(27)教育和认知症风险-Education?and Dementia Risk-公开课-关爱惟士
(27)教育和认知症风险-Education?and Dementia Risk

课程视频:http://player.youku.com/embed/XMjY3ODM4MzMzNg




Prof. Carol Brayne

Carol Brayne教授


What are the detailed effects of education? I think that is a very challenging question, because it could be argued that a poor education or low access to education, is itself a risk factor, and that maybe high education is separately a protective factor, and an average education is maybe the neutral state. I would argue that we probably don’t really know the answer to that question. There is the opportunity across the world to examine it because there are many populations in which access to education is very limited. And, of course, we’re talking about findings from a country in which education has been the norm for a long time. So we’re looking at variations in education, rather than no access, or absolutely minimal access. So I think we’ll understand a lot more about education in the years to come.

教育的具体影响是什么?我认为这是一个非常具有挑战性的问题,因为可以争论教育水平低或教育机会太少本身是否就是一个患认知症的风险因素,也许高等教育是一个保护因素,普通教育可能是中立状态。我认为我们可能并不真的知道这个问题的答案。我们会有机会检查它,因为在世界上很多人能获得的教育是非常有限的。当然,我们正在谈论一个国家的相关发现,在这个国家,教育已经成为长期的规范。因此,我们正在研究教育的变化,而不是没有接受教育的途径,或绝对最小的接触。所以我想我们将更多地了解教育在未来几年的情况。


So the EClipSE Study is a grouping of three population based studies of dementia. One is of the 65 plus population; one is of the 75 plus population and one is of the 85 plus population and there are two in the UK and one in Finland. These studies have all studied dementia in the population. But what makes them stand out, is that they’ve also had a brain donation program associated with them. So in that research, we have gone out and asked people whether they were willing to consider donating their brains to medical research after they died, and their families as well, so we talk with their families. Between them those studies have collected a thousand donations. The reason why we brought them together was because, individually, each study is not powerful enough to look at the relationship between what you see in the brain and what you’ve measured during life, taking into account the various different factors. So we wanted to have the ability to look at what might be protective factors and compensatory factors in people’s lives that influence how they might or might not have had dementia.

因此,EClipSE研究是一个基于认知症研究的三组人群的组合。一组是65岁以上的人群,一组是75岁以上的人群,一组是85岁以上的人群,有两个在英国和一个在芬兰。这些研究都调查了人口中的认知症患者。但是使他们脱颖而出的是他们也有一个大脑捐赠计划与他们相关联。因此,在这项研究中,我们已经去问过人们是否愿意考虑在他们去世后捐赠他们和家人的大脑进行医学研究,所以我们也与他们的家人谈话。在他们之间,这些研究已收集了一千个捐赠。我们把他们聚在一起的原因是,每个研究都不能强大到能够看到你在大脑中看到的和你在生活中测量到的之间的关系,从而考虑到各种不同的因素。所以我们想要有能力去看看什么可能是人们的生活中的保护因素和补偿因素,从而影响他们将来可能会或不会得认知症。


In that study we explored the hypothesis that education is associated with less dementia. Now that’s a question that’s been addressed many times in ordinary cohort studies, in ordinary longitudinal studies, and we know that education is protective of later development of dementia, from a whole range of studies. What we wanted to do with this study was see what was the brain mechanism for that. And what we found was that if you have a certain amount of the changes associated with dementia in your brain, and if you have high education compared to low education, that the people in the high education group have less dementia during life. So just rephrasing that, if you hold the amount of neuropathology steady in a brain, whether you have more education or not influences whether you develop dementia during life or not. So that tells us that there are other things going on in the brain which allow us not to express dementia during life, even if we have say Alzheimer’s or vascular changes in our brain.

在这项研究中,我们探讨了教育与较少的认知症相关的假说。现在这是一个问题,在普通队列研究中已经被多次提到,在普通纵向研究中,我们知道从整个研究范围来看,教育是后续发展痴呆的保护因素。我们想要做的这项研究是搞清这是什么大脑机制造成的。我们发现,如果你在大脑中有一定量的与认知症有关的变化,如果你受过相对于较低教育的高等教育,那么受过高等教育的人在生活中较少有认知症。所以只是改述一下,如果你在脑中保持神经病理学的稳定,无论你有没有受过更多的教育都会影响你是否会在生活中发展为认知症。这告诉我们,即使我们说阿尔茨海默病或我们的大脑中的血管变化,在大脑中还有其他事情发生,从而使我们不在生命历程中患认知症。


What we looked at was the dose of education and the dose of education seemed to be important. Not just the availability of education, so it’s not just confounded by other things. But it seems almost certain that there are a variety of ways in which the measure of education could be associated with protection from expression of dementia. So it could be having a bigger brain at the beginning. It could be higher IQ because there’s an association between those two. It could be higher access to educational exposure. And then it can be the things that a higher education then is associated with in later life. Because we also know that more intellectually stimulating occupations and later life engagement, also have a protective effect, and each of those, they’re associated with each other, but we know they also have independent effects.

我们看到的是教育的剂量,教育的剂量似乎很重要。不只是教育的可用性,所以它不仅仅混淆其他事情。但是,似乎几乎可以肯定的是,有多种方式的教育措施可以与保护免于表现认知症相关联。所以它在刚开始时可能有一个更大的脑子。它可能是更高的智商,因为这两者之间有一个关联。它可能更容易接受教育。然后它可以是高等教育,然后与后来的生活相关联。因为我们也知道有更多智力刺激的职业与后来的生活参与,也有保护作用,并且它们的每一个都彼此相关联,但我们知道它们也有独立的影响。


翻译:关爱惟士-未经允许不得转载,违者必追究法律责任

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