<b><i>Introduction:</i></b> Previous studies have shown an association between a high health numeracy and good cognitive functioning. <b><i>Objective:</i></b> To investigate the moderation effect of education on this relationship and which brain structures support health numeracy. <b><i>Methods:</i></b> We examined 70 healthy older persons (66% females; mean ± SD: age, 75.73 ± 4.52 years; education, 12.21 ± 2.94 years). The participants underwent a T1-weighted 3-T MRI and a neuropsychological assessment including a health numeracy task. Statistical parametric mapping was applied to identify focal changes in cortical thickness throughout the entire brain and to correlate image parameters with behavioral measures. <b><i>Results:</i></b> Executive functions and mental calculation emerged as predictors of health numeracy (<i>B</i> = 0.22, <i>p</i> &#x3c; 0.05, and <i>B</i> = 0.38, <i>p</i> &#x3c; 0.01). An interaction was found between education and executive functions (<i>B</i> = –0.16, <i>p</i> = 0.01) and between education and mental calculation (<i>B</i> = –0.11, <i>p</i> &#x3c; 0.05). Executive functions and mental calculation had an impact on health numeracy in participants with a low to intermediate edu­cation (≤12 years) but not in those with a higher education (&#x3e;12 years). Health numeracy scores were associated with cortical thickness in the right dorsomedial prefrontal cortex and the right superior temporal gyrus (<i>p</i> = 0.01). <b><i>Conclusions:</i></b> Older people with a higher education perform better in health numeracy tasks than those with a lower education. They have access to previously acquired knowledge about ratio concepts and do not need to rely on executive functions and computational skills. This is highly relevant when decisions about health care have to be made.

Both, decline of sensorimotor functions and cortical thickness are known processes in healthy aging. Physical activity has been suggested to enhance the execution of daily routine activities and to extend the time of functional independence in advanced age. We hypothesized that cortical thickness of motor areas in retired individuals could be related to physical demands of the profession carried out during working life. Depending on their former occupations, 69 cognitively healthy individuals (range 70–85 years) were divided into higher and lower physically complex occupations (HPCO n = 27 and LPCO n = 42) according to the international standard classification of occupations (ISCO-08). Participants underwent a high-resolution 3T T1-weighted MRI scan. Surface-based analysis revealed higher cortical thickness in the left precentral (P = 0.001) and postcentral gyrus (P < 0.001) and right postcentral gyrus (P = 0.001) for the HPCO relative to the LPCO group (corrected for multiple comparisons, sex, age and leisure activities in the past 20 years). Physical leisure activities associated with exertion were positively correlated with cortical thickness in the left pre- and postcentral gyrus (P = 0.037) of the LPCO group. Time since retirement was negatively associated with cortical thickness in the left postcentral gyrus (P = 0.004) of the HPCO group. Executing a higher physically complex occupation before retirement was related to relative higher cortical thickness in the primary motor and somatosensory cortex in later life, supporting the hypothesis that physical activity contributes to neural reserve in these regions. However, these benefits appear to vanish when physical activity is reduced due to retirement.

Objective: To assess the role of cognitive reserve, age, gender and brain structure in proper name retrieval in advanced age. Method: Performance in 2 naming tasks (asking for proper names or common names) and 2 memory tasks was assessed. In separate hierarchical regressions, we evaluated whether retrieval was predicted by gray matter thickness or volume in selected structures (Model 1) and whether the addition of age and gender (Model 2) or of education (Model 3) explained significantly more variance. Participants were healthy persons (ages 70−90 years). Out of 91 individuals, 18 were excluded after inspection of magnetic resonance imaging scans showing relevant white matter changes. The remaining 73 individuals (47 women) showed good cognitive abilities. Results: Age was a significant predictor for the retrieval of well-known proper names, whereas selected gray matter measures and education had no significant effect. In contrast, education was predictive of common names retrieval and performance in the memory tasks. Gray matter measures predicted performance in the 2 memory tasks. Conclusions: Cognitive reserve has a differential effect on cognitive abilities in advances age. Education did not support the retrieval of well-known proper names but positively affected the retrieval of common names and performance in memory tasks. Cognitive reserve has to be considered in neuropsychological diagnostic procedures.