Abstract
Introduction: Cognitive reserve predicts delayed diagnosis of Alzheimer's disease (AD) and faster postdiagnosis decline. The net impact of cognitive reserve, combining both prediagnosis and postdiagnosis risk, on adverse AD-related outcomes is unknown. We adopted a novel approach, using AD genetic risk scores (AD-GRS), to evaluate this. Methods: Using 242,959 UK Biobank participants age 56+ years, we evaluated whether cognitive reserve (operationalized as education) modified associations between AD-GRS and mortality or hospitalization (total count, fall-related, and urinary tract infection–related). Results: AD-GRS predicted mortality and hospitalization outcomes. Education did not modify AD-GRS effects on mortality, but had a nonsignificantly (interaction P =.10) worse effect on hospitalizations due to urinary tract infection or falls among low education (OR = 1.07 [95% CI: 1.02, 1.12]) than high education (OR = 1.01 [0.95, 1.07]) individuals. Discussion: Education did not convey differential survival advantages to individuals with higher genetic risk of AD, but may reduce hospitalization risk associated with AD genetic risk.
| Original language | English |
|---|---|
| Pages (from-to) | 907-916 |
| Number of pages | 10 |
| Journal | Alzheimer's and Dementia |
| Volume | 15 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2019 |
| Externally published | Yes |
Keywords
- Alzheimer's disease
- Cognitive aging
- Cognitive reserve
- Education
- Falls
- Genetic risk
- Genetic risk score
- Hospitalization
- Mortality
- UTIs