Genetic and environmental protective factors and risks modulate brain structure and function in neurodegenerative diseases and their preclinical stages. We wanted to investigate whether the years of formal education, a proxy measure for cognitive reserve, would influence hippocampal structure in Alzheimer’s disease patients, and whether apolipoprotein Eε4 (APOE4) carrier status and a first-degree family history of the disease would change a possible association. Fifty-eight Alzheimer’s disease patients underwent 3T magnetic resonance imaging. We applied a cortical unfolding approach to investigate individual subregions of the medial temporal lobe. Among patients homozygous for the APOE4 genotype or carrying both APOE4 and family history risks, lower education was associated with a thinner cortex in multiple medial temporal regions, including the hippocampus. Our data suggest that the years of formal education and genetic risks interact in their influence on hippocampal structure in Alzheimer’s disease patients.

Genetic and environmental protective factors and risks modulate brain structure and function in neurodegenerative diseases and their preclinical stages. We wanted to investigate whether the years of formal education, a proxy measure for cognitive reserve, would influence hippocampal structure in Alzheimer’s disease patients, and whether apolipoprotein Eε4 (APOE4) carrier status and a first-degree family history of the disease would change a possible association. Fifty-eight Alzheimer’s disease patients underwent 3T magnetic resonance imaging. We applied a cortical unfolding approach to investigate individual subregions of the medial temporal lobe. Among patients homozygous for the APOE4 genotype or carrying both APOE4 and family history risks, lower education was associated with a thinner cortex in multiple medial temporal regions, including the hippocampus. Our data suggest that the years of formal education and genetic risks interact in their influence on hippocampal structure in Alzheimer’s disease patients.

Objective: Cognitive reserve influences age of onset, speed of progression, and clinical manifestations of Alzheimer’s disease. We investigated whether cognitive reserve interacts with clinical and neuropsychological parameters in mild cognitive impairment (MCI). Methods: In this cross-sectional study, we recruited 273 people (70.6 ± 10.1 years, 54.6% women) suffering from subjective memory complaints (n = 65), MCI (n = 121), or dementia (n = 87). Patients underwent neuropsychological evaluation, laboratory testing, and brain imaging. Additionally, we obtained information on years of education and help-seeking motivation. Results: MCI patients with a university degree were significantly older than those without (71.6 ± 9.6 vs. 66.9 ± 10.3, p = 0.02). University-educated MCI patients demonstrated superior performance in verbal fluency. Intrinsic help-seeking motivation (self-referral) was associated with higher cognitive reserve. Female MCI patients presented with greater intrinsic motivation. Conclusion: Cognitive reserve modulates clinical and neuropsychological measures in patients with MCI.

Bei altersbedingt abnehmender kognitiver Funktion stellt das steigende Renteneintrittsalter Arbeitgeber und -nehmer vor wachsende Herausforderungen. Der Aufbau der kognitiven Reserve (CR) durch geistig stimulierende Aktivitäten verspricht eine Resilienz gegenüber neuropathologisch bedingten kognitiven Defiziten. In der vorliegenden Arbeit wird die Rolle der CR in Bezug auf die kognitive Leistungsfähigkeit und die neuronale Informationsverarbeitung gesunder Erwachsener im Berufsalter untersucht. Unter Ableitung des Elektroenzephalogramms bearbeiteten Probanden mittleren und hohen Erwerbsalters (34-45 J. und 46-62 J.) im 2-Jahres-Abstand Aufgaben zu drei Domänen exekutiver Funktionen: Arbeitsgedächtnis (AG), kognitive Flexibilität und Inhibitionskontrolle. Hoch-CR-Probanden wiesen aufgabenübergreifend schnellere Reaktionen und geringere Fehlerraten auf. Reduzierte Leistung ließ sich in der Gering-CR-Gruppe tendenziell bei älteren Probanden und in anspruchsvollen Aufgabenbedingungen beobachten. Nach 2 Jahren zeigten Gering-CR-Ältere eine numerisch abnehmende AG-Kapazität, während Hoch-CR-Ältere ihre hohe Leistung steigern konnten. Die P3-Amplitude variierte in Abhängigkeit von der CR und dem Alter. Hoch-CR-Jüngere wiesen im Vergleich zu Gering-CR-Jüngeren höhere P3-Amplituden auf, während Hoch-CR-Ältere im Gegensatz zu Gering-CR-Älteren kleinere P3-Amplituden generierten. Zudem legten kürzere P3-Latenzen in der Hoch-CR-Gruppe eine schnellere neuronale Verarbeitungsgeschwindigkeit nahe. In der Aufgabe zur kognitiven Flexibilität ließ sich bei Gering-CR-Probanden ein Anterior-Shift der P3 beobachten. Die Untersuchungsergebnisse konnten nach 2 Jahren repliziert werden. Alterungsrelevante Leistungsvariablen und neuronale Informationsverarbeitungsprozesse zeigten sich bereits im Berufsalter sensitiv gegenüber der CR. Das mittlere Erwachsenenalter sollte bei der Erarbeitung und Evaluation CR-basierter Maßnahmen zur Prävention kognitiver Defizite stärker berücksichtigt werden. / The increasing retirement date accompanied by an age-associated decline of cognitive functions poses growing challenges to employers and employees. The cognitive reserve (CR) promises a resilience to brain damage-associated cognitive deficits through intellectually stimulating lifestyle activities. The present study examines the role of CR relating to cognitive performance and neuronal information processing of healthy adults in working age. Using an electroencephalogram, subjects of middle and high working age (34-45 years and 46-62 years of age, respectively) completed tasks on three domains of executive functions: working memory, cognitive flexibility and inhibition control. Follow-up assessments were conducted after two years. High-CR subjects performed better across tasks than Low-CR subjects, with faster reaction times and lower error rates. Reduced performance in the Low-CR group tended to be more common among older participants and during the more challenging task conditions. In addition, after two years, Low-CR older workers showed a decreased working memory capacity while older High-CR individuals improved their higher performance. The P3 amplitude of the event-related brain potential varied systematically as a function of CR and age. High-CR younger individuals revealed higher P3 amplitudes compared to Low-CR younger individuals, while High-CR older individuals generated smaller P3 amplitudes than Low-CR older individuals. The shorter P3 peak-latencies of the High-CR group suggested moreover a difference in neural processing speed. When testing cognitive flexibility an anterior shift of the P3 was observed in older Low-CR subjects. The results were almost completely replicated after two years. Age-related performance variables and neuronal information processes revealed to be sensitive to CR already at working age. These findings recommend more research on early adulthood in the development and evaluation of CR-based programs to prevent cognitive deficits.