Table 4.
Life Experience Factors Contributing to Resilience and Resistance in Dominantly Inherited Alzheimer Disease
| Concepts | Resilience | Resistance |
| Definition | Maintaining cognitive function better than expected in the presence of high pathology | Lower-than-expected pathology |
| Contributing life experience factors | Conscientiousnessa,d | Moderate-intensity exercisec |
| Openness to experiencea | Years of formal educationc | |
| Agreeablenessb |
Compared with the susceptible control group (symptomatic, high pathology), the lifestyle contributors for the high-resilience group (asymptomatic, high pathology) were higher level of conscientiousness and openness to experience, controlling for age and depression.
Compared with the low-resilience group (symptomatic, low pathology), the lifestyle contributor for the high-resilience group (asymptomatic, high pathology) was higher level of agreeableness, controlling for age and depression.
Compared with the low-resistance group (high pathology, asymptomatic, estimated years from expected symptom onset [EYO] <0), the lifestyle contributors for high resistance (low pathology, asymptomatic, EYO <0) included more frequent moderate-intensity exercise, more years of formal education, and family pathogenic variation, controlling for age and depression.
a-cAge and depression were also significant multivariable factors. Although all multivariable comparisons were adjusted for age and depression as covariates, they were not included in this table because they do not fall within the scope of modifiable lifestyle factors conceptually.
In the results of cohort 2, conscientiousness was the consistent lifestyle contributor for delaying the onset age compared with that of parents, even after adjusting for CSFp-tau181 levels (model 1), Mini-Mental State Examination (MMSE) scores (model 2), both CSFp-tau181 levels and MMSE scores (model 3), and years of education (model 4).