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Higher education affects accelerated cortical thinning in Alzheimer's disease: a 5-year preliminary longitudinal study

Published online by Cambridge University Press:  16 September 2014

Hanna Cho
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
Seun Jeon
Affiliation:
Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
Changsoo Kim
Affiliation:
Department of Preventive Medicine and the Institute for Environmental Research
Byoung Seok Ye
Affiliation:
Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
Geon Ha Kim
Affiliation:
Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
Young Noh
Affiliation:
Department of Neurology, Gachon University Gil Medical Center, Incheon, South Korea
Hee Jin Kim
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Cindy W Yoon
Affiliation:
Department of Neurology, Inha University School of Medicine, Incheon, South Korea
Yeo Jin Kim
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Jung-Hyun Kim
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Sang Eon Park
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Sung Tae Kim
Affiliation:
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Jong-Min Lee
Affiliation:
Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
Sue J. Kang
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Mee Kyung Suh
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Juhee Chin
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Duk L. Na
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Dae Ryong Kang
Affiliation:
Biostatics of Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
Sang Won Seo*
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
*
Correspondence should be addressed to: Sang Won Seo, MD, PhD Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, South Korea. Phone: +82-2-3410-1233; Fax: +82-2-3410-0052. Email: sangwonseo@empal.com.

Abstract

Background:

Epidemiological studies have reported that higher education (HE) is associated with a reduced risk of incident Alzheimer's disease (AD). However, after the clinical onset of AD, patients with HE levels show more rapid cognitive decline than patients with lower education (LE) levels. Although education level and cognition have been linked, there have been few longitudinal studies investigating the relationship between education level and cortical decline in patients with AD. The aim of this study was to compare the topography of cortical atrophy longitudinally between AD patients with HE (HE-AD) and AD patients with LE (LE-AD).

Methods:

We prospectively recruited 36 patients with early-stage AD and 14 normal controls. The patients were classified into two groups according to educational level, 23 HE-AD (>9 years) and 13 LE-AD (≤9 years).

Results:

As AD progressed over the 5-year longitudinal follow-ups, the HE-AD showed a significant group-by-time interaction in the right dorsolateral frontal and precuneus, and the left parahippocampal regions compared to the LE-AD.

Conclusion:

Our study reveals that the preliminary longitudinal effect of HE accelerates cortical atrophy in AD patients over time, which underlines the importance of education level for predicting prognosis.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

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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, 10711076. doi:10.3346/jkms.2010.25.7.1071.CrossRefGoogle ScholarPubMed
Alexander, G. E., et al. (1997). Association of premorbid intellectual function with cerebral metabolism in Alzheimer's disease: implications for the cognitive reserve hypothesis. American Journal of Psychiatry, 154, 165172.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.Google Scholar
Andel, R., Vigen, C., Mack, W. J., Clark, L. J. and Gatz, M. (2006). The effect of education and occupational complexity on rate of cognitive decline in Alzheimer's patients. Journal of the International Neuropsychological Society, 12, 147152. doi:10.1017/s1355617706060206.Google Scholar
Bruandet, A., et al. (2008). Cognitive decline and survival in Alzheimer's disease according to education level. Dementia and Geriatric Cognitive Disorders, 25, 7480. doi:10.1159/000111693.Google Scholar
Cho, H., et al. (2013a). Longitudinal changes of cortical thickness in early- versus late-onset Alzheimer's disease. Neurobiology of Aging, 34, 1921 e1929–1921 e1915. doi:10.1016/j.neurobiolaging.2013.01.004.Google Scholar
Cho, H., et al. (2013b). Changes in subcortical structures in early- versus late-onset Alzheimer's disease. Neurobiology of Aging, 34, 17401747. doi:10.1016/j.neurobiolaging.2013.01.001.Google Scholar
Evans, D. A., et al. (1997). Education and other measures of socioeconomic status and risk of incident Alzheimer disease in a defined population of older persons. Archives of Neurology, 54, 13991405.Google Scholar
Fitzmaurice, G. M., Laird, N. M. and Ware, J. H. (2012). Applied Longitudinal Analysis. Hoboken, N.J.: John Wiley & Sons.Google Scholar
Genovese, C. R., Lazar, N. A. and Nichols, T. (2002). Thresholding of statistical maps in functional neuroimaging using the false discovery rate. NeuroImage, 15, 870878. doi:10.1006/nimg.2001.1037.Google Scholar
Hanyu, H., Sato, T., Shimizu, S., Kanetaka, H., Iwamoto, T. and Koizumi, K. (2008). The effect of education on rCBF changes in Alzheimer's disease: a longitudinal SPECT study. European Journal of Nuclear Medicine and Molecular Imaging, 35, 21822190. doi:10.1007/s00259-008-0848-4.Google Scholar
Julkunen, V., et al. (2010). Differences in cortical thickness in healthy controls, subjects with mild cognitive impairment, and Alzheimer's disease patients: a longitudinal study. Journal of Alzheimer's Disease, 21, 11411151.CrossRefGoogle ScholarPubMed
Kang, Y. and Na, D. L. (2003). Seoul Neuropsychological Screening Battery (SNSB). Incheon, South Korea: Human Brain Research & Consulting Co.Google Scholar
Kemppainen, N. M., et al. (2008). Cognitive reserve hypothesis: Pittsburgh compound B and fluorodeoxyglucose positron emission tomography in relation to education in mild Alzheimer's disease. Annals of Neurology, 63, 112118. doi:10.1002/ana.21212.Google Scholar
Lerch, J. P. and Evans, A. C. (2005). Cortical thickness analysis examined through power analysis and a population simulation. NeuroImage, 24, 163173. doi:10.1016/j.neuroimage.2004.07.045.Google Scholar
Letenneur, L., Commenges, D., Dartigues, J. F. and Barberger-Gateau, P. (1994). Incidence of dementia and Alzheimer's disease in elderly community residents of south-western France. International Journal of Epidemiology, 23, 12561261.Google Scholar
Liao, Y. C., et al. (2005). Cognitive reserve: a SPECT study of 132 Alzheimer's disease patients with an education range of 0–19 years. Dementia and Geriatric Cognitive Disorders, 20, 814. doi:10.1159/000085068.Google Scholar
Liu, Y., et al. (2012). Education increases reserve against Alzheimer's disease–evidence from structural MRI analysis. Neuroradiology, 54, 929938. doi:10.1007/s00234-012-1005-0.Google Scholar
McKeith, I. G., et al. (2005). Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology, 65, 18631872. doi:10.1212/01.wnl.0000187889.17253.b1.Google Scholar
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, 939944.CrossRefGoogle ScholarPubMed
Mirra, S. S., et al. (1991). The consortium to establish a registry for Alzheimer's disease (CERAD). Part II. Standardization of the neuropathologic assessment of Alzheimer's disease. Neurology, 41, 479486.Google Scholar
Neary, D., et al. (1998). Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology, 51, 15461554.Google Scholar
Qiu, C., Backman, L., Winblad, B., Aguero-Torres, H. and Fratiglioni, L. (2001). The influence of education on clinically diagnosed dementia incidence and mortality data from the Kungsholmen Project. Archives of Neurology, 58, 20342039.Google Scholar
Querbes, O., et al. (2009). Early diagnosis of Alzheimer's disease using cortical thickness: impact of cognitive reserve. Brain, 132, 20362047. doi:10.1093/brain/awp105.CrossRefGoogle ScholarPubMed
Roman, G. C., et al. (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology, 43, 250260.Google Scholar
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, 308316. doi:10.1136/jnnp.2005.072306.Google Scholar
Scarmeas, N. and Stern, Y. (2004). Cognitive reserve: implications for diagnosis and prevention of Alzheimer's disease. Current Neurology and Neuroscience Reports, 4, 374380.Google Scholar
Scarmeas, N., et al. (2003). Association of life activities with cerebral blood flow in Alzheimer disease: implications for the cognitive reserve hypothesis. Archives of Neurology, 60, 359365.Google Scholar
Seo, S. W., et al. (2011). Effects of demographic factors on cortical thickness in Alzheimer's disease. Neurobiology of Aging, 32, 200209. doi:10.1016/j.neurobiolaging.2009.02.004.Google Scholar
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8, 448460.Google Scholar
Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47, 20152028. doi:10.1016/j.neuropsychologia.2009.03.004.Google Scholar
Stern, Y. (2012). Cognitive reserve in ageing and Alzheimer's disease. Lancet Neurology, 11, 10061012. doi:10.1016/s1474-4422(12)70191-6.Google Scholar
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, 19421947.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. Journal of the American Medical Association, 271, 10041010.Google Scholar
Verbeke, G. and Molenberghs, G. (2000). Linear Mixed Models for Longitudinal Data. New York: Springer.Google Scholar
Wilson, R. S., Bennett, D. A., Gilley, D. W., Beckett, L. A., Barnes, L. L. and Evans, D. A. (2000). Premorbid reading activity and patterns of cognitive decline in Alzheimer disease. Archives of Neurology, 57, 17181723.Google Scholar
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