![]() The extent to which the positive effects of education are sustained across SCD, MCI, and Alzheimer’s disease dementia (AD) remains poorly understood. Educational attainment is a major contributor to this heterogeneity, where individuals with higher levels of education are not only at a lower risk of developing cognitive impairments ( Livingston et al., 2020), but also demonstrate better cognitive performance than those with lower educational attainment, sometimes even in advanced stages of pathological aging ( Lövdén et al., 2020 Seblova et al., 2020 Stern et al., 2020). Within each diagnostic group, however, there is considerable inter-individual variability in the extent to which cognitive decline manifests itself ( Cabeza et al., 2018 Soldan et al., 2020). The process of aging is accompanied by alterations in cognitive functions, ranging in severity from normal aging-related changes, to subjective cognitive decline (SCD), mild cognitive impairment (MCI) and, ultimately, dementia ( Jack et al., 2018 Salthouse, 2019). ![]() Future studies may further unravel the extent to which different dimensions of an individual’s disease severity contribute to the waxing and waning of protective effects in cognitive aging. ![]() However, these interaction effects did not survive FDR-corrections.Ĭonclusions: Altogether, our results demonstrated that positive effects of education on cognitive functioning reduce with diagnosis severity, but the role of neuropathological burden within a particular diagnosis was small and warrants further investigation. Education related to episodic memory only at relatively lower levels of neuropathology in SCD (β = −0.23, uncorrected p = 0.02), whereas education related to episodic memory in those with higher levels of neuropathology in MCI (β = 0.15, uncorrected p = 0.04). As diagnosis became more severe, however, the strength of these associations decreased (all adjusted p-values < 0.05). Results: We observed significant positive associations between education and performance for global cognition and executive functions (all adjusted p-values < 0.05). False discovery rate (FDR) corrections for multiple comparisons were applied. We re-ran each model with an additional interaction term to investigate whether these effects were influenced by neuropathological burden for each diagnostic group separately. To investigate whether the contribution of education to cognitive performance differed across SCD, MCI, and AD, we employed several multiple linear regression models, stratified by diagnosis and adjusted for age, sex, and neurodegeneration. We combined visual ratings of hippocampal atrophy, global atrophy, and white matter hyperintensities on MRI into a single neuropathology score. Methods: In this cross-sectional study, we included 108 patients with subjective cognitive decline, 190 with mild cognitive impairment, and 245 with Alzheimer’s disease dementia (AD). We aimed to investigate whether protective effects of education on cognition depend on (1) clinical diagnosis severity, and (2) the neuropathological burden within a diagnosis in a memory clinic setting. However, it remains unclear to which extent different disease states alter protective effects of education. 5Vincent van Gogh Institute for Psychiatry, Venray, Netherlandsīackground: Variability in cognitive functions in healthy and pathological aging is often explained by educational attainment.4Department of Medical Psychology, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |