La maladie de Parkinson en France (serveur d'exploration)

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Motor function in the elderly

Identifieur interne : 000522 ( Pmc/Curation ); précédent : 000521; suivant : 000523

Motor function in the elderly

Auteurs : Alexis Elbaz ; Pavla Vicente-Vytopilova ; Béatrice Tavernier ; Séverine Sabia ; Julien Dumurgier ; Bernard Mazoyer ; Archana Singh-Manoux ; Christophe Tzourio

Source :

RBID : PMC:3776533

Abstract

Objective:

The reserve hypothesis accounts for the lack of direct relationship between brain pathology and its clinical manifestations. Research has mostly focused on cognition; our objective is to examine whether the reserve hypothesis applies to motor function. We investigated whether education, a marker of reserve, modifies the association between white matter lesions (WMLs), a marker of vascular brain damage, and maximum walking speed (WS), an objective measure of motor function. We also examined the cross-sectional and longitudinal association between education and WS.

Methods:

Data are from 4,010 participants aged 65–85 years in the longitudinal Three-City–Dijon Study with up to 4 WS measures over 10 years. We examined the interaction between education and WMLs for baseline WS. We studied the association between education and repeated WS measures using linear mixed models, and the role of covariates in explaining the education-WS association.

Results:

Education was strongly associated with baseline WS; the difference in mean WS between the high and low education groups (0.145 m/s, 95% confidence interval = 0.125–0.165) was equivalent to 7.4 years of age. WMLs were associated with slow WS only in the low education group (p interaction = 0.026). WS declined significantly over time (−0.194 m/s/10 years, 95% confidence interval = −0.206, −0.182), but education did not influence rate of decline. Anthropometric characteristics, parental education, general health, and cognition had the strongest role in explaining the baseline education-WS association.

Conclusions:

Participants with more education were less susceptible to WMLs' effect on motor function. Higher education was associated with better motor performances but not with motor decline. These results are consistent with the passive reserve hypothesis.


Url:
DOI: 10.1212/WNL.0b013e31829d8761
PubMed: 23803317
PubMed Central: 3776533

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PMC:3776533

Le document en format XML

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<sec>
<title>Methods:</title>
<p>Data are from 4,010 participants aged 65–85 years in the longitudinal Three-City–Dijon Study with up to 4 WS measures over 10 years. We examined the interaction between education and WMLs for baseline WS. We studied the association between education and repeated WS measures using linear mixed models, and the role of covariates in explaining the education-WS association.</p>
</sec>
<sec>
<title>Results:</title>
<p>Education was strongly associated with baseline WS; the difference in mean WS between the high and low education groups (0.145 m/s, 95% confidence interval = 0.125–0.165) was equivalent to 7.4 years of age. WMLs were associated with slow WS only in the low education group (
<italic>p</italic>
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<title>Conclusions:</title>
<p>Participants with more education were less susceptible to WMLs' effect on motor function. Higher education was associated with better motor performances but not with motor decline. These results are consistent with the passive reserve hypothesis.</p>
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<p>
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<title>Gifts:</title>
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<p>NONE</p>
</list-item>
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<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
<list-item>
<p>NONE</p>
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<p>NONE</p>
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<title>Patents:</title>
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<p>NONE</p>
</list-item>
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<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
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<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>NONE</p>
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<list list-type="order">
<title>Consultancies:</title>
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<p>NONE</p>
</list-item>
</list>
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<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
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<p>NONE</p>
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<title>Other Activities:</title>
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<p>NONE</p>
</list-item>
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<title>Clinical Procedures or Imaging Studies:</title>
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<p>NONE</p>
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<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>NONE</p>
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<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
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<p>Agence nationale de la recherche (France) - IGE-MP (2010-2012)</p>
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</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
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<p>NONE</p>
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<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
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<p>NONE</p>
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<p>NONE</p>
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<title>Patents:</title>
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<p>NONE</p>
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<p>
<list list-type="order">
<title>Publishing Royalties:</title>
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<p>NONE</p>
</list-item>
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<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
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<p>NONE</p>
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<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>NONE</p>
</list-item>
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<list list-type="order">
<title>Speakers' Bureaus:</title>
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<p>NONE</p>
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<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>NONE</p>
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</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
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<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
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<list list-type="order">
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<title>Publishing Royalties:</title>
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<given-names>Séverine</given-names>
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<degrees>PhD</degrees>
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<title>Gifts:</title>
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<p>NONE</p>
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<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
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<p>NONE</p>
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<list list-type="order">
<title>Editorial Boards:</title>
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<p>NONE</p>
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<title>Patents:</title>
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<p>NONE</p>
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<list list-type="order">
<title>Publishing Royalties:</title>
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<p>NONE</p>
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<title>Employment, Commercial Entity:</title>
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<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>I am supported by a grant from the National Institute on Aging, NIH (R01AG034454).</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dumurgier</surname>
<given-names>Julien</given-names>
</name>
<degrees>MD, PhD</degrees>
<author-comment content-type="disclosure">
<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Funding for travel or speaker honoraria:</title>
<list-item>
<p>Received funding for travel from Novartis (2013).</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Editorial Boards:</title>
<list-item>
<p>Serve an associate editor, Journal of Alzheimer's Disease, (2012-present).</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mazoyer</surname>
<given-names>Bernard</given-names>
</name>
<degrees>PhD</degrees>
<author-comment content-type="disclosure">
<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Editorial Boards:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Singh-Manoux</surname>
<given-names>Archana</given-names>
</name>
<degrees>PhD</degrees>
<author-comment content-type="disclosure">
<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Editorial Boards:</title>
<list-item>
<p>Journal of Epidemiology & Community Health (Associate Editor, since 2011)</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
<list-item>
<p>(1) MRC UK G10011354, Co-I, 2011-2015; (2) French Institute for Research on Public Health, PI, 2011-2014; (3) NIH/NIA R01AG013196, PI, 2009-2014; (4) NIH/NIA R01AG034454, PI, 2009-2014; (5) MRC UK K013351, Co-I, 2013-2017</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tzourio</surname>
<given-names>Christophe</given-names>
</name>
<degrees>MD, PhD</degrees>
<author-comment content-type="disclosure">
<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
<list-item>
<p>Fondation Plan Alzheimer</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Funding for travel or speaker honoraria:</title>
<list-item>
<p>1) ABBOTT, speaker honoraria 2) Fondation Recherche HTA, speaker honoraria</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Editorial Boards:</title>
<list-item>
<p>Member editorial board of Neuroepidemiology (2005-) Member editorial board of J Hypertension(2010-) Associate editor Journal of Universal Rejection (2011-)</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
<list-item>
<p>Agence Nationale de la Recherche</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>Fondation Plan Alzheimer</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<aff>From INSERM (A.E., A.S.-M.), Centre for Research in Epidemiology and Population Health, U1018, Social and Occupational Determinants of Health, Villejuif; University of Versailles St.-Quentin (A.E., A.S.-M.), UMRS 1018, Villejuif; INSERM (P.V.-V., C.T.), U708, Neuroepidemiology, Paris and Bordeaux; CHU de Dijon (B.T.), Department of Geriatrics, Dijon, France; Department of Epidemiology and Public Health (A.E., S.S., A.S.-M.), University College London, UK; CMRR Paris Nord Ile-de-France (J.D.), Lariboisiere Fernand Widal Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Diderot, Paris; Groupe d'Imagerie Neurofonctionnelle (B.M.), UMR5296, CNRS, CEA, Université de Bordeaux, Bordeaux; Centre de Gérontologie (A.S.-M.), Hôpital Ste Périne, AP-HP, Paris; and Université Victor Segalen Bordeaux 2 (C.T.), Bordeaux, France.</aff>
</contrib-group>
<author-notes>
<corresp>Correspondence to Dr. Elbaz:
<email>alexis.elbaz@inserm.fr</email>
</corresp>
<fn fn-type="financial-disclosure">
<p>Go to
<ext-link ext-link-type="uri" xlink:href="http://neurology.org/">Neurology.org</ext-link>
for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<day>30</day>
<month>7</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>30</day>
<month>1</month>
<year>2014</year>
</pub-date>
<pmc-comment> PMC Release delay is 6 months and 0 days and was based on the . </pmc-comment>
<volume>81</volume>
<issue>5</issue>
<fpage>417</fpage>
<lpage>426</lpage>
<history>
<date date-type="received">
<day>14</day>
<month>1</month>
<year>2013</year>
</date>
<date date-type="accepted">
<day>29</day>
<month>4</month>
<year>2013</year>
</date>
</history>
<permissions>
<copyright-statement>© 2013 American Academy of Neurology</copyright-statement>
<copyright-year>2013</copyright-year>
<copyright-holder>American Academy of Neurology</copyright-holder>
</permissions>
<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="WNL205251.pdf"></self-uri>
<abstract>
<sec>
<title>Objective:</title>
<p>The reserve hypothesis accounts for the lack of direct relationship between brain pathology and its clinical manifestations. Research has mostly focused on cognition; our objective is to examine whether the reserve hypothesis applies to motor function. We investigated whether education, a marker of reserve, modifies the association between white matter lesions (WMLs), a marker of vascular brain damage, and maximum walking speed (WS), an objective measure of motor function. We also examined the cross-sectional and longitudinal association between education and WS.</p>
</sec>
<sec>
<title>Methods:</title>
<p>Data are from 4,010 participants aged 65–85 years in the longitudinal Three-City–Dijon Study with up to 4 WS measures over 10 years. We examined the interaction between education and WMLs for baseline WS. We studied the association between education and repeated WS measures using linear mixed models, and the role of covariates in explaining the education-WS association.</p>
</sec>
<sec>
<title>Results:</title>
<p>Education was strongly associated with baseline WS; the difference in mean WS between the high and low education groups (0.145 m/s, 95% confidence interval = 0.125–0.165) was equivalent to 7.4 years of age. WMLs were associated with slow WS only in the low education group (
<italic>p</italic>
interaction = 0.026). WS declined significantly over time (−0.194 m/s/10 years, 95% confidence interval = −0.206, −0.182), but education did not influence rate of decline. Anthropometric characteristics, parental education, general health, and cognition had the strongest role in explaining the baseline education-WS association.</p>
</sec>
<sec>
<title>Conclusions:</title>
<p>Participants with more education were less susceptible to WMLs' effect on motor function. Higher education was associated with better motor performances but not with motor decline. These results are consistent with the passive reserve hypothesis.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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