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Effect of intellectual enrichment on AD biomarker trajectories: Longitudinal imaging study
Vemuri P, Lesnick TG, Przybelski SA, Knopman DS, Machulda M, Lowe VJ, Mielke MM, Roberts RO et al.. Neurology, 2016-02-24
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
Objective To investigate the effect of age, sex, APOE4 genotype, and lifestyle enrichment (education/occupation, midlife cognitive activity, and midlife physical activity) on Alzheimer disease (AD) biomarker trajectories using longitudinal imaging data (brain β-amyloid load via Pittsburgh compound B PET and neurodegeneration via (18)fluorodeoxyglucose (FDG) PET and structural MRI) in an elderly population without dementia. Methods In the population-based longitudinal Mayo Clinic Study of Aging, we studied 393 participants without dementia (340 clinically normal, 53 mild cognitive impairment; 70 years and older) who had cognitive and physical activity measures and at least 2 visits with imaging biomarkers. We dichotomized participants into high (≥14 years) and low ( Results Age was associated with amyloid and neurodegeneration trajectories; APOE4 status appears to influence only the amyloid and FDG trajectories but not hippocampal volume trajectory. In the high-education stratum, high midlife cognitive activity was associated with lower amyloid deposition in APOE4 carriers. APOE4 status was associated with lower FDG uptake in the entire cohort and in participants with lower education but not the high-education cohort. Conclusions There were minimal effects of lifestyle enrichment on AD biomarker trajectories (specifically rates). Lifetime intellectual enrichment (high education, high midlife cognitive activity) is associated with lower amyloid in APOE4 carriers. High education is protective from the APOE4 effect on FDG metabolism. Differing education levels may explain the conflicting results seen in the literature.
What this study adds
Evidence grade: Moderate
This is a follow-up (cohort) study of 393 participants. In this longitudinal imaging study, lifestyle enrichment had minimal effects on the rates of Alzheimer's disease biomarker changes. High midlife cognitive activity was linked to lower amyloid deposition only in APOE4 carriers with high education, so it does not show that enrichment prevents or treats Alzheimer's disease.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Vemuri, P., Lesnick, T. G., Przybelski, S. A., Knopman, D. S., Machulda, M., Lowe, V. J., et al. (2016). Effect of intellectual enrichment on AD biomarker trajectories: Longitudinal imaging study. Neurology. https://doi.org/10.1212/wnl.0000000000002490
Vancouver
Vemuri P, Lesnick TG, Przybelski SA, Knopman DS, Machulda M, Lowe VJ, et al. Effect of intellectual enrichment on AD biomarker trajectories: Longitudinal imaging study. Neurology. 2016. doi:10.1212/wnl.0000000000002490. PMID: 26911640.
BibTeX
@article{vemuri2016-26911640,
author = {Vemuri, P. and Lesnick, T. G. and Przybelski, S. A. and Knopman, D. S. and Machulda, M. and Lowe, V. J. and Mielke, M. M. and Roberts, R. O. and others},
title = {{Effect of intellectual enrichment on AD biomarker trajectories: Longitudinal imaging study}},
journal = {Neurology},
year = {2016},
doi = {10.1212/wnl.0000000000002490},
pmid = {26911640},
url = {https://doi.org/10.1212/wnl.0000000000002490}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- We dichotomized participants into high (≥14 years) and low ( Results Age was associated with amyloid and neurodegeneration trajectories; APOE4 status appears to influence only the amyloid and FDG trajectories but not hippocampal volume trajectory.
- In the high-education stratum, high midlife cognitive activity was associated with lower amyloid deposition in APOE4 carriers.
- APOE4 status was associated with lower FDG uptake in the entire cohort and in participants with lower education but not the high-education cohort.
- Lifetime intellectual enrichment (high education, high midlife cognitive activity) is associated with lower amyloid in APOE4 carriers.
- Differing education levels may explain the conflicting results seen in the literature.
Why it matters
In this longitudinal imaging study, lifestyle enrichment had minimal effects on the rates of Alzheimer's disease biomarker changes. High midlife cognitive activity was linked to lower amyloid deposition only in APOE4 carriers with high education, so it does not show that enrichment prevents or treats Alzheimer's disease.
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Study details
- Study designlongitudinal study
- Participants393
- Evidence strengthModerate
How this study scored 62/100
Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2016 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 393 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 82 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.8 citations a year over 12 year(s) since 2016 |
| Impact for its field and year | 4 / 6 | Cited 10.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Clifford R. Jack: h-index 203 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Mayo Clinic: institution h-index 1,606 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 26911640) |
| Free to read | 2 / 2 | Free to read |
| Total | 62 / 100 | — |
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