Very low levels of education and cognitive reserve

Abstract

Objective: We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could contribute to cognitive reserve and modify the relation of neuropathologic indices to dementia. Methods:In this cross-sectional study, we included 675 individuals 50 years of age or older from the Brazilian Aging Brain Study Group. Cognitive abilities were evaluated through a structured interview with an informant at the time of autopsy, including the Clinical Dementia Rating (CDR) scale. Neuropathologic examinations were performed using immunohistochemistry and following internationally accepted criteria. Multivariate linear regression models were conducted to determine whether the association between cognitive abilities (measured by CDR sum of boxes) and years of education was independent of sociodemographic variables and neuropathologic indices, including neuritic plaques, neurofibrillary tangles, lacunar infarctions, small-vessel disease, and Lewy bodies. In addition, interaction models were used to examine whether education modified the relation between neuropathologic indices and cognition.Results: Mean education was 3.9 6 3.5 years. The cognitive reserve theory is increasingly used to explain the clinicopathologic dissociation observed in Alzheimer disease (AD). 1 Approximately 30% of cognitively normal subjects have intermediate-to high-likelihood AD pathology at autopsy. [2][3][4][5][6][7] According to this theory, subjects with greater cognitive reserve require a more severe neuropathologic burden to reach the threshold for clinical dementia. 8 Previous clinicopathologic studies suggest that although education is not directly related to the development of neuropathologic lesions, it appears to reduce the impact of such lesions on the development of dementia, thereby increasing cognitive reserve. However, the studies supporting this hypothesis have investigated populations with relatively high levels of educational attainment, with mean formal education ranging from 9 to 18 years. [8][9][10][11][12] Little information is available regarding the effect of very few years of education on cognitive reserve. Low educational attainment is the reality for a high proportion of the elderly worldwide. According to a report from the United Nations Education, Scientific and Cultural Organization, nearly 800 million adults remained illiterate in 2009, representing about 16% of the global population. 13 Most of

Miniexame do Estado Mental: evidências de validade baseadas na estrutura interna

“…Muitas pesquisas têm destacado que a escolaridade influencia o desempenho no MEEM (Bertolucci et al, 1994;Brucki, Mansur, Carthery-Goulart, & Nitrini, 2011) e, consequentemente, deve ser considerada ao se estabelecerem pontos de corte. Alerta-se que não somente a quantidade de anos estudados é importante mas também a qualidade do ensino recebido e sua influência sobre o desenvolvimento cognitivo, especialmente na velhice (Aprahamian, Martinelli, Cecato, & Yassuda, 2011) e em países em desenvolvimento, como o Brasil, onde a educação formal é muito heterogênea (Farfel et al, 2013 O segundo componente extraído na ACPOrientação -reuniu os mesmos dez itens agrupados no estudo de Folstein et al (1975). Embora sejam funções importantes a serem avaliadas no contexto da cognição, autores, como Carnero-Pardo (2013), argumentam que valerse de 10 itens para avaliar a orientação em um instrumento com um total de 30 itens pode ser exagero.…”

Prevalence of chronic pain in a metropolitan area of a developing country: a population-based study

“…These data suggested that independent of the country's development level, people with lower educational levels present a higher risk for CP. The reasons for this are manyfold, and may reflect different degrees of cognitive reserve 29 and coping in more and less educated individuals. In fact, it has been suggested that patients with a better cognitive reserve may present with less CP after surgery 30 .…”

Essen stroke risk score, cerebral cholinergic pathways and cognitive performances in patients with cerebral small vessel disease

“…Therefore education was controlled as a covariate in our study though it explained comparatively large variance of MoCA. While it is worthy of note that some recent studies suggested the link among the socioeconomic factors including educational level, cerebral white matter integrity and risk of vascular diseases especially stroke in later life [14][15][16]. The underlying mechanisms were assumed that education helped build cortical network and improve cerebral white matter integrity, as well as increase the resistance of central nervous system against impairments.…”