• Open Access

Cognition, reserve, and amyloid deposition in normal aging

Authors

  • Dorene M. Rentz PsyD,

    1. Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
    2. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Joseph J. Locascio PhD,

    1. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    2. Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA
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  • John A. Becker PhD,

    1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Erin K. Moran BA,

    1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Elisha Eng BA,

    1. Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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  • Randy L. Buckner PhD,

    1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    2. Department of Psychology and Center for Brain Science, Harvard University, Cambridge, MA
    3. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    4. Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA
    5. Howard Hughes Medical Institute, Cambridge, MA
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  • Reisa A. Sperling MD,

    1. Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
    2. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Keith A. Johnson MD

    Corresponding author
    1. Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
    2. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    3. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    • Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, White 427, 33 Fruit Street, Boston, MA 02114
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Abstract

Objective

To determine whether amyloid deposition is associated with impaired neuropsychological (NP) performance and whether cognitive reserve (CR) modifies this association.

Methods

In 66 normal elderly controls and 17 patients with Alzheimer disease (AD), we related brain retention of Pittsburgh Compound B (PiB) to NP performance and evaluated the impact of CR using education and American National Adult Reading Test intelligence quotient as proposed proxies.

Results

We found in the combined sample of subjects that PiB retention in the precuneus was inversely related to NP performance, especially in tests of memory function, but also in tests of working memory, semantic processing, language, and visuospatial perception. CR significantly modified the relationship, such that at progressively higher levels of CR, increased amyloid deposition was less or not at all associated with poorer neuropsychological performance. In a subsample of normal controls, both the main effect of amyloid deposition of worse memory performance and the interaction with CR were replicated using a particularly challenging memory test.

Interpretation

Amyloid deposition is associated with lower cognitive performance both in AD patients and in the normal elderly, but the association is modified by CR, suggesting that CR may be protective against amyloid-related cognitive impairment. ANN NEUROL 2010;67:353–364

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