TY -的T1 -编者注:反省认知与认知和大脑健康协会没有老年人JF -神经学乔-神经病学SP - 261 LP - 261 - 10.1212 / WNL。首页0000000000206812六世- 100 - 5盟Aravind Ganesh AU -史蒂文Galetta Y1 - 2023/01/31 UR - //www.ez-admanager.com/c首页ontent/100/5/261.1.abstract N2 - Demnitz-King博士等人研究了自我反省和标记之间的联系对阿尔茨海默病125年老年人主观认知能力下降并与134老年人认知没有成熟的临床试验。他们发现自我反省与更好的全球认知和更高的葡萄糖代谢在氟脱氧葡萄糖正电子发射断层扫描,较弱的证据表明,其他健康和生活方式的观察协会是独立的行为。他们得出的结论是,纵向实验研究需要澄清是否反省可以帮助保护认知和脑葡萄糖代谢与较低的自省能力是否认知能力下降的先兆和葡萄糖代谢减退。作为回应,戴利博士指出,这项研究忽视了大脑健康的社会决定因素和行为包括那些与自我反省和认为,研究这些因素可能是痴呆研究优先级高于介入研究。应对这些评论,作者指出,他们发现了一个高等教育(一个重要的社会决定因素)与更好的自我反省,但自我反省和研究结果之间的关系仍在调整了教育。他们也报告额外分析检查反省和孤独之间的关系以及主要职业。他们发现,孤独与反省,但将孤独作为一个额外的协变量的模型并没有改变协会自我反省认知和葡萄糖代谢。作者反驳说,这些发现表明,在目标效用反省,但认为可能有承诺在处理这些个人风险或保护性因素的大背景里大脑健康的社会决定因素。这交易凸显了挑战的因果推断保护性行为研究的认知能力下降或痴呆症引起的标记,和设定优先事项所涉及的复杂性痴呆预防研究基于这种data.Dr。 Demnitz-King et al. examined the association between self-reflection and markers sensitive to Alzheimer disease in 125 older adults with subjective cognitive decline and compared them with 134 cognitively unimpaired older adults in the Age-Well clinical trial. They found that self-reflection was associated with better global cognition and higher glucose metabolism in fluorodeoxyglucose positron emission tomography scans, with weak evidence that the observed associations were independent of other health and lifestyle behaviors. They concluded that longitudinal and experimental studies are needed to clarify whether self-reflection can actually help preserve cognition and cerebral glucose metabolism vs whether a lower capacity to self-reflect is a harbinger of cognitive decline and glucose hypometabolism. In response, Dr. Daly notes that the study overlooked social determinants of brain health and behaviors including those associated with self-reflection and argues that studying such determinants is potentially a higher priority for dementia research than interventional studies. Responding to these comments, the authors note that they found a higher education (an important social determinant) was associated with better self-reflection, but that the associations between self-reflection and the study outcomes remained after adjusting for education. They also report additional analyses examining the relationship between self-reflection and loneliness as well as primary occupation. They found that loneliness was associated with self-reflection, but incorporating loneliness as an additional covariate in their models did not change the associations of self-reflection with cognition and glucose metabolism. The authors counter that these findings suggest that there is utility in targeting self-reflection but agree that there may be promise in addressing such individual risk or protective factors within the broader context of social determinants of brain health. This exchange underscores the challenges of making causal inferences about protective behaviors from studies of cognitive decline or dementia-related markers, and the complexities involved in setting priorities for dementia prevention research based on such data. ER -