Academic Commons


Cognitive Reserve Associated with FDG-PET in Preclinical Alzheimer Disease

Ewers, Michael; Insel, Philip S.; Stern, Yaakov; Weiner, Michael W.

OBJECTIVE: To examine the effect of education (a surrogate measure of cognitive reserve) on FDG-PET brain metabolism in elderly cognitively healthy (HC) subjects with preclinical Alzheimer disease (AD). METHODS: Fifty-two HC subjects (mean age 75 years) with FDG-PET and CSF measurement of Abeta1-42 were included from the prospective Alzheimer's Disease Neuroimaging Initiative biomarker study. HC subjects received a research classification of preclinical AD if CSF Abeta1-42 was <192 pg/mL (Abeta1-42 [+]) vs HC with normal Abeta (Abeta1-42 [-]). In regression analyses, we tested the interaction effect between education and CSF Abeta1-42 status (Abeta1-42 [+] vs Abeta1-42 [-]) on FDG-PET metabolism in regions of interest (ROIs) (posterior cingulate, angular gyrus, inferior/middle temporal gyrus) and the whole brain (voxel-based). RESULTS: An interaction between education and CSF Abeta1-42 status was observed for FDG-PET in the posterior cingulate (p < 0.001) and angular gyrus ROIs (p = 0.03), but was not significant for the inferior/middle temporal gyrus ROI (p = 0.06), controlled for age, sex, and global cognitive ability (Alzheimer's Disease Assessment Scale-cognitive subscale). The interaction effect was such that higher education was associated with lower FDG-PET in the Abeta1-42 (+) group, but with higher FDG-PET in the Abeta1-42 (-) group. Voxel-based analysis showed that this interaction effect was primarily restricted to temporo-parietal and ventral prefrontal brain areas. CONCLUSIONS: Higher education was associated with lower FDG-PET in preclinical AD (Abeta1-42 [+]), suggesting that cognitive reserve had a compensatory function to sustain cognitive ability in presence of early AD pathology that alters FDG-PET metabolism.


  • thumnail for Ewers-2013-Cognitive reserve associated with F.pdf Ewers-2013-Cognitive reserve associated with F.pdf application/pdf 755 KB Download File

More Information

Published In
Publisher DOI
1194 - 1201
Academic Units
Academic Commons provides global access to research and scholarship produced at Columbia University, Barnard College, Teachers College, Union Theological Seminary and Jewish Theological Seminary. Academic Commons is managed by the Columbia University Libraries.