Relationship of cognitive reserve and cerebrospinal fluid biomarkers to the emergence of clinical symptoms in preclinical Alzheimer's disease.


Journal Article

The levels of β-amyloid (Aβ) and phosphorylated tau (p-tau), as measured in cerebrospinal fluid, have been associated with the risk of progressing from normal cognition to onset of clinical symptoms during preclinical Alzheimer's disease. We examined whether cognitive reserve (CR) modifies this association. Cerebrospinal fluid was obtained at baseline from 239 participants (mean age, 57.2 years) who had been followed for up to 17 years with clinical and cognitive assessments (mean follow-up, 8 years). A composite score based on the National Adult Reading Test, vocabulary, and years of education at baseline was used as an index of CR. Cox regression models showed that the increased risk of progressing from normal cognition to symptom onset was associated with lower CR, lower baseline Aβ, and higher baseline p-tau. There was no interaction between CR and Aβ, suggesting that the protective effects of higher CR are equivalent across the observed range of amyloid levels. In contrast, both tau and p-tau interacted with CR, indicating that CR was more protective at lower levels of tau and p-tau.

Full Text

Duke Authors

Cited Authors

  • Soldan, A; Pettigrew, C; Li, S; Wang, M-C; Moghekar, A; Selnes, OA; Albert, M; O'Brien, R; BIOCARD Research Team,

Published Date

  • December 2013

Published In

Volume / Issue

  • 34 / 12

Start / End Page

  • 2827 - 2834

PubMed ID

  • 23916061

Pubmed Central ID

  • 23916061

Electronic International Standard Serial Number (EISSN)

  • 1558-1497

Digital Object Identifier (DOI)

  • 10.1016/j.neurobiolaging.2013.06.017


  • eng

Conference Location

  • United States