語言技能可以預測晚年的失智風險


  July 13, 2009 — 研究者報告,有語言技能優勢者,即便他們有疾病徵兆,也比較不會在晚年發生阿茲海默氏症。這項研究線上發表於7月8日的神經學期刊。
  
  資深作者、約翰霍普金斯大學的Juan Troncoso醫師在新聞稿中表示,阿茲海默氏症的謎題之一,就是對每個人的影響不同。他指出,一個有神經乙型澱粉樣斑塊和神經纖維糾結的人,會有阿茲海默氏症的完整特徵,但同樣有這些問題的另一個人,卻可能沒有影響記憶的症狀。
  
  【修女研究】
  研究者在38名天主教修女死後研究她們的腦部,這些對象屬於「修女研究」這項進行中的聖母學校修女會臨床試驗研究的部份研究對象,來自美國東、中西、南部區域的修會。
  
  Troncoso醫師及其研究團隊探討三個組別:有記憶問題且有斑塊和糾結的婦女,記憶正常的婦女、有或沒有阿茲海默氏症徵兆。
  
  研究者分析14名研究對象在10幾歲或20出頭進入修道院時所寫的論文,他們研究每10個字可以表達的平均觀念數,這項分析也測量每篇論文的文法複雜度。
  
  【語言分數高出20%】
  研究發現,沒有記憶問題的婦女,語言分數高出20%。不過,兩組之間的文法分數沒有差異。
  
  Troncoso醫師表示,儘管這部份研究的研究對象少,該項研究發現有其值得注意之處。我們的結果顯示,20出頭歲時的智力測驗可以預測五、六十年後是否仍有正常認知的可能性,即使有大量的阿茲海默氏症病理出現。
  
  研究者也測量何種細胞生長與腦中對阿茲海默氏症的早期反應有關,或許可以有助於大量斑塊和糾結存在時的記憶缺損預防。
  
  他們發現,相較於無斑塊、糾結者與有記憶問題者,有阿茲海默氏症徵兆者,其腦細胞大小顯著增加,但是沒有認知缺損。
  
  Troncoso醫師表示,或許20歲時的心智能力,可以用來預測晚年時腦部對疾病的處理能力是否較佳。
  
  約翰霍普金斯大學阿茲海默氏症研究中心、國家健康研究中心、修女研究、國家老化研究中心、肯塔基大學阿茲海默氏症中心、Abercrombie基金會與Kleberg基因會資助本研究。研究作者宣告沒有相關財務關系。
  
  Neurology. 線上發表於2009年7月9日。
  

Language Skills May Predict Dementia Risk Later in Life

By Allison Gandey
Medscape Medical News

July 13, 2009 — People who have strong language skills may be less likely to develop Alzheimer's disease decades later even if they have signs of disease, report researchers. Their study is published online July 8 in Neurology.

"A puzzling feature of Alzheimer's disease is how it affects people differently," senior author Juan Troncoso, MD, from Johns Hopkins University, in Baltimore, Maryland, said in a news release. One person with neuritic amyloid plaques and neurofibrillary tangles could end up with a full-blown case of Alzheimer's disease, but another person with those same problems might show no symptoms affecting memory, he noted.

Nun Study

Investigators studied the brains of 38 Catholic nuns after death. Participants were part of the Nun Study, an ongoing clinical trial of the School Sisters of Notre Dame congregation living throughout the Eastern, Midwestern, and Southern regions of the United States.

Dr. Troncoso and his team identified 3 groups — women with memory problems and plaques and tangles and women with normal memory, with or without signs of Alzheimer's disease.

The researchers analyzed essays that 14 participants wrote when they entered the convent in their late teens or early 20s. They studied the average number of ideas expressed for every 10 words. The analysis also measured how complex the grammar was in each essay.

Language Scores 20% Higher

Investigators found that language scores were 20% higher in the women without memory problems. The grammar score, however, did not suggest any difference between groups.

"Despite the small number of participants in this portion of the study, the finding is a fascinating one," Dr. Troncoso said. "Our results show that an intellectual ability test in the early 20s may predict the likelihood of remaining cognitively normal 5 or 6 decades later, even in the presence of a large amount of Alzheimer's disease pathology."

The researchers also measured how cell growth might be part of the brain's early response to Alzheimer's disease and may prevent memory impairment despite the presence of a large amount of plaques and tangles.

They found significant increases in the size of brain cells of those with signs of Alzheimer's disease but no cognitive impairment compared with both those without plaques and tangles and those with memory problems.

Dr. Troncoso said, "Perhaps mental abilities at age 20 are indicative of a brain that will be better able to cope with diseases later in life."

This study was funded by the Johns Hopkins University Alzheimer's Disease Research Center, the National Institutes of Health, the Nun Study, the National Institute on Aging, the University of Kentucky Alzheimer's Disease Center, the Abercrombie Foundation, and the Kleberg Foundation. The researchers have disclosed no relevant financial relationships.

Neurology. Published online July 9, 2009.

    
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