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Effects of education on the progression of early- versus late-stage mild cognitive impairment

Published online by Cambridge University Press:  04 December 2012

Byoung Seok Ye ,
Sang Won Seo ,
Hanna Cho ,
Seong Yoon Kim ,
Jung-Sun Lee ,
Eun-Joo Kim ,
Yunhwan Lee ,
Joung Hwan Back ,
Chang Hyung Hong  and
Seong Hye Choi
...Show all authors
Byoung Seok Ye
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Sang Won Seo*
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Hanna Cho
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Seong Yoon Kim
Affiliation:
Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
Jung-Sun Lee
Affiliation:
Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
Eun-Joo Kim
Affiliation:
Department of Neurology, Pusan National University School of Medicine, Pusan, Republic of Korea
Yunhwan Lee
Affiliation:
Departments of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
Joung Hwan Back
Affiliation:
Departments of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea
Chang Hyung Hong
Affiliation:
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
Seong Hye Choi
Affiliation:
Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
Kyung Won Park
Affiliation:
Department of Neurology, Dong-A University College of Medicine, Pusan, Republic of Korea
Bon D. Ku
Affiliation:
Department of Neurology, Kwandong University College of Medicine, Gyeonggi-do, Republic of Korea
So Young Moon
Affiliation:
Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
SangYun Kim
Affiliation:
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Seol-Heui Han
Affiliation:
Department of Neurology, Konkuk University College of Medicine, Seoul, Republic of Korea
Jae-Hong Lee
Affiliation:
Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
Hae-Kwan Cheong
Affiliation:
Department of Social and Preventive Medicine, School of Medicine, Sungkyunkwan University, Suwon, Republic of Korea
Duk L. Na
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
*
Correspondence should be addressed to: Sang Won Seo, MD, PhD, Department of Neurology, Samsung Medical Center, Sunkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Republic of Korea. Phone: +82-2-3410-1233; Fax: +82-2-3410-0052. Email: sangwonseo@empal.com.
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Abstract

Background: Highly educated participants with normal cognition show lower incidence of Alzheimer's disease (AD) than poorly educated participants, whereas longitudinal studies involving AD have reported that higher education is associated with more rapid cognitive decline. We aimed to evaluate whether highly educated amnestic mild cognitive impairment (aMCI) participants show more rapid cognitive decline than those with lower levels of education.

Methods: A total of 249 aMCI patients enrolled from 31 memory clinics using the standard assessment and diagnostic processes were followed with neuropsychological evaluation (duration 17.2 ± 8.8 months). According to baseline performances on memory tests, participants were divided into early-stage aMCI (−1.5 to −1.0 standard deviation (SD)) and late-stage aMCI (below −1.5 SD) groups. Risk of AD conversion and changes in neuropsychological performances according to the level of education were evaluated.

Results: Sixty-two patients converted to AD over a mean follow-up of 1.43 years. The risk of AD conversion was higher in late-stage aMCI than early-stage aMCI. Cox proportional hazard models showed that aMCI participants, and late-stage aMCI participants in particular, with higher levels of education had a higher risk of AD conversion than those with lower levels of education. Late-stage aMCI participants with higher education showed faster cognitive decline in language, memory, and Clinical Dementia Rating Sum of Boxes (CDR-SOB) scores. On the contrary, early-stage aMCI participants with higher education showed slower cognitive decline in MMSE and CDR-SOB scores.

Conclusions: Our findings suggest that the protective effects of education against cognitive decline remain in early-stage aMCI and disappear in late-stage aMCI.

Keywords

educationmild cognitive impairmentAlzheimer's diseasecognitive reserve
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 4 , April 2013 , pp. 597 - 606
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Ahn, H. J.et al. (2010). Seoul Neuropsychological Screening Battery-dementia version (SNSB-D): a useful tool for assessing and monitoring cognitive impairments in dementia patients. Journal of Korean Medical Science, 25, 1071–1076.CrossRefGoogle ScholarPubMed
Ahn, H. J.et al. (2011). The cortical neuroanatomy of neuropsychological deficits in mild cognitive impairment and Alzheimer's disease: a surface-based morphometric analysis. Neuropsychologia, 49, 3931–3945.CrossRefGoogle ScholarPubMed
Aisen, P. S.et al. (2010). Clinical Core of the Alzheimer's Disease Neuroimaging Initiative: progress and plans. Alzheimer's & Dementia, 6, 239–246.CrossRefGoogle Scholar
Amieva, H.et al. (2005). The 9 year cognitive decline before dementia of the Alzheimer type: a prospective population-based study. Brain, 128, 1093–1101.CrossRefGoogle ScholarPubMed
Ardila, A., Ostrosky-Solis, F., Rosselli, M. and Gomez, C. (2000). Age-related cognitive decline during normal aging: the complex effect of education. Archives of Clinical Neuropsychology, 15, 495–513.Google ScholarPubMed
Barnes, D. E. and Yaffe, K. (2011). The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurology, 10, 819–828.CrossRefGoogle ScholarPubMed
Bruandet, A.et al. (2008). Cognitive decline and survival in Alzheimer's disease according to education level. Dementia and Geriatric Cognitive Disorder, 25, 74–80.CrossRefGoogle ScholarPubMed
Burggren, A. C.et al. (2008). Reduced cortical thickness in hippocampal subregions among cognitively normal apolipoprotein E e4 carriers. Neuroimage, 41, 1177–1183.CrossRefGoogle ScholarPubMed
Christensen, K. J., Multhaup, K. S., Nordstrom, S. K., and Voss, K. A. (1991). A cognitive battery for dementia: development and measurement characteristics. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3, 168–174.CrossRefGoogle Scholar
Ellis, K. A.et al. (2009). The Australian Imaging, Biomarkers and Lifestyle (AIBL) study of aging: methodology and baseline characteristics of 1112 individuals recruited for a longitudinal study of Alzheimer's disease. International Psychogeriatrics, 21, 672–687.CrossRefGoogle ScholarPubMed
Evans, D. A.et al. (1993). Level of education and change in cognitive function in a community population of older persons. Annals of Epidemiology, 3, 71–77.CrossRefGoogle Scholar
Fratiglioni, L. and Wang, H. X. (2007). Brain reserve hypothesis in dementia. Journal of Alzheimer's Disease, 12, 11–22.CrossRefGoogle ScholarPubMed
Garibotto, V.et al. (2008). Education and occupation as proxies for reserve in aMCI converters and AD: FDG-PET evidence. Neurology, 71, 1342–1349.CrossRefGoogle Scholar
Gauthier, S.et al. (2006). Mild cognitive impairment. Lancet, 367, 1262–1270.CrossRefGoogle ScholarPubMed
Kang, Y. and Na, D. L. (2003). Seoul Neuropsychological Screening Battery (SNSB). Incheon, South Korea: Human Brain Research & Consulting Co.Google Scholar
Kang, Y., Chin, J., Na, D. L., Lee, J. and Park, J. (2000). Brief report: a normative study of the Korean version of Controlled Oral Word Association Test (COWAT) in the elderly. The Korean Journal of Clinical Psychology, 19, 385–392.Google Scholar
Kang, Y., Chin, J. and Na, D. L. (2002). A normative study of the Digit Span Test for the elderly. The Korean Journal of Clinical Psychology, 21, 911–922.Google Scholar
Kim, H. and Na, D. L. (1999). Normative data on the Korean version of the Boston Naming Test. Journal of Clinical and Experimental Neuropsychology, 21, 127–133.CrossRefGoogle ScholarPubMed
Lee, J., Kang, Y. and Na, D. L. (2000). Efficiencies of stroop interference indexes in healthy older adults and dementia patients. The Korean Journal of Clinical Psychology, 19, 807–818.Google Scholar
Lyketsos, C. G., Chen, L. S. and Anthony, J. C. (1999). Cognitive decline in adulthood: an 11.5-year follow-up of the Baltimore Epidemiologic Catchment Area study. Americal Journal of Psychiatry, 156, 58–65.CrossRefGoogle ScholarPubMed
Manly, J. J., Schupf, N., Tang, M. X. and Stern, Y. (2005). Cognitive decline and literacy among ethnically diverse elders. Journal of Geriatric Psychiatry and Neurology, 18, 213–217.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Park, H. K.et al. (2011). Clinical characteristics of a nationwide hospital-based registry of mild-to-moderate Alzheimer's disease patients in Korea: a CREDOS (Clinical Research Center for Dementia of South Korea) study. Journal of Korean Medical Scince, 26, 1219–1226.CrossRefGoogle ScholarPubMed
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303–308.CrossRefGoogle ScholarPubMed
Scarmeas, N., Albert, S. M., Manly, J. J. and Stern, Y. (2006). Education and rates of cognitive decline in incident Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 77, 308–316.CrossRefGoogle ScholarPubMed
Sole-Padulles, C.et al. (2009). Brain structure and function related to cognitive reserve variables in normal aging, mild cognitive impairment and Alzheimer's disease. Neurobiological Aging, 30, 1114–1124.CrossRefGoogle ScholarPubMed
Stern, Y. (2006). Cognitive reserve and Alzheimer disease. Alzheimer Disease and Associated Disorders, 20, S69–74.CrossRefGoogle ScholarPubMed
Stern, Y., Albert, S., Tang, M. X. and Tsai, W. Y. (1999). Rate of memory decline in AD is related to education and occupation: cognitive reserve? Neurology, 53, 1942–1947.CrossRefGoogle ScholarPubMed
Stern, Y., Gurland, B., Tatemichi, T. K., Tang, M. X., Wilder, D. and Mayeux, R. (1994). Influence of education and occupation on the incidence of Alzheimer's disease. JAMA, 271, 1004–1010.CrossRefGoogle ScholarPubMed
Teri, L., McCurry, S. M., Edland, S. D., Kukull, W. A. and Larson, E. B. (1995). Cognitive decline in Alzheimer's disease: a longitudinal investigation of risk factors for accelerated decline. The Journals of Gerontology, Series A, Biological Science and Medical Sciences, 50A, M49–55.CrossRefGoogle ScholarPubMed
Wilson, R. S., Hebert, L. E., Scherr, P. A., Barnes, L. L., Mendes de Leon, C. F. and Evans, D. A. (2009). Educational attainment and cognitive decline in old age. Neurology, 72, 460–465.CrossRefGoogle ScholarPubMed
Winblad, B.et al. (2004). Mild cognitive impairment–beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240–246.CrossRefGoogle Scholar
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