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Education and rates of cognitive decline in incident Alzheimer's disease.
J Neurol Neurosurg Psychiatry 2006; 77(3):308-16JN

Abstract

BACKGROUND

Some (but not all) epidemiological studies have noted faster rates of progression in high education patients with Alzheimer's disease (AD), which has been attributed to harbouring/tolerating a higher pathological burden at the time of clinical dementia for subjects with higher education. We wanted to assess the relationship between education and rates of decline in AD.

METHODS

During the course of a community based multiethnic prospective cohort study of individuals aged > or = 65 years living in New York, 312 patients were diagnosed with incident AD and were followed overall for 5.6 (up to 13.3) years. The subjects received an average of 3.7 (up to 9) neuropsychological assessments consisting of 12 individual tests. With the aid of a normative sample, a standardised composite cognitive score as well as individual cognitive domain scores were calculated. Generalised estimating equation models were used to examine the association between education and rates of cognitive decline.

RESULTS

Composite cognitive performance declined by 9% of a standard deviation per year. Rates of decline before and after AD incidence were similar. For each additional year of education there was 0.3% standard deviation lower composite cognitive performance for each year of follow up. The association between higher education and faster decline was noted primarily in the executive speed (0.6%) and memory (0.5%) cognitive domains and was present over and above age, gender, ethnicity, differential baseline cognitive performance, depression, and vascular comorbidity.

CONCLUSIONS

We conclude that higher education AD patients experience faster cognitive decline.

Authors+Show Affiliations

Cognitive Neuroscience Division, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, 622 West 168th Street, PH 19th Floor, New York, NY 10032, USA. ns257@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16484637

Citation

Scarmeas, N, et al. "Education and Rates of Cognitive Decline in Incident Alzheimer's Disease." Journal of Neurology, Neurosurgery, and Psychiatry, vol. 77, no. 3, 2006, pp. 308-16.
Scarmeas N, Albert SM, Manly JJ, et al. Education and rates of cognitive decline in incident Alzheimer's disease. J Neurol Neurosurg Psychiatry. 2006;77(3):308-16.
Scarmeas, N., Albert, S. M., Manly, J. J., & Stern, Y. (2006). Education and rates of cognitive decline in incident Alzheimer's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 77(3), pp. 308-16.
Scarmeas N, et al. Education and Rates of Cognitive Decline in Incident Alzheimer's Disease. J Neurol Neurosurg Psychiatry. 2006;77(3):308-16. PubMed PMID: 16484637.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Education and rates of cognitive decline in incident Alzheimer's disease. AU - Scarmeas,N, AU - Albert,S M, AU - Manly,J J, AU - Stern,Y, PY - 2006/2/18/pubmed PY - 2006/3/25/medline PY - 2006/2/18/entrez SP - 308 EP - 16 JF - Journal of neurology, neurosurgery, and psychiatry JO - J. Neurol. Neurosurg. Psychiatry VL - 77 IS - 3 N2 - BACKGROUND: Some (but not all) epidemiological studies have noted faster rates of progression in high education patients with Alzheimer's disease (AD), which has been attributed to harbouring/tolerating a higher pathological burden at the time of clinical dementia for subjects with higher education. We wanted to assess the relationship between education and rates of decline in AD. METHODS: During the course of a community based multiethnic prospective cohort study of individuals aged > or = 65 years living in New York, 312 patients were diagnosed with incident AD and were followed overall for 5.6 (up to 13.3) years. The subjects received an average of 3.7 (up to 9) neuropsychological assessments consisting of 12 individual tests. With the aid of a normative sample, a standardised composite cognitive score as well as individual cognitive domain scores were calculated. Generalised estimating equation models were used to examine the association between education and rates of cognitive decline. RESULTS: Composite cognitive performance declined by 9% of a standard deviation per year. Rates of decline before and after AD incidence were similar. For each additional year of education there was 0.3% standard deviation lower composite cognitive performance for each year of follow up. The association between higher education and faster decline was noted primarily in the executive speed (0.6%) and memory (0.5%) cognitive domains and was present over and above age, gender, ethnicity, differential baseline cognitive performance, depression, and vascular comorbidity. CONCLUSIONS: We conclude that higher education AD patients experience faster cognitive decline. SN - 0022-3050 UR - https://www.unboundmedicine.com/medline/citation/16484637/Education_and_rates_of_cognitive_decline_in_incident_Alzheimer's_disease_ L2 - http://jnnp.bmj.com/cgi/pmidlookup?view=long&pmid=16484637 DB - PRIME DP - Unbound Medicine ER -