TY - JOUR
T1 - Education amplifies brain atrophy effect on cognitive decline
T2 - implications for cognitive reserve
AU - Mungas, Dan
AU - Gavett, Brandon
AU - Fletcher, Evan
AU - Farias, Sarah Tomaszewski
AU - DeCarli, Charles
AU - Reed, Bruce
PY - 2018/8
Y1 - 2018/8
N2 - Level of education is often regarded as a proxy for cognitive reserve in older adults. This implies that brain degeneration has a smaller effect on cognitive decline in those with more education, but this has not been directly tested in previous research. We examined how education, quantitative magnetic resonance imaging-based measurement of brain degeneration, and their interaction affect cognitive decline in diverse older adults spanning the spectrum from normal cognition to dementia. Gray matter atrophy was strongly related to cognitive decline. While education was not related to cognitive decline, brain atrophy had a stronger effect on cognitive decline in those with more education. Importantly, high education was associated with slower decline in individuals with lesser atrophy but with faster decline in those with greater atrophy. This moderation effect was observed in Hispanics (who had high heterogeneity of education) but not in African-Americans or Caucasians. These results suggest that education is an indicator of cognitive reserve in individuals with low levels of brain degeneration, but the protective effect of higher education is rapidly depleted as brain degeneration progresses.
AB - Level of education is often regarded as a proxy for cognitive reserve in older adults. This implies that brain degeneration has a smaller effect on cognitive decline in those with more education, but this has not been directly tested in previous research. We examined how education, quantitative magnetic resonance imaging-based measurement of brain degeneration, and their interaction affect cognitive decline in diverse older adults spanning the spectrum from normal cognition to dementia. Gray matter atrophy was strongly related to cognitive decline. While education was not related to cognitive decline, brain atrophy had a stronger effect on cognitive decline in those with more education. Importantly, high education was associated with slower decline in individuals with lesser atrophy but with faster decline in those with greater atrophy. This moderation effect was observed in Hispanics (who had high heterogeneity of education) but not in African-Americans or Caucasians. These results suggest that education is an indicator of cognitive reserve in individuals with low levels of brain degeneration, but the protective effect of higher education is rapidly depleted as brain degeneration progresses.
KW - Aged
KW - Aged, 80 and over
KW - Atrophy
KW - Brain/diagnostic imaging
KW - Cognitive Dysfunction/pathology
KW - Cognitive Reserve/physiology
KW - Continental Population Groups
KW - Educational Status
KW - Female
KW - Gray Matter/diagnostic imaging
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Neuroimaging
UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85047090415&origin=resultslist&sort=plf-f&src=s&st1=Education+amplifies+brain+atrophy+effect+on+cognitive+decline%3a+implications+for+cognitive+reserve&st2=&sid=dd6fcbea218b022cfa4a7216164d98f4&sot=b&sdt=b&sl=104&s=TITLE%28Education+amplifies+brain+atrophy+effect+on+cognitive+decline%3a+implications+for+cognitive+reserve%29&relpos=0&citeCnt=1&searchTerm=
U2 - 10.1016/j.neurobiolaging.2018.04.002
DO - 10.1016/j.neurobiolaging.2018.04.002
M3 - Article
C2 - 29798764
VL - 68
SP - 142
EP - 150
JO - Neurobiology of Aging: experimental and clinical research
JF - Neurobiology of Aging: experimental and clinical research
SN - 0197-4580
ER -