Clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and women
Abstract Background Interindividual differences in cognitive reserve (CR) are associated with complex and dynamic clinical phenotypes observed in cognitive impairment and dementia. We tested whether (1) CR early in life (E-CR; measured by education and IQ), (2) CR later in life (L-CR; measured by oc...
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| Format: | Article |
| Language: | English |
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BMC
2018-09-01
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| Series: | Alzheimer’s Research & Therapy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13195-018-0419-2 |
| _version_ | 1818777496452071424 |
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| author | Shraddha Sapkota Joel Ramirez Donald T. Stuss Mario Masellis Sandra E. Black |
| author_facet | Shraddha Sapkota Joel Ramirez Donald T. Stuss Mario Masellis Sandra E. Black |
| author_sort | Shraddha Sapkota |
| collection | DOAJ |
| description | Abstract Background Interindividual differences in cognitive reserve (CR) are associated with complex and dynamic clinical phenotypes observed in cognitive impairment and dementia. We tested whether (1) CR early in life (E-CR; measured by education and IQ), (2) CR later in life (L-CR; measured by occupation), and (3) CR panel (CR-P) with the additive effects of E-CR and L-CR, act as moderating factors between baseline ventricular size and clinical dementia severity at baseline and across 2 years. We further examined whether this moderation is differentially represented by sex. Methods We examined a longitudinal model using patients (N = 723; mean age = 70.8 ± 9.4 years; age range = 38–90 years; females = 374) from the Sunnybrook Dementia Study. The patients represented Alzheimer’s disease (n = 439), mild cognitive impairment (n = 77), vascular cognitive impairment (n = 52), Lewy body disease (n = 30), and frontotemporal dementia (n = 125). Statistical analyses included (1) latent growth modeling to determine how clinical dementia severity changes over 2 years (measured by performance on the Dementia Rating Scale), (2) confirmatory factor analysis to establish a baseline E-CR factor, and (3) path analysis to predict dementia severity. Baseline age (continuous) and Apolipoprotein E status (ɛ4−/ɛ4+) were included as covariates. Results The association between higher baseline ventricular size and dementia severity was moderated by (1) E-CR and L-CR and (2) CR-P. This association was differentially represented in men and women. Specifically, men in only the low CR-P had higher baseline clinical dementia severity with larger baseline ventricular size. However, women in the low CR-P showed the (1) highest baseline dementia severity and (2) fastest 2-year decline with larger baseline ventricular size. Conclusions Clinical dementia severity associated with ventricular size may be (1) selectively moderated by complex and additive CR networks and (2) differentially represented by sex. Trials registration ClinicalTrials.gov, NCT01800214. Registered on 27 February 2013. |
| first_indexed | 2024-12-18T11:29:45Z |
| format | Article |
| id | doaj.art-b46ad26d9b20452e9aa534cb9352364c |
| institution | Directory Open Access Journal |
| issn | 1758-9193 |
| language | English |
| last_indexed | 2024-12-18T11:29:45Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Alzheimer’s Research & Therapy |
| spelling | doaj.art-b46ad26d9b20452e9aa534cb9352364c2022-12-21T21:09:37ZengBMCAlzheimer’s Research & Therapy1758-91932018-09-0110111310.1186/s13195-018-0419-2Clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and womenShraddha Sapkota0Joel Ramirez1Donald T. Stuss2Mario Masellis3Sandra E. Black4Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences CentreHurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences CentreHurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences CentreHurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences CentreHurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences CentreAbstract Background Interindividual differences in cognitive reserve (CR) are associated with complex and dynamic clinical phenotypes observed in cognitive impairment and dementia. We tested whether (1) CR early in life (E-CR; measured by education and IQ), (2) CR later in life (L-CR; measured by occupation), and (3) CR panel (CR-P) with the additive effects of E-CR and L-CR, act as moderating factors between baseline ventricular size and clinical dementia severity at baseline and across 2 years. We further examined whether this moderation is differentially represented by sex. Methods We examined a longitudinal model using patients (N = 723; mean age = 70.8 ± 9.4 years; age range = 38–90 years; females = 374) from the Sunnybrook Dementia Study. The patients represented Alzheimer’s disease (n = 439), mild cognitive impairment (n = 77), vascular cognitive impairment (n = 52), Lewy body disease (n = 30), and frontotemporal dementia (n = 125). Statistical analyses included (1) latent growth modeling to determine how clinical dementia severity changes over 2 years (measured by performance on the Dementia Rating Scale), (2) confirmatory factor analysis to establish a baseline E-CR factor, and (3) path analysis to predict dementia severity. Baseline age (continuous) and Apolipoprotein E status (ɛ4−/ɛ4+) were included as covariates. Results The association between higher baseline ventricular size and dementia severity was moderated by (1) E-CR and L-CR and (2) CR-P. This association was differentially represented in men and women. Specifically, men in only the low CR-P had higher baseline clinical dementia severity with larger baseline ventricular size. However, women in the low CR-P showed the (1) highest baseline dementia severity and (2) fastest 2-year decline with larger baseline ventricular size. Conclusions Clinical dementia severity associated with ventricular size may be (1) selectively moderated by complex and additive CR networks and (2) differentially represented by sex. Trials registration ClinicalTrials.gov, NCT01800214. Registered on 27 February 2013.http://link.springer.com/article/10.1186/s13195-018-0419-2Cognitive reserveVentricular sizeSexCognitive impairmentDementiaSunnybrook Dementia Study |
| spellingShingle | Shraddha Sapkota Joel Ramirez Donald T. Stuss Mario Masellis Sandra E. Black Clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and women Alzheimer’s Research & Therapy Cognitive reserve Ventricular size Sex Cognitive impairment Dementia Sunnybrook Dementia Study |
| title | Clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and women |
| title_full | Clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and women |
| title_fullStr | Clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and women |
| title_full_unstemmed | Clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and women |
| title_short | Clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and women |
| title_sort | clinical dementia severity associated with ventricular size is differentially moderated by cognitive reserve in men and women |
| topic | Cognitive reserve Ventricular size Sex Cognitive impairment Dementia Sunnybrook Dementia Study |
| url | http://link.springer.com/article/10.1186/s13195-018-0419-2 |
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