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@ARTICLE{DemnitzKing:164983,
      author       = {Demnitz-King, Harriet and Gonneaud, Julie and Klimecki,
                      Olga M and Chocat, Anne and Collette, Fabienne and
                      Dautricourt, Sophie and Jessen, Frank and Krolak-Salmon,
                      Pierre and Lutz, Antoine and Morse, Rachel M and Molinuevo,
                      José Luis and Poisnel, Géraldine and Touron, Edelweiss and
                      Wirth, Miranka and Walker, Zuzana and Chételat, Gaël and
                      Marchant, Natalie L},
      collaboration = {Group, Medit-Ageing Research},
      title        = {{A}ssociation {B}etween {S}elf-{R}eflection, {C}ognition,
                      and {B}rain {H}ealth in {C}ognitively {U}nimpaired {O}lder
                      {A}dults.},
      journal      = {Neurology},
      volume       = {99},
      number       = {13},
      issn         = {0028-3878},
      address      = {[S.l.]},
      publisher    = {Ovid},
      reportid     = {DZNE-2022-01387},
      pages        = {e1422 - e1431},
      year         = {2022},
      abstract     = {Self-reflection (the active evaluation of ones thoughts,
                      feelings and behaviours) can confer protection against
                      adverse health outcomes. Its impact on markers sensitive to
                      Alzheimer's disease (AD), however, is unknown. The primary
                      objective of this cross-sectional study was to examine the
                      association between self-reflection and AD-sensitive
                      markers.This study utilised baseline data from cognitively
                      unimpaired older adults enrolled in the Age-Well clinical
                      trial and older adults with subjective cognitive decline
                      from the SCD-Well clinical trial. In both cohorts,
                      self-reflection was measured via the reflective pondering
                      subscale of the Rumination Response Scale, global cognition
                      assessed via the Preclinical Alzheimer's Cognitive Composite
                      5, and a modified late-life Lifestyle-for-Brain-Health
                      (LIBRA) index computed to assess health and lifestyle
                      factors. In Age-Well, glucose metabolism and amyloid
                      deposition were quantified in AD-sensitive grey matter
                      regions via FDG- and AV45-PET scans, respectively.
                      Associations between self-reflection and AD-sensitive
                      markers (global cognition, glucose metabolism, and amyloid
                      deposition) were assessed via unadjusted and adjusted
                      regressions. Further, we explored whether associations were
                      independent of health and lifestyle factors. To control for
                      multiple comparisons in Age-Well, false discovery rate
                      corrected p-values (p FDR) are reported.A total of 134 (mean
                      age 69.3 ± 3.8 years, $61.9\%$ female) Age-Well and 125
                      (mean age 72.6 ± 6.9 years, $65.6\%$ female) SCD-Well
                      participants were included. Across unadjusted and adjusted
                      analyses self-reflection was positively associated with
                      global cognition in both cohorts (Age-Well: adjusted-β =
                      0.22, $95\%$ confidence interval [CI] 0.05-0.40, p FDR =
                      0.041; SCD-Well: adjusted-β = 0.18, $95\%$ CI 0.03-0.33, p
                      = 0.023) and with glucose metabolism in Age-Well after
                      adjustment for all covariates (adjusted-β = 0.29, $95\%$ CI
                      0.03-0.55, p FDR = 0.041). Associations remained following
                      additional adjustment for LIBRA but did not survive FDR
                      correction. Self-reflection was not associated with amyloid
                      deposition (adjusted-β = 0.13, $95\%$ CI -0.07-0.34, p FDR
                      = 0.189).Self-reflection was associated with better global
                      cognition in two independent cohorts and with higher glucose
                      metabolism after adjustment for covariates. There was weak
                      evidence that relationships were independent from health and
                      lifestyle behaviours. Longitudinal and experimental studies
                      are warranted to elucidate whether self-reflection helps
                      preserve cognition and glucose metabolism, or whether
                      reduced capacity to self-reflect is a harbinger of cognitive
                      decline and glucose hypometabolism.Age-Well: NCT02977819;
                      SCD-Well: NCT03005652.},
      keywords     = {Aged / Alzheimer Disease: metabolism / Amyloid
                      beta-Peptides: metabolism / Biomarkers: metabolism / Brain:
                      diagnostic imaging / Brain: metabolism / Cognition:
                      physiology / Cognitive Dysfunction: diagnostic imaging /
                      Cognitive Dysfunction: metabolism / Cross-Sectional Studies
                      / Female / Glucose: metabolism / Humans / Magnetic Resonance
                      Imaging / Male / Positron-Emission Tomography / Amyloid
                      beta-Peptides (NLM Chemicals) / Biomarkers (NLM Chemicals) /
                      Glucose (NLM Chemicals)},
      cin          = {AG Wirth / AG Donix},
      ddc          = {610},
      cid          = {I:(DE-2719)1710011 / I:(DE-2719)1710008},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35853750},
      doi          = {10.1212/WNL.0000000000200951},
      url          = {https://pub.dzne.de/record/164983},
}