Cognitive reserve and rate of change in Alzheimer's and cerebrovascular disease biomarkers among cognitively normal individuals

Corinne Pettigrew, Anja Soldan, Yuxin Zhu, Qing Cai, Mei Cheng Wang, Abhay Moghekar, Michael I. Miller, Baljeet Singh, Oliver Martinez, Evan Fletcher, Charles DeCarli, Marilyn Albert

Research output: Contribution to journalArticle


We examined whether cognitive reserve (CR) impacts level of, or rate of change in, biomarkers of Alzheimer's disease (AD) and small-vessel cerebrovascular disease in >250 individuals who were cognitively normal and middle-aged and older at the baseline. The four primary biomarker categories commonly examined in studies of AD were measured longitudinally: cerebrospinal fluid measures of amyloid (A) and tau (T); cerebrospinal fluid and neuroimaging measures of neuronal injury (N); and neuroimaging measures of white matter hyperintensities (WMHs) to assess cerebrovascular pathology (V). CR was indexed by a composite score including years of education, reading, and vocabulary test performance. Higher CR was associated with lower levels of WMHs, particularly among those who subsequently progressed from normal cognition to MCI. CR was not associated with WMH trajectories. In addition, CR was not associated with either levels of, or rate of change in, A/T/N biomarkers. This may suggest that higher CR is associated with lifestyle factors that reduce levels of cerebrovascular disease, allowing individuals with higher CR to better tolerate other types of pathology.

Original languageEnglish (US)
JournalNeurobiology of Aging
StateAccepted/In press - Jan 1 2020



  • Alzheimer's disease
  • Amyloid
  • Biomarkers
  • Cerebrovascular disease
  • Cognitive reserve
  • Tau

ASJC Scopus subject areas

  • Neuroscience(all)
  • Aging
  • Clinical Neurology
  • Developmental Biology
  • Geriatrics and Gerontology

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