Education and age-related decline in cognitive performance: Systematic review and meta-analysis of longitudinal cohort studies

Seblova, Dominika; Berggren, Rasmus; Lövdén, Martin

doi:10.1016/j.arr.2019.101005

Cited by 123 publications

(103 citation statements)

References 89 publications

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“…However, studies that have attempted to address this issue have not reported substantially altered estimates (Foverskov et al, 2018;Glymour et al, 2012;Gottesman et al, 2014). We also note that in the meta-analysis described above, estimates of the association between educational attainment and cognitive change were related neither to participants' age nor to the length of follow-up (Seblova et al, 2020). Given that age and length of follow-up would likely be associated with the extent of a bias introduced by selective dropout, these results do not suggest that selective dropout had a major influence on the estimates.…”

Section: Education and Aging-related Cognitive Changes In The Generalmentioning

confidence: 82%

“…Most previous studies have focused on older age, and it may, for example, be the case that an association is present during early adulthood. However, the reviewed meta-analysis (Seblova et al, 2020) and recent studies including an adult life-span sample (participants were 35-80 years old) have shown no strong indication that effects of education on cognitive ability are larger at younger ages (Berggren et al, 2018). It may also be that an association is nonlinear, such that effects of educational attainment on cognitive change may appear, for example, in samples of individuals who are poorly educated, but no such pattern was evident for any cognitive outcome examined in the reviewed meta-analysis.…”

Section: Education and Aging-related Cognitive Changes In The Generalmentioning

confidence: 99%

“…Against this background of small and inconsistent associations between education and longitudinal cognitive changes, as well as inconsistent results across measures, Seblova, Berggren, and Lövdén (2020) recently performed a meta-analysis to complement the streamlined, but less generalizable, analyses of harmonized data. Their results confirmed the general impression from the major recent studies.…”

Section: Evidence From Observational Studiesmentioning

confidence: 99%

“…A negative association indicates that greater education attainment is associated with faster cognitive decline (see Box 1). Adapted from “Education and Age-Related Decline in Cognitive Performance: Systematic Review and Meta-Analysis of Longitudinal Cohort Studies,” by D. Seblova, R. Berggren, and M. Lövdén, 2020 , Ageing Research Reviews, Vol. 58. doi:10.1016/j.arr.2019.101005.…”

Section: Evidence From Observational Studiesmentioning

confidence: 99%

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Education and Cognitive Functioning Across the Life Span

Lövdén

Fratiglioni

Glymour

et al. 2020

Psychol Sci Public Interest

684

308

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Cognitive abilities are important predictors of educational and occupational performance, socioeconomic attainment, health, and longevity. Declines in cognitive abilities are linked to impairments in older adults’ everyday functions, but people differ from one another in their rates of cognitive decline over the course of adulthood and old age. Hence, identifying factors that protect against compromised late-life cognition is of great societal interest. The number of years of formal education completed by individuals is positively correlated with their cognitive function throughout adulthood and predicts lower risk of dementia late in life. These observations have led to the propositions that prolonging education might (a) affect cognitive ability and (b) attenuate aging-associated declines in cognition. We evaluate these propositions by reviewing the literature on educational attainment and cognitive aging, including recent analyses of data harmonized across multiple longitudinal cohort studies and related meta-analyses. In line with the first proposition, the evidence indicates that educational attainment has positive effects on cognitive function. We also find evidence that cognitive abilities are associated with selection into longer durations of education and that there are common factors (e.g., parental socioeconomic resources) that affect both educational attainment and cognitive development. There is likely reciprocal interplay among these factors, and among cognitive abilities, during development. Education–cognitive ability associations are apparent across the entire adult life span and across the full range of education levels, including (to some degree) tertiary education. However, contrary to the second proposition, we find that associations between education and aging-associated cognitive declines are negligible and that a threshold model of dementia can account for the association between educational attainment and late-life dementia risk. We conclude that educational attainment exerts its influences on late-life cognitive function primarily by contributing to individual differences in cognitive skills that emerge in early adulthood but persist into older age. We also note that the widespread absence of educational influences on rates of cognitive decline puts constraints on theoretical notions of cognitive aging, such as the concepts of cognitive reserve and brain maintenance. Improving the conditions that shape development during the first decades of life carries great potential for improving cognitive ability in early adulthood and for reducing public-health burdens related to cognitive aging and dementia.

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Section: Education and Aging-related Cognitive Changes In The Generalmentioning

confidence: 82%

Section: Education and Aging-related Cognitive Changes In The Generalmentioning

confidence: 99%

Section: Evidence From Observational Studiesmentioning

confidence: 99%

Section: Evidence From Observational Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Education and Cognitive Functioning Across the Life Span

Lövdén

Fratiglioni

Glymour

et al. 2020

Psychol Sci Public Interest

684

308

View full text Add to dashboard Cite

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“…It is well-established that there is a positive association between education and various cognitive functions, including memory, attention, and executive function in healthy older adults (Cabral et al, 2016;Opdebeeck et al, 2016;Zhang et al, 2019). However, other studies have also reported that education is associated with the level of cognitive performance in healthy older adults but not with the rate of cognitive decline itself (Bendayan et al, 2017;Seblova et al, 2020). Our result also showed little association between working activity and detailed neuropsychological tests in both correlation and regression analyses, implying little effect of working activities on detailed cognition at the early stage of cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Reserve, Leisure Activity, and Neuropsychological Profile in the Early Stage of Cognitive Decline

Lee

Kang

Kim

et al. 2020

Front. Aging Neurosci.

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In older adults with normal cognition, cognitive reserve (CR) is known to be associated with the neuropsychological profile. We investigated the association between comprehensive CR and detailed neuropsychological profile in the early stage of cognitive decline. Fifty-five participants with mild cognitive impairment or subjective cognitive decline completed the cognitive reserve index questionnaire (CRIq) that yielded total, education, working activity, and leisure time scores (CRI-Total, CRI-Education, CRI-Working activity, and CRI-Leisure time, respectively). Mini-mental state examination (MMSE) and detailed neuropsychological evaluation were performed. Psychiatric symptom scales were applied to measure depression, apathy, positive or negative affect, and quality of life. Correlation and linear regression analyses of the variables were performed. The effect of CR-Education, CRI-Working activity, and CRI-Leisure time on the composite cognitive score was determined using a multivariable regression model. We observed that for CRI-Total (B = 3.00, p = 0.005), CRI-Education (B = 3.39, p = 0.002), and CRI-Leisure time (B = 2.56, p = 0.015), CR correlated with MMSE scores, while only CRI-Leisure time associated with the naming ability (B = 2.20, p = 0.033) in the detailed neuropsychological test results of the participants. Multivariable regression model also indicated that among CRI subscores, CRI-Leisure time directly affects the composite cognitive score (β = 0.32, p = 0.011). We found that in the early stage of cognitive decline in older adults, comprehensive CR was associated with global cognition, and only leisure activity was identified to be associated with the detailed neuropsychological profile including naming ability. These results may imply the positive effect of leisure activity on cognitive function in the early stages of cognitive decline.

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Association of Socioeconomic Status With Dementia Diagnosis Among Older Adults in Denmark

et al. 2021

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IMPORTANCE Low socioeconomic status (SES) has been identified as a risk factor for the development of dementia. However, few studies have focused on the association between SES and dementia diagnostic evaluation on a population level. OBJECTIVE To investigate whether household income (HHI) is associated with dementia diagnosis and cognitive severity at the time of diagnosis. DESIGN, SETTING, AND PARTICIPANTS This population-and register-based cross-sectional study analyzed health, social, and economic data obtained from various Danish national registers. The study population comprised individuals who received a first-time referral for a diagnostic evaluation for dementia to the secondary health care sector of Denmark between January 1, 2017, and December 17, 2018. Dementia-related health data were retrieved from the Danish Quality Database for Dementia. Data analysis was conducted from October 2019 to December 2020. EXPOSURES Annual HHI (used as a proxy for SES) for 2015 and 2016 was obtained from Statistics Denmark and categorized into upper, middle, and lower tertiles within 5-year interval age groups. MAIN OUTCOMES AND MEASURES Dementia diagnoses (Alzheimer disease, vascular dementia, mixed dementia, dementia with Lewy bodies, Parkinson disease dementia, or other) and cognitive stages at diagnosis (cognitively intact; mild cognitive impairment but not dementia; or mild, moderate, or severe dementia) were retrieved from the database. Univariable and multivariable logistic and linear regressions adjusted for age group, sex, region of residence, household type, period (2017 and 2018), medication type, and medical conditions were analyzed for a possible association between HHI and receipt of dementia diagnosis. RESULTS Among the 10 191 individuals (mean [SD] age, 75 [10] years; 5476 women [53.7%])included in the study, 8844 (86.8%) were diagnosed with dementia. Individuals with HHI in the upper tertile compared with those with lower-tertile HHI were less likely to receive a dementia diagnosis after referral (odds ratio, 0.65; 95% CI, 0.55-0.78) and, if diagnosed with dementia, had less severe cognitive stage (β, −0.16; 95% CI, −0.21 to −0.10). Individuals with middle-tertile HHI did not significantly differ from those with lower-tertile HHI in terms of dementia diagnosis (odds ratio, 0.92; 95% CI, 0.77-1.09) and cognitive stage at diagnosis (β, 0.01; 95% CI, −0.04 to 0.06). CONCLUSIONS AND RELEVANCEThe results of this study revealed a social inequality in dementia diagnostic evaluation: in Denmark, people with higher income seem to receive an earlier diagnosis.Public health strategies should target people with lower SES for earlier dementia detection and intervention.

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Education and age-related decline in cognitive performance: Systematic review and meta-analysis of longitudinal cohort studies

Abstract: Association of education and change in cognitive performance is negligible.• Articles included in meta-analysis displayed high unexplained heterogeneity.

Cited by 123 publications

References 89 publications

Education and Cognitive Functioning Across the Life Span

Education and Cognitive Functioning Across the Life Span

Cognitive Reserve, Leisure Activity, and Neuropsychological Profile in the Early Stage of Cognitive Decline

Association of Socioeconomic Status With Dementia Diagnosis Among Older Adults in Denmark

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