Education and the course of cognitive decline in Alzheimer disease

Wilson, Robert S.; Li, Yanglan; Aggarwal, Neelum T.; Barnes, Lisa L.; McCann, Judith J.; Gilley, David W.; Evans, Denis A.

doi:10.1212/01.wnl.0000140488.65299.53

Cited by 110 publications

(102 citation statements)

References 27 publications

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“…Other studies have noted faster rates of progression in high CR patients after the diagnosis of AD 3,9,10 . A research has indicated that high PLA is associated with more rapid cognitive decline than in those with lower PLA 9 and some studies have shown that AD patients with higher education have a more rapid cognitive decline 3,10 than those with lower education, because at any level of clinical severity, the underlying progression is more advanced in patients with higher education, which has been attributed to harbouring a higher pathological burden at the time of clinical dementia for subjects with higher education 3 . Other authors 7,11 concluded that education slows the rate of cognitive decline in person with AD and Treiber and colleagues 12 proved that the increased engagement in cognitive LA through late life was associated with slower deterioration in general cognitive ability in mild dementia.…”

Section: Introductionmentioning

confidence: 83%

Cognitive reserve and the severity of Alzheimer’s disease

Sobral

Pestana

Paúl

2015

Arq. Neuro-Psiquiatr.

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Alzheimer's disease (AD) is the most common form of dementia in the elderly 1 and a clinical syndrome caused by neurodegeneration and characterized by a progressive deterioration in cognitive ability and capacity for independent living. The course of AD is not the same in every person, but symptoms seem to develop over the same general stages. Cognitive reserve (CR) is a hypothetical construct that has been used to inform of cognitive aging and describes the capacity of the adult brain to deal with the effects of the neurodegenerative process and to minimize the clinical manifestation of pathology of dementia that is probably the result of innate intelligence or life experience 2 . The CR hypothesis suggests that individual differences in the ability to cope with AD pathology 2,3 are consistent with the prediction that people with more reserve can cope with advancing AD pathology longer before it is expressed clinically 3,4,5 . CR is not fixed, but continues to evolve across the lifespan 5 . Variables pertaining to lifetime experience (education, occupation attainment and leisure activities) 4,5 are the most commonly used proxies for CR and help retain cognitive function in old age. Epidemiological studies suggest that lifelong experiences, including educational, occupational attainment and leisure activities (LA) in later life, can increase reserve 4 . Greater understanding of the concept of CR could lead to ABSTRACTAlzheimer´s disease (AD) is a clinical syndrome caused by neurodegeneration and characterized by a progressive deterioration in cognitive ability and capacity for independent living. Cognitive reserve (CR) describes the capacity of the adult brain to cope with the effects of the neurodegenerative process and to minimize the clinical manifestation of pathology of dementia. The aim of this study was to evaluate the association of CR and the severity of AD. Method: This study was cross-sectional. Functional and neuropsychological abilities of 75 outpatients with probable AD diagnosis were evaluated. Patients completed two questionnaires, "Participation in leisure activities throughout life" and CR Questionnaire. Result: The relationship between Clinical Dementia Rating (CDR) and the level of CR was statistically significant (likelihood ratio (LR), p = 0.015). Conclusion: The level of CR influenced the severity of dementia. This study suggests that AD patients with higher CR may benefit against cognitive decline after diagnosis of AD.Keywords: Alzheimer´s disease, cognitive reserve, education, leisure activities, lifelong occupation. RESUMODoença de Alzheimer (DA) é uma síndrome neurodegenerativa caracterizada por uma deterioração progressiva das capacidades cognitivas e das competências para uma vida independente. A reserva cognitiva (RC) descreve a capacidade do cérebro adulto em lidar com os efeitos deste processo neurodegenerativo e minimizar a manifestação clínica da patologia de demência. O objetivo deste trabalho foi avaliar a associação entre RC e a severidade da DA. Método: Este estudo foi tra...

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Section: Introductionmentioning

confidence: 83%

Cognitive reserve and the severity of Alzheimer’s disease

Sobral

Pestana

Paúl

2015

Arq. Neuro-Psiquiatr.

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“…decline of cognitive functions once they are diagnosed with AD (Andel, Vigen, Mack, Clark, & Gatz, 2006;Hall et al, 2007;Roe, Xiong, Miller, & Morris, 2007;Scarmeas, Albert, Manly, & Stern, 2006;Stern, Albert, Tang, & Tsai, 1999;Wilson et al, 2004). This faster rate of decline is thought to be caused by a more advanced stage of neuropathology at diagnosis in AD patients with higher education, compared with patients with less education.…”

Section: Potential Confounding Effect Of Cases With Prodromal Admentioning

confidence: 99%

No protective effects of education during normal cognitive aging: Results from the 6-year follow-up of the Maastricht Aging Study.

Dijk¹,

Gerven²,

Boxtel³

et al. 2008

Psychology and Aging

107

112

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Recent large-scale longitudinal aging studies question earlier claims that higher education protects against cognitive decline in older age. In the present study, the authors addressed this issue by determining whether educational level had an attenuating effect on the rate of cognitive change assessed with a broad range of neuropsychological tests in a community sample of 872 healthy individuals aged 49 to 81 years at baseline. The participants were followed for 6 years and were tested 3 times (at baseline and at 3 and 6 years after baseline). Results of linear mixed-model analyses showed that education had no significant effect on cognitive change over time. These results are discussed in terms of the age range of the sample, definition and range of education, cognitive measures used, length of the study and number of consecutive assessments, and confounding effect of health. The findings question the extent of the presumed protective effects of higher education on cognitive decline during normal aging.

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“…La funcionalidad comienza a afectarse, el paciente, de manera progresiva, va perdiendo la autonomía e independencia para realizar actividades instrumentales complejas, como el manejo de la medicación y del dinero, la movilización por su ciudad, la capacidad de realizar oficios domésticos y la utilización de los electrodomésticos 4 .…”

Section: Descripción Fenotípicaunclassified

“…La EA se define como un trastorno neurodegenerativo que produce pérdida progresiva de la memoria y de otras funciones cognitivas 4 , y en la actualidad hay una prevalecía de más de 35 millones de personas en todo el mundo 5 . Teniendo en cuenta la heterogeneidad en el genotipo y fenotipo de esta demencia, y la ausencia de Respecto a las características de esta enfermedad, en el ámbito neuroanatómico, la EA produce una pérdida progresiva de volumen en los lóbulos temporales, en especial en las áreas mediales como el hipocampo y la corteza entorrinal, lo que se explica microscópicamente por la acumulación de placas amiloides y ovillos neurofibrilares, producto de la agregación de proteínas anormales beta-amiloide y TAU, respectivamente 6 .…”

Section: Introductionunclassified

Descripción genotípica y fenotípica de la enfermedad de Alzheimer tardía y familiar precoz: revisión

Castrillón¹,

Jiménez²,

Restrepo³

et al. 2015

MedUPB

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RESUMENLa demencia es la pérdida de varias áreas del funcionamiento cognitivo respecto al nivel premórbido, con deterioro significativo en la funcionalidad. La más común es ocasionada por la enfermedad de Alzheimer, que se define como un trastorno neurodegenerativo que produce una alteración progresiva de la memoria y de otras habilidades mentales, por una pérdida de volumen en los lóbulos temporales, en especial en las áreas mediales como el hipocampo y la corteza entorrinal. Menos del 5% de los pacientes con esta enfermedad presenta formas hereditarias que pueden tener un inicio precoz (antes de los 65 años) o tardío (después de dicha edad). La EA precoz presenta un patrón de herencia autosómico dominante y puede ser causado por mutaciones en el gen de la proteína precursora de amiloide, en presenilina-1 o presenilina-2. Los casos de EA tardía, están influenciados por una genética compleja, con múltiples factores de susceptibilidad y el alelo ApoE4 es el principal y más reconocido. La EA es una enfermedad heterogénea tanto en su genotipo como en su fenotipo que varían en cuanto a intensidad y tipo de síntomas, edad de inicio y severidad de la demencia, de acuerdo con las mutaciones que el paciente presenta y su interacción con factores ambientales.

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Education and the course of cognitive decline in Alzheimer disease

Abstract: Higher educational attainment is associated with a slightly accelerated rate of cognitive decline in Alzheimer disease.

Cited by 110 publications

References 27 publications

Cognitive reserve and the severity of Alzheimer’s disease

Cognitive reserve and the severity of Alzheimer’s disease

No protective effects of education during normal cognitive aging: Results from the 6-year follow-up of the Maastricht Aging Study.

Descripción genotípica y fenotípica de la enfermedad de Alzheimer tardía y familiar precoz: revisión

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