High Education May Offer Protection Against Tauopathy in Patients with Mild Cognitive Impairment

Rolstad, Sindre; Nordlund, Arto; Eckerström, Carl; Gustavsson, M.H.; Blennow, Kaj; Olesen, Jes; Zetterberg, Henrik; Wallin, Anders

doi:10.3233/jad-2010-091012

Cited by 24 publications

(16 citation statements)

References 49 publications

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“…Biologically, early life SES alters telomere attrition rates and hippocampal volumes 37, 68 and low childhood SES is a risk factor for stroke 69 . In addition, education increases cognitive and brain reserve; higher education has been associated with increased cortical thickness in the temporal lobe 70 , as well as lower CSF tau concentrations in patients with amnestic MCI 71 . Importantly, education is partially separable from other risk factors: though education may determine adult SES, low education is an independent risk factor for AD 72, 73 .…”

Section: Discussionmentioning

confidence: 99%

Early Life Epidemiology of Alzheimer's Disease - A Critical Review

et al. 2015

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Background: As adult brain structure is primarily established in early life, genetic and environmental exposures in infancy and childhood influence the risk for Alzheimer disease (AD). In this systematic review, we identified several early life risk factors and discussed the evidence and underlying mechanism for each. Summary: Early risk factors for AD may alter brain anatomy, causing vulnerability to AD-related dementia later in life. In the perinatal period, both genes and learning disabilities have been associated with the development of distinct AD phenotypes. During early childhood, education and intellect, as well as body growth, may predispose to AD through alterations in cognitive and brain reserve, though the specific mediators of neural injury are disputed. Childhood socioeconomic status (SES) may predispose to AD by influencing adult SES and cognition. Association of these risk factors with underlying AD pathology (rather than just clinical diagnosis) has not been sufficiently examined. Key Messages: Factors that impede or alter brain growth during early life could render certain brain regions or networks selectively vulnerable to the onset, accumulation or spread of AD-related pathology during later life. Careful life-course epidemiology could provide clues as to why the brain systematically degenerates during AD.

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Section: Discussionmentioning

confidence: 99%

Early Life Epidemiology of Alzheimer's Disease - A Critical Review

et al. 2015

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“…The use of state-based modeling yielded an easily interpretable model that was able to accommodate potential state misclassification, death, and censoring. Furthermore, many previous studies of cognitive lifestyle and cognition have focused on small samples with AD/dementia or MCI [17][18][19] as opposed to a heterogeneous population-based sample that encompasses all levels of cognitive ability. Furthermore, whilst there were statistically significant differences in the hazards of cognitive transitions for men and women, a sensitivity analysis found no evidence for an interaction between gender and cognitive lifestyle (results not shown).…”

Section: Discussionmentioning

confidence: 99%

“…This was assessed at multiple times in CFAS and was used to assign the subjects' cognitive states. The cognitive states were defined as follows: no cognitive impairment (MMSE 27-30); slight cognitive impairment (23-26); moderate cognitive impairment (18)(19)(20)(21)(22); severe cognitive impairment (<18). The groupings were based around the slight cognitive impairment category, which is based on a figure from Stephan et al [9].…”

Section: Cognitive Assessmentmentioning

confidence: 99%

Active Cognitive Lifestyle Associates with Cognitive Recovery and a Reduced Risk of Cognitive Decline

Marioni

Hout

Valenzuela

et al. 2012

JAD

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Education and lifestyle factors linked with complex mental activity are thought to affect the progression of cognitive decline. Collectively, these factors can be combined to create a cognitive reserve or cognitive lifestyle score. This study tested the association between cognitive lifestyle score and cognitive change in a population-based cohort of older persons from five sites across England and Wales. Data came from 13,004 participants of the Medical Research Council Cognitive Function and Ageing Study who were aged 65 years and over. Cognition was assessed at multiple waves over 16 years using the Mini-Mental State Examination. Subjects were grouped into four cognitive states (no impairment, slight impairment, moderate impairment, severe impairment) and cognitive lifestyle score was assessed as a composite measure of education, mid-life occupation, and current social engagement. A multi-state model was used to test the effect of cognitive lifestyle score on cognitive transitions. Hazard ratios for cognitive lifestyle score showed significant differences between those in the upper compared to the lower tertile with a more active cognitive lifestyle associating with: a decreased risk of moving from no to slight impairment (0.58, 95% CI (0.45, 0.74)); recovery from a slightly impaired state back to a non-impaired state (2.93 (1.35, 6.38)); but an increased mortality risk from a severely impaired state (1.28 (1.12, 1.45)). An active cognitive lifestyle is associated with a more favorable cognitive trajectory in older persons. Future studies would ideally incorporate neuroradiological and neuropathological data to determine if there is causal evidence for these associations.

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“…Recent investigations based on neuroimaging measurements (Solé-Padullésa et al 2009), biochemical methods (Rolstad et al 2010), and epidemiological studies (Afgin et al 2012) were indicative that the cognitive reserve hypothesis may be applied also in MCI subjects.…”

Section: Introductionmentioning

confidence: 99%

Mild cognitive impairment: effect of education on the verbal and nonverbal tasks performance decline

et al. 2012

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We sought to longitudinally evaluate the potential association of educational level with performance on verbal and nonverbal tasks in individuals with mild cognitive impairment (MCI). We evaluated patients with MCI, age >50 years, no medication intake, absent vascular risk factors, and no lesions on brain magnetic resonance imaging (MRI). Each patient underwent a clinical assessment packet and a series of neuropsychological tests of the language and constructional praxis subtests of Cambridge Cognitive Examination (CAMGOG) and the Boston naming test (BNT), at baseline, 6 months, and 12 months. Educational levels were defined taking into account the total years of education, the school level, and diplomas. MCI patients with low education level showed a stepwise reduction in scores of naming objects (NO; P = 0.009), definition (DF; P = 0.012), language (LT; P = 0.021), constructional praxis (CD; P = 0.022), confrontation naming skills (BXB; P = 0.033), phonemic help (BFB; P = 0.041), and BNT (P = 0.002). Analysis of covariance, controlling for baseline scores, showed that education was associated with NO score (P = 0.002), DF score (P = 0.005), LT (P = 0.008), CD score (P = 0.008), BXB score (44.36 ± 1.84, P = 0.0001), BFB (P = 0.022), and BNT (P = 0.004). Our findings indicate that education appeared to affect verbal and nonverbal task performance in MCI patients. Despite the fact that higher educated patients are more acquainted with the tasks, slower deterioration in consecutive follow-up examinations could be explained by the cognitive reserve theory. The potential association of this protective effect with delayed onset of symptoms deserves further investigation.

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High Education May Offer Protection Against Tauopathy in Patients with Mild Cognitive Impairment

Cited by 24 publications

References 49 publications

Early Life Epidemiology of Alzheimer's Disease - A Critical Review

Early Life Epidemiology of Alzheimer's Disease - A Critical Review

Active Cognitive Lifestyle Associates with Cognitive Recovery and a Reduced Risk of Cognitive Decline

Mild cognitive impairment: effect of education on the verbal and nonverbal tasks performance decline

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