Mapping the connections between education and dementia

Abstract

Explanations for the association between educational attainment and the risk of dementia fall into three main categories. It may arise as an artefact of study methods; education may predict broader socioeconomic circumstances and exposures, or education may reflect brain reserve or cognitive capacity that protect against dementia. Data from the Canadian Study of Health and Aging (N=6646, giving 44,676 person-years of follow-up) are analyzed to test a series of hypotheses reflecting these explanations. Years of education showed a strong association with the risk of dementia (relative risk [RR] 2.1 for those with less than 6 years of education compared to those with 13 or more years; RR=2.9 among survivors). Possible artefactual factors were detected, but were insufficient to invalidate the association. Adjustments for a range of other socioeconomic indicators, health problems and lifestyle factors reduced, but did not remove, the association. Adjustments for intelligence and for an indicator of lifetime mental activity also appeared to account for some but not all of the association. The conclusion is that there appears to be a real association between educational attainment and the risk of dementia 50 to 60 years later; this influence appears to run through a number of different, and sometimes complementary, pathways.

Metabolic Networks Underlying Cognitive Reserve in Prodromal Alzheimer Disease: A European Alzheimer Disease Consortium Project

“…In the field of aging and dementia, cognitive reserve is based on the clinical observation that highly educated Alzheimer disease (AD) patients maintain a relatively preserved functional level for a longer time than less educated people, even after adjusting for socioeconomic indicators, health problems, intelligence, and lifestyle (2,3). This concept is supported by frequent discrepancies between measured pathology and cognitive decline (4,5).…”

Childhood cognitive ability and risk of late-onset Alzheimer and vascular dementia

“…16 The same may be applicable to educational attainment, which is closely related to premorbid cognitive ability, 26 and is also associated with dementia risk. 27 Education correlates with the extent of the parietotemporal regional cerebral blood flow (CBF) deficit in AD and this has been put forward as evidence of cognitive reserve. 28 However, such CBF deficits might also result from subtle vascular changes.…”

Enriched Environment Improves Motor Function and Increases Neurotrophins in Hemicerebellar Lesioned Rats

“…[2][3][4][5] A number of studies have shown the importance of environmental enrichment (EE) in maintaining motor and cognitive performance even in the presence of brain pathology. [6][7][8] The underlying molecular mechanism of EE-induced neuroprotection has been partially attributed to the upregulation of the levels of neurotrophins, proteins involved in both neuronal survival and death, and in activity-dependent plasticity. [9][10][11] Studies conducted in rodents have convincingly demonstrated that exposure to an enriched environment increases the production of neurotrophins, such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), in the cerebral cortex and hippocampal formation.…”