Cognitive reserve as one of the determinants of the progression of Alzheimer disease.

Fiche publication

Date publication

janvier 2022

Journal

Geriatrie et psychologie neuropsychiatrie du vieillissement

Auteurs

Membres identifiés du Cancéropôle Est :
Pr SAULEAU Erik-André

Tous les auteurs :
Albrecht P, Perisse J, Sauleau EA, Blanc F

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/35031531

Résumé

To assess the validity of Yaakov Stern's theory, which postulates that the first cognitive deficits of Alzheimer disease are delayed in patients with high cognitive reserve, compared to those with low cognitive reserve, but this is subsequently associated with faster cognitive decline when cerebral lesions have reached a certain degree of severity. A retrospective study of 318 patients with Alzheimer disease without associated cerebral disorders, was performed at the Memory Clinic of the University Hospital of Strasbourg. The patients were divided into five groups according to their degree of cognitive reserve, as assessed by their level of education (primary, middle school, intermediate, high school and higher education). Cognitive status was assessed by scores on the Mini Mental Status Examination (MMSE) at the first examination and during follow-up lasting four years or longer. Slopes of cognitive decline were computed and compared between groups using ß linear regression. Patients in the higher education group had higher MMSE scores than those in the other groups at the first consultation, but a statistically significant steeper slope during the follow-up. Our results are consistent with Stern's theoretical model, which assumes that high cognitive reserve is accompanied by compensation mechanisms which hinder the onset of clinical cognitive decline in patients with Alzheimer disease, but that is then associated with a faster decline at a later stage when the reserve is exhausted.