{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T07:15:33Z","timestamp":1765178133631,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,14]],"date-time":"2023-05-14T00:00:00Z","timestamp":1684022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The optimal assessment of cognitive function, including the impact of education, is crucial in managing Alzheimer\u2019s disease (AD). This study aimed to evaluate the role of cognitive reserve (CR), represented by the metabolic status of regions of the cerebral cortex, to evaluate cognitive decline considering the educational attainment of patients with AD. Materials and Methods: We used data from the Alzheimer\u2019s Disease Neuroimaging Initiative database, and selected 124 patients who underwent both baseline F-18 fluorodeoxyglucose (FDG) and F-18 florbetaben (FBB) positron emission tomography (PET) scans. Demographics, cognitive function variables (Clinical Dementia Rating\u2014Sum of Boxes [CDR]; AD Assessment Scale 11\/13 [ADAS11\/13] Mini-Mental State Examination [MMSE]), and the average standardized uptake value ratio (SUVR) of cerebral cortex regions to those of the cerebellum were obtained from the data. The participants\u2019 education level was divided into low and high education subgroups using four cut-offs of 12, 14, 16, and 18 years of educational attainment (G12, G14, G16, and G18, respectively). Demographic and cognitive function variables were compared between the two subgroups in each of the four groups, and their correlations with the SUVRs were evaluated. Results: There was no significant difference between the high and low education subgroups in each of the four groups, except for ADAS11\/13 and MMSE in G14 and age in G16. The SUVRs of FDG PET (FDGSUVR) were significantly correlated with CDR, ADAS11\/13, and MMSE scores. FDGSUVR showed different trajectories of neurodegeneration between the low and high education groups. Conclusions: FDGSUVR correlated moderately but significantly with neuropsychological test results, without being influenced by education level. Therefore, FDG PET may reflect CR independent of education level, and therefore could be a reliable tool to evaluate cognitive decline in AD.<\/jats:p>","DOI":"10.3390\/medicina59050945","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T02:56:57Z","timestamp":1684119417000},"page":"945","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Use of F-18 FDG PET-Based Cognitive Reserve to Evaluate Cognitive Decline in Alzheimer\u2019s Disease, Independent of Educational Influence"],"prefix":"10.3390","volume":"59","author":[{"given":"Hyung Jin","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Ulsan University Hospital, Ulsan 44033, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9037-2155","authenticated-orcid":false,"given":"Minjung","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan 44033, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahro","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan 44033, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seol Hoon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan 44033, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1002\/ana.26071","article-title":"NIA-AA Alzheimer\u2019s Disease Framework: Clinical Characterization of Stages","volume":"89","author":"Petersen","year":"2021","journal-title":"Ann. 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