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Intelectual demand and formal education as cognitive protection factors in Alzheimer's disease.

ABSTRACT: To investigate the possible association between educational level and previous professional occupation, and objective cognitive and functional evaluation in a sample of elderly patients with Alzheimer's disease. Methods:Through retrospective analysis of medical files, 174 patients with probable Alzheimer disease were randomly selected, classified and submitted to analysis according to previous professional occupation and years of formal education. Results:Subjects with lower education and less intellectually-demanding occupations performed worse than higher educated subjects in all cognitive subtests and on the functional scale. Conclusions:Results indicate that not only the total years of education, but also professional occupation has an impact on cognition and functioning in accordance with the hypothesis of cognitive reserve. Our findings confirmed this hypothesis, where subjects with higher education/ higher intellectual demand manifested first symptoms later than low education/ low intellectual demand subjects, with the latter group also exhibiting faster disease progression.

SUBMITTER: Wajman JR

PROVIDER: S-EPMC5619066 | biostudies-literature | 2010 Oct-Dec

REPOSITORIES: biostudies-literature

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Intelectual demand and formal education as cognitive protection factors in Alzheimer's disease.

Wajman José Roberto JR Bertolucci Paulo Henrique Ferreira F PHFF

Dementia & neuropsychologia 20101001 4

To investigate the possible association between educational level and previous professional occupation, and objective cognitive and functional evaluation in a sample of elderly patients with Alzheimer's disease.<h4>Methods</h4>Through retrospective analysis of medical files, 174 patients with probable Alzheimer disease were randomly selected, classified and submitted to analysis according to previous professional occupation and years of formal education.<h4>Results</h4>Subjects with lower educat ...[more]

PMID: 29213705

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Project description:IntroductionThe objective of this study was to determine the factors including neuropsychological test performances and cerebrospinal fluid (CSF) biomarkers which can predict disease progression of early Alzheimer's disease (AD) in a Japanese population.MethodsThe group classification on early AD population in both Japanese Alzheimer's Disease Neuroimaging Initiative (J-ADNI) and North American ADNI (NA-ADNI) was performed using the inclusion criteria including brain amyloid positivity on positron emission tomography or CSF. Participants with early AD from each cohort were stratified into two groups based on a cutoff 1.0 of Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) change at month 24 (m24): participants in "progress group" have CDR-SB change ≥ 1.0 and participants in "stable group" have CDR-SB change < 1.0. Then, we performed identification of prognostic factors from baseline items including neuropsychological scores (Assessment Scale-Cognitive Subscale[ADAS-cog 13], Mini-Mental State Examination (MMSE), CDR, FAQ, and Geriatric Depression Scale ), CSF markers (t-tau, p-tau, and beta-amyloid 1-42), vital signs (body weight, pulse rate, etc.,), by using two statistical approaches, Welch's t-test and simple linear regression by ordinary least squares. Comparisons between participants with J-ADNI and participants with NA-ADNI were also performed.ResultsTrends of CDR-SB changes were very similar between J-ADNI and NA-ADNI early AD population enrolled in this study. Baseline levels of CSF t-tau, p-tau, Mini-Mental State Examination, FAQ, and ADAS-cog13 were identified as prognostic factors in both J-ADNI and NA-ADNI. Based on a detailed subscale analysis on ADAS-cog13, four subscales (Q1: word recall, Q3: construction, Q4: delayed word recall, and Q8: word recognition) were identified as prognostic factors in both J-ADNI and NA-ADNI.DiscussionCharacterizing population with early AD can provide benefits for promoting efficiency in conducting AD clinical trials for disease-modifying treatments. Thus, implementing these prognostic factors into clinical trials may be potentially a good method to enrich participants with early AD who are suitable for evaluating treatment effects.

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Intelectual demand and formal education as cognitive protection factors in Alzheimer's disease.

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Intelectual demand and formal education as cognitive protection factors in Alzheimer's disease.

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