Levels of Education Affect Rates of Decline in Dementia

Onset delayed by more education, but acceleration after diagnosis is more rapid

TUESDAY, Oct. 23 (HealthDay News) -- The onset of cognitive decline due to Alzheimer's disease and other forms of dementia occurs more slowly in people with higher levels of education, but accelerates more rapidly once dementia is diagnosed, according to research published in the Oct. 23 issue of Neurology.

Charles B. Hall, Ph.D., of the Albert Einstein College of Medicine, Bronx, N.Y., and colleagues conducted annual assessments of 117 individuals in the Bronx Aging Study, who were cognitively normal at baseline but who developed some form of dementia. Subjects were mostly white (90 percent), mostly female (64.5 percent) and between 75 and 85 years old at enrollment between 1980 and 1983. Median follow-up before diagnosis of dementia was 5.6 years.

At baseline, lower levels of formal education were associated with poorer performance on memory, verbal fluency and selective reminding tests. Based on change point models, each additional year of formal education delayed the time of accelerated decline by 0.21 years. Once the change point had been reached, each year of formal education increased the rate of memory decline by 0.10 points per year.

"As predicted by the cognitive reserve hypothesis, higher education delays the onset of accelerated cognitive decline; once it begins it is more rapid in persons with more education," the authors conclude.

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