Imagine that your brain is like a valuable library, filled with years of knowledge and stories. Now, imagine that some books in this library are more vulnerable to damage and decay from a dangerous substance called Aβ deposition. Researchers have been investigating the impact of education years, or your cognitive reserve, on the progression of Alzheimer’s disease (AD). In this study, they explored how Aβ deposition and APOE ε4 carrier status can affect the relationship between education years and cortical volume in AD-vulnerable brain regions among cognitively normal older adults. The results showed that certain brain regions had different associations with education years depending on the presence of Aβ deposition and APOE ε4 carrier status. Additionally, the link between cortical volume and cognitive function was primarily observed in individuals without AD risk factors. These findings shed light on the intricate factors influencing the progression of AD, allowing us to better understand how our cognitive reserves come into play during the early stages of the disease. So dive into the research to uncover more about the fascinating world of Alzheimer’s disease!

BackgroundEducation years, as a measure of cognitive reserve, have been shown to affect the progression of Alzheimer’s disease (AD), both pathologically and clinically. However, inconsistent results have been reported regarding the association between years of education and intermediate structural changes in AD-vulnerable brain regions, particularly when AD risk factors were not considered during the preclinical phase.ObjectiveThis study aimed to examine how Aβ deposition and APOE ε4 carrier status moderate the relationship between years of education and cortical volume in AD-vulnerable regions among cognitively normal older adults.MethodsA total of 121 participants underwent structural MRI, [18F] flutemetamol PET-CT imaging, and neuropsychological battery assessment. Multiple regression analysis was conducted to examine the interaction between years of education and the effects of potential modifiers on cortical volume. The associations between cortical volume and neuropsychological performance were further explored in subgroups categorized based on AD risk factors.ResultsThe cortical volume of the left lateral occipital cortex and bilateral fusiform gyrus demonstrated a significant differential association with years of education, depending on the presence of Aβ deposition and APOE ε4 carrier status. Furthermore, a significant relationship between the cortical volume of the bilateral fusiform gyrus and AD-nonspecific cognitive function was predominantly observed in individuals without AD risk factors.ConclusionAD risk factors exerted varying influences on the association between years of education and cortical volume during the preclinical phase. Further investigations into the long-term implications of these findings would enhance our understanding of cognitive reserves in the preclinical stages of AD.

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