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New findings on protective effects in Alzheimer's Disease

A study by Michael Ewers & colleagues, published this week in NEUROLOGY, suggests that higher levels of education have protective effects (cognitive reserve) in AD. The authors found that in the early stage of AD, elderly subjects with more years of education remained cognitively normal despite more severe brain hypo-metabolism, indicating that education allows to tolerate better AD pathology.

About 30% of elderly subjects above the age of 60 years show Alzheimer’s disease (AD) typical brain pathologies but are cognitively normal - a condition called „preclincal AD“. A major research question is what factors explain such a surprising discrepancy between high levels of AD pathology and relatively well preserved cognitive function.

In an international collaboration with the University of California at San Francisco and Columbia University (New York), researchers at the ISD demonstrated that cognitive reserve may help to explain this puzzling observation of preserved cognitive performance in preclinical AD. Cognitive reserve is defined by the ability to maintain cognitive abilities relatively well in the presence of brain damage and is thought to be acquired by life time experiences such as schooling and education. The findings of the study, recently published in the journal Neurology, showed that preclinical AD patients with higher levels of education exhibited more FDG-PET hypometabolism, while still remaining cognitively normal. These findings suggest that preclinical AD subjects with high cognitive reserve (education) could accumulate more neurodegeneration without showing cognitive impairment than preclinical AD subjects with low cognitive reserve (education). Thus cognitive reserve may guard against the impact of AD pathology on cognition early in the course of AD.

Read the full text article, an editorial and a pod-cast featured by the journal Neurology here...


neurology_meFigure: Preclincal AD subjects with high education can preserve cognitive performance in the presence of relatively stronger FDG-PET hypometabolism (colored in red) compared to subjects with low levels of education.
 

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