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Comparison of Education and Episodic Memory as Modifiers of Brain Atrophy Effects on Cognitive Decline: Implications for Measuring Cognitive Reserve

Published online by Cambridge University Press:  18 January 2021

Dan Mungas Open the ORCID record for Dan Mungas [Opens in a new window] ,
Evan Fletcher ,
Brandon E. Gavett Open the ORCID record for Brandon E. Gavett [Opens in a new window] ,
Keith Widaman ,
Laura B. Zahodne Open the ORCID record for Laura B. Zahodne [Opens in a new window] ,
Timothy J. Hohman ,
Elizabeth Rose Mayeda ,
N. Maritza Dowling ,
David K. Johnson  and
Sarah Tomaszewski Farias
Dan Mungas*
Affiliation:
Department of Neurology, University of California, Davis, 4860 Y Street, Sacramento, CA95817, USA
Evan Fletcher
Affiliation:
Department of Neurology, University of California, Davis, 1544 Newton Court, Davis, CA95616, USA
Brandon E. Gavett
Affiliation:
Department of Psychology, University of Western Australia, School of Psychological Science (M304), 35 Stirling Hwy, Perth, WA6009, Australia
Keith Widaman
Affiliation:
Graduate School of Education, University of California, Riverside, 1207 Sproul Hall, 900 University Avenue, Riverside, CA92521, USA
Laura B. Zahodne
Affiliation:
Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI48109, Australia
Timothy J. Hohman
Affiliation:
Department of Neurology, Vanderbilt University, Vanderbilt Memory & Alzheimer’s Center, 1207 17th Ave South, Suite 204F, Nashville, TN37212, USA
Elizabeth Rose Mayeda
Affiliation:
Department of Epidemiology, University of California, Los Angeles, UCLA Pub Hlth - Epidemiology, BOX 951772, 46-070B CHS, Los Angeles, CA90095, USA
N. Maritza Dowling
Affiliation:
Department of Acute & Chronic Care, The George Washington School of Nursing, 1919 Pennsylvania Street NW, Suite 500, Washington, DC20006, USA
David K. Johnson
Affiliation:
Department of Neurology, University of California, Davis, 100 N. Wiget Lane, Suite 150, Walnut Creek, CA94598, USA
Sarah Tomaszewski Farias
Affiliation:
Department of Neurology, University of California, Davis, 4860 Y Street, Sacramento, CA95817, USA
*
*Correspondence and reprint requests to: Dan Mungas, Department of Neurology, UC Davis Medical Center, 4860 Y Street, Suite 3900, Sacramento, CA 95817, USA. E-mail: dmmungas@ucdavis.edu
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Abstract

Objective:

This study compared the level of education and tests from multiple cognitive domains as proxies for cognitive reserve.

Method:

The participants were educationally, ethnically, and cognitively diverse older adults enrolled in a longitudinal aging study. We examined independent and interactive effects of education, baseline cognitive scores, and MRI measures of cortical gray matter change on longitudinal cognitive change.

Results:

Baseline episodic memory was related to cognitive decline independent of brain and demographic variables and moderated (weakened) the impact of gray matter change. Education moderated (strengthened) the gray matter change effect. Non-memory cognitive measures did not incrementally explain cognitive decline or moderate gray matter change effects.

Conclusions:

Episodic memory showed strong construct validity as a measure of cognitive reserve. Education effects on cognitive decline were dependent upon the rate of atrophy, indicating education effectively measures cognitive reserve only when atrophy rate is low. Results indicate that episodic memory has clinical utility as a predictor of future cognitive decline and better represents the neural basis of cognitive reserve than other cognitive abilities or static proxies like education.

Keywords

Agingcognitive changeEducationCognitive reserveMRIGray matter changeCognitive declineBrain atrophy
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 27 , Issue 5 , May 2021 , pp. 401 - 411
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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