Abstract
Cognitive reserve is the ability to optimize performance through differential recruitment of brain networks, which may reflect the use of alternative cognitive strategies. Objectives: To identify factors related to cognitive reserve associated with progression from mild cognitive impairment (MCI) to degenerative dementia. Methods: A cohort of 239 subjects with MCI (age: 72.2±8.1 years, 58% women, education: 12 years) was assessed and followed for five years (2001 to 2006). Results: In the first year, 13.7% of MCI converted to dementia and 34.7% converted within three years (78.3% converted to Alzheimer's dementia). Risk factors for those who converted were education less than 12 years, MMSE score less than 27, Boston naming test score less than 51, IQ (Intelligence Quotient) less than 111, age over 75 years, lack of occupation at retirement, and presence of intrusions in memory recall (all account for 56% of the variability of conversion). Conclusions: MCI patients are a population at high risk for dementia. The study of risk factors (e.g. IQ, education and occupation), particularly those related to cognitive reserve, can contribute important evidence to guide the decision-making process in routine clinical activity and public health policy.
Key words:
mild cognitive impairment; risk factors; dementia; cognitive reserve
Resumo
Reserva cognitiva é a habilidade em otimizar o desempenho através do recrutamento de redes neurais, que talvez reflitam o uso de estratégias cognitivas alternativas. Objetivos: Identificar fatores relacionados à reserva cognitiva associados à progressão do comprometimento cognitivo leve (CCL) para demência degenerativa. Métodos: Uma coorte de 239 indivíduos com CCL (idade: 72.2±8.1 anos, 58% mulheres, educação: 12 anos) foram avaliados e seguidos por cinco anos (2001-2006). Resultados: No primeiro ano 13.7% dos CCL converteram para demência e 34.7% em três anos (78.3% converteram para doença de Alzheimer). Os fatores de risco para aqueles que converteram foram: educação menor do que 12 anos, MMSE menor do que 27, teste de Nomeação de Boston menor do que 51, QI (Quociente de Inteligência) menor do que 111, idade superior a 75 anos, falta de ocupação na aposentadoria, e presença de intrusões na memória de evocação (todos contando para 56% da variabilidade de conversão). Conclusões: Pacientes com CCL são uma população de risco para demência. O estudo dos fatores de risco (como QI, educação e ocupação), principalmente, aqueles relacionados à reserva cognitiva podem contribuir para uma evidência importante para o processo de decisões na atividade clínica e na saúde pública.
Palavras-chave:
comprometimento cognitivo leve; fatores de risco; demência; reserva cognitiva
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Publication Dates
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Publication in this collection
Jan-Mar 2010
History
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Received
29 Sept 2009 -
Accepted
03 Feb 2010