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The contribution of education and intelligence to resilience against age-related cognitive decline is not clear, particularly in the presence of 'normal for age' minor brain abnormalities.Participants (n = 208, mean age 69.2 years, s.d. = 5.4) in the Whitehall II imaging substudy attended for neuropsychological testing and multisequence 3T brain magnetic resonance imaging. Images were independently rated by three trained clinicians for global and hippocampal atrophy, periventricular and deep white matter changes.Although none of the participants qualified for a clinical diagnosis of dementia, a screen for cognitive impairment (Montreal Cognitive Assessment (MoCA) <26) was abnormal in 22%. Hippocampal atrophy, in contrast to other brain measures, was associated with a reduced MoCA score even after controlling for age, gender, socioeconomic status, years of education and premorbid IQ. Premorbid IQ and socioeconomic status were associated with resilience in the presence of hippocampal atrophy.Independent contributions from a priori risk (age, hippocampal atrophy) and resilience (premorbid function, socioeconomic status) combine to predict measured cognitive impairment.

Original publication

DOI

10.1192/bjp.bp.114.152363

Type

Journal article

Journal

The British journal of psychiatry : the journal of mental science

Publication Date

11/2015

Volume

207

Pages

435 - 439

Addresses

Anya Topiwala, BMBCh, Charlotte L. Allan, MBChB, Vyara Valkanova, MD, Enikő Zsoldos, MSc, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Nicola Filippini, DPhil, Claire E. Sexton, DPhil, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK and Oxford Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Abda Mahmood, MSc, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Archana Singh-Manoux, PhD, Department of Epidemiology and Public Health, UCL, London, UK and INSERM, U1018, Centre for Research in Epidemiology and Population Health, France; Clare E. Mackay, PhD, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Mika Kivimäki, PhD, Department of Epidemiology and Public Health, UCL, London, UK; Klaus P. Ebmeier, MD, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.

Keywords

Hippocampus, Humans, Atrophy, Magnetic Resonance Imaging, Logistic Models, Cohort Studies, Cognition Disorders, Neuropsychological Tests, Aged, Middle Aged, London, Female, Male, Resilience, Psychological