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• W2896822092 abstract "The heterogeneity of neurocognitive manifestation of underlying neuropathologies was first documented in post-mortem samples and later with neuroimaging data. Cognitive reserve is hypothesized to partially explain heterogeneity between brain pathology and function. We aimed to test a statistically-defined measure of memory reserve (MR) in a community-based sample of older women using a novel brain MRI biomarker. We analyzed brain volumetric and cognitive performance data of 1,050 older women (aged 65-80) who participated in the Women's Health Initiative (WHI) Memory Study - Magnetic Resonance Imaging (WHIMS-MRI) and the WHI Study of Cognitive Aging. A quantitative measure of MR was derived via structural equation modeling and variance decomposition of episodic memory. We use the Alzheimer's Disease (AD) pattern similarity (AD-PS) score, which captured the spatial pattern of high-dimensional gray matter atrophies predictive of clinical AD, to represent a summary measure of the severity of underlying AD neuropathologies. The AD-PS score (range:0-1) was developed by supervised machine learning and validated with data from the Alzheimer's Disease Neuroimaging Initiative (Casanova, 2013) and applied to the WHIMS-MRI data (AAIC, 2017). Using the Cox proportional hazard regression, we examined the association between AD-PS and clinically significant decline (>10-point decrease) in global cognitive function, assessed by the modified mini-mental state (3MS) examination, and incident MCI. We then tested whether MR moderated the observed associations. All models adjusted for socio-demographic, lifestyle (e.g., smoking; alcohol; exercise), and clinical variables (e.g. diabetes; high cholesterol; hypertension; cardiovascular disease). Each increment of 0.10 in AD-PS score was associated with an increased risk for 3MS decline (HR=1.33; p<0.01) and incident MCI (HR=1.27; p<0.01). Measure of MR moderated the adverse effect of AD-PS on 3MS decline (p=0.01) and MCI (p=0.03). For instance, we observed a statistically significant association between AD-PS score and an increased risk for 3MS decline (adjusted HR=1.45, p<0.01) among older women with low MR (< median), but no appreciable increase in relative risk (HR=0.78; p=0.28) among those with high MR (see figure 1). Modified Mini mental Status (3MS) and incident Mild Cognitive Impairment (MCI) survival rates by memory reserve (MR) and Alzheimer's imaging pathology score (AD-PS). All models adjusted for socio-demographic factors (education, ethnicity), lifestyle (e.g. smoking, alcohol, exercise), and clinical variables (e.g. diabetes, high cholesterol, hypertension, and cardiovascular disease). Note MR and AD-PS dichotomized via median split. These findings support the concept of MR applied to community-based populations, and further demonstrate the validity of statistical approaches to measuring MR." @default.
• W2896822092 created "2018-10-26" @default.
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• W2896822092 date "2018-07-01" @default.
• W2896822092 modified "2023-10-16" @default.
• W2896822092 title "P2‐617: MEMORY RESERVE MODERATES THE ASSOCIATION BETWEEN A NEUROANATOMICAL MEASURE OF AD RISK AND GLOBAL COGNITIVE DECLINE IN THE WOMEN'S HEALTH INITIATIVE MEMORY STUDY" @default.
• W2896822092 doi "https://doi.org/10.1016/j.jalz.2018.06.1313" @default.
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