PURPOSE Emerging evidence suggests that limbic-predominant age-related TAR DNA-binding protein-43 (TDP-43) encephalopathy impacts domain-specific literacy, a complex ability not assessed in traditional cognitive evaluations. We examined longitudinal profiles of financial and health literacy in relation to limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC). PARTICIPANTS A total of 275 community-dwelling older persons who had completed annual literacy assessments, died and undergone brain autopsy. METHODS Financial and health literacy was assessed using a 32-item instrument. Latent class mixed effects models identified groups of individuals with distinct longitudinal literacy profiles. Regression models examined group differences in 9 common age-related neuropathologies assessed via uniform structured neuropathologic evaluations. RESULTS Two distinct literacy profiles emerged. The first group (N=121, 44%) had higher level of literacy at baseline, slower decline and less variabilities over time. The second group (N=154, 56%) had lower level of literacy at baseline, faster decline, and greater variabilities. Individuals from the latter group were older, with fewer years of education and more female. They also had higher burdens of Alzheimer disease and LATE-NC. The group association with Alzheimer disease was attenuated and no longer significant after controlling for cognition. By contrast, the association with LATE-NC persisted. CONCLUSION Limbic-predominant age-related TDP-43 encephalopathy is uniquely associated with distinct longitudinal profiles of financial and health literacy in old age.

中文翻译：

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边缘系统主导的年龄相关 TDP-43 脑病和特定领域读写能力的独特纵向特征。

目的 新出现的证据表明，边缘系统主导的与年龄相关的 TAR DNA 结合蛋白 43 (TDP-43) 脑病会影响特定领域的读写能力，这是一种在传统认知评估中未评估的复杂能力。我们研究了与边缘系统主导的年龄相关 TDP-43 脑病神经病理变化 (LATE-NC) 相关的财务和健康素养的纵向概况。参与者 共有 275 名社区老年人完成了年度识字率评估，死亡并接受了脑部尸检。方法 使用 32 项工具评估财务和健康素养。潜在类别混合效应模型识别出具有不同纵向读写能力特征的个体群体。回归模型检查了 9 种常见的与年龄相关的神经病理学的组间差异，这些神经病理学通过统一的结构化神经病理学评估进行评估。结果 出现了两种不同的识字情况。第一组 (N=121, 44%) 基线时的识字水平较高，随着时间的推移，下降速度较慢且变化较小。第二组（N=154，56%）基线识字水平较低，下降速度较快，且变异性较大。后一组人年龄较大，受教育年限较少，且女性较多。他们的阿尔茨海默病和 LATE-NC 负担也较高。在控制认知后，群体与阿尔茨海默病的关联减弱，不再显着。相比之下，与 LATE-NC 的关联仍然存在。结论 边缘系统主导的年龄相关 TDP-43 脑病与老年财务和健康素养的不同纵向特征具有独特的相关性。