitive impairment to Alzheimer's disease (AD). Forty-two amnestic mild cognitive impairment patients were consecutively recruited. They underwent magnetic resonance imaging and a comprehensive questionnaire to classify them as individuals with low or high CR. Patients were then clinically followed-up for 2 years. The patients' risk for conversion to AD because of CR was estimated by controlling for cognitive efficiency, MTA, and WMLs at baseline. Global cognition was the best predictor of conversion to AD in low CR patients. Conversely, in high CR patients only, WMLs (but not MTA) highly contributed in increasing the risk for conversion to AD. In conclusion, CR interacts with both patients' cognitive features and WMLs in modulating the impact of AD pathology. This seems relevant for clinical prognosis and therapeutic strategies.
authors.affiliation: Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Serra
authors.affiliation: Institute of Biomedical Technologies-National Research Council (ITB-CNR), Segrate, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Musicco
authors.affiliation: Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Brighton & Sussex Medical School, CISC, University of Sussex, Brighton, UK.
authors.forename: Mara
authors.initials: M
authors.lastname: Cercignani
authors.affiliation: Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Torso
authors.affiliation: Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Spanò
authors.affiliation: Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mastropasqua
authors.affiliation: Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Giulietti
authors.affiliation: Institute of Neurology, Catholic University, Rome, Italy.
authors.forename: Camillo
authors.initials: C
authors.lastname: Marra
authors.affiliation: Department of Neurology and Psychiatry, La Sapienza University of Rome, Viale dell'Università, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bruno
authors.affiliation: Department of Neuroscience, University of Rome 'Tor Vergata', Rome, Italy; Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Koch
authors.affiliation: Department of Neuroscience, University of Rome 'Tor Vergata', Rome, Italy; Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
authors.affiliation: Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy. Electronic address: m.bozzali@hsantalucia.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Bozzali
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology* / Q000523:psychology*; D001284:Atrophy; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D003071:Cognition; D060825:Cognitive Dysfunction / Q000473:pathology / Q000523:psychology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009410:Nerve Degeneration / Q000473:pathology; D009483:Neuropsychological Tests; D011379:Prognosis; D012306:Risk; D011795:Surveys and Questionnaires; D013702:Temporal Lobe / Q000473:pathology; D013997:Time Factors; D066127:White Matter / Q000473:pathology
keywords: AD; Cognitive reserve; MTA; Relative risk; White matter lesions; a-MCI