Quantifying longitudinal cognitive resilience to Alzheimer's disease and other neuropathologies
Francine Grodstein and Ana W. Capuano contributed equally to this work.
Correction added on 1st March 2022, after first online publication: Affiliation 1 has been added to the first author Maude Wagner.
Abstract
Introduction
Cognitive resilience (CR) has been defined as the continuum of better (or worse) than expected cognition, given the degree of neuropathology. To quantify this concept, existing approaches focus on either cognitive level at a single time point or slopes of cognitive decline.
Methods
In a prospective study of 1215 participants, we created a continuous measure of CR defined as the mean of differences between estimated person-specific and marginal cognitive levels over time, after accounting for neuropathologies.
Results
Neuroticism and depressive symptoms were associated with all CR measures (P-values < .012); as expected, cognitive activity and education were only associated with the cognitive-level approaches (P-values < .0002). However, compared with the existing CR measures focusing on a single measure or slopes of cognition, our new measure yielded stronger relations with risk factors.
Discussion
Defining CR based on the longitudinal differences between person-specific and marginal cognitive levels is a novel and complementary way to quantify CR.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
The R code to replicate the analyses is provided in the supplementary material. All data in these analyses (and descriptions of the studies and variables) can be requested through the Rush Alzheimer's Disease Center Research Resource Sharing Hub at www.radc.rush.edu.
