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The contribution of education and intelligence to resilience against
age-related cognitive decline is not clear, particularly in the presence
of ‘normal for age’ minor brain abnormalities.
Participants (n = 208, mean age 69.2 years, s.d. = 5.4)
in the Whitehall II imaging substudy attended for neuropsychological
testing and multisequence 3T brain magnetic resonance imaging. Images
were independently rated by three trained clinicians for global and
hippocampal atrophy, periventricular and deep white matter changes.
Although none of the participants qualified for a clinical diagnosis of
dementia, a screen for cognitive impairment (Montreal Cognitive
Assessment (MoCA) <26) was abnormal in 22%. Hippocampal atrophy, in
contrast to other brain measures, was associated with a reduced MoCA
score even after controlling for age, gender, socioeconomic status, years
of education and premorbid IQ. Premorbid IQ and socioeconomic status were
associated with resilience in the presence of hippocampal atrophy.
Independent contributions from a priori risk (age,
hippocampal atrophy) and resilience (premorbid function, socioeconomic
status) combine to predict measured cognitive impairment.
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