Very low levels of education and cognitive reserve: A clinicopathologic study
OBJECTIVE:We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could contribute to cognitive reserve and modify the relation of neuropathologic indices to dementia. METHODS:In this cross-sectional study, we in...
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| Published in: | Neurology Vol. 81; no. 7; pp. 650 - 657 |
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| Main Authors: | , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Hagerstown, MD
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13-08-2013
Lippincott Williams & Wilkins |
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| Abstract | OBJECTIVE:We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could contribute to cognitive reserve and modify the relation of neuropathologic indices to dementia.
METHODS:In this cross-sectional study, we included 675 individuals 50 years of age or older from the Brazilian Aging Brain Study Group. Cognitive abilities were evaluated through a structured interview with an informant at the time of autopsy, including the Clinical Dementia Rating (CDR) scale. Neuropathologic examinations were performed using immunohistochemistry and following internationally accepted criteria. Multivariate linear regression models were conducted to determine whether the association between cognitive abilities (measured by CDR sum of boxes) and years of education was independent of sociodemographic variables and neuropathologic indices, including neuritic plaques, neurofibrillary tangles, lacunar infarctions, small-vessel disease, and Lewy bodies. In addition, interaction models were used to examine whether education modified the relation between neuropathologic indices and cognition.
RESULTS:Mean education was 3.9 ± 3.5 years. Formal education was associated with a lower CDR sum of boxes (β = −0.197; 95% confidence interval −0.343, −0.052; p = 0.008), after adjustment for sociodemographic variables and neuropathologic indices. Furthermore, education modified the relationship of lacunar infarcts with cognitive abilities (p = 0.04).
CONCLUSIONS:Even a few years of formal education contributes to cognitive reserve. |
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| AbstractList | We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could contribute to cognitive reserve and modify the relation of neuropathologic indices to dementia.
In this cross-sectional study, we included 675 individuals 50 years of age or older from the Brazilian Aging Brain Study Group. Cognitive abilities were evaluated through a structured interview with an informant at the time of autopsy, including the Clinical Dementia Rating (CDR) scale. Neuropathologic examinations were performed using immunohistochemistry and following internationally accepted criteria. Multivariate linear regression models were conducted to determine whether the association between cognitive abilities (measured by CDR sum of boxes) and years of education was independent of sociodemographic variables and neuropathologic indices, including neuritic plaques, neurofibrillary tangles, lacunar infarctions, small-vessel disease, and Lewy bodies. In addition, interaction models were used to examine whether education modified the relation between neuropathologic indices and cognition.
Mean education was 3.9 ± 3.5 years. Formal education was associated with a lower CDR sum of boxes (β = -0.197; 95% confidence interval -0.343, -0.052; p = 0.008), after adjustment for sociodemographic variables and neuropathologic indices. Furthermore, education modified the relationship of lacunar infarcts with cognitive abilities (p = 0.04).
Even a few years of formal education contributes to cognitive reserve. OBJECTIVEWe conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could contribute to cognitive reserve and modify the relation of neuropathologic indices to dementia. METHODSIn this cross-sectional study, we included 675 individuals 50 years of age or older from the Brazilian Aging Brain Study Group. Cognitive abilities were evaluated through a structured interview with an informant at the time of autopsy, including the Clinical Dementia Rating (CDR) scale. Neuropathologic examinations were performed using immunohistochemistry and following internationally accepted criteria. Multivariate linear regression models were conducted to determine whether the association between cognitive abilities (measured by CDR sum of boxes) and years of education was independent of sociodemographic variables and neuropathologic indices, including neuritic plaques, neurofibrillary tangles, lacunar infarctions, small-vessel disease, and Lewy bodies. In addition, interaction models were used to examine whether education modified the relation between neuropathologic indices and cognition. RESULTSMean education was 3.9 ± 3.5 years. Formal education was associated with a lower CDR sum of boxes (β = -0.197; 95% confidence interval -0.343, -0.052; p = 0.008), after adjustment for sociodemographic variables and neuropathologic indices. Furthermore, education modified the relationship of lacunar infarcts with cognitive abilities (p = 0.04). CONCLUSIONSEven a few years of formal education contributes to cognitive reserve. OBJECTIVE:We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could contribute to cognitive reserve and modify the relation of neuropathologic indices to dementia. METHODS:In this cross-sectional study, we included 675 individuals 50 years of age or older from the Brazilian Aging Brain Study Group. Cognitive abilities were evaluated through a structured interview with an informant at the time of autopsy, including the Clinical Dementia Rating (CDR) scale. Neuropathologic examinations were performed using immunohistochemistry and following internationally accepted criteria. Multivariate linear regression models were conducted to determine whether the association between cognitive abilities (measured by CDR sum of boxes) and years of education was independent of sociodemographic variables and neuropathologic indices, including neuritic plaques, neurofibrillary tangles, lacunar infarctions, small-vessel disease, and Lewy bodies. In addition, interaction models were used to examine whether education modified the relation between neuropathologic indices and cognition. RESULTS:Mean education was 3.9 ± 3.5 years. Formal education was associated with a lower CDR sum of boxes (β = −0.197; 95% confidence interval −0.343, −0.052; p = 0.008), after adjustment for sociodemographic variables and neuropathologic indices. Furthermore, education modified the relationship of lacunar infarcts with cognitive abilities (p = 0.04). CONCLUSIONS:Even a few years of formal education contributes to cognitive reserve. Objective: We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could contribute to cognitive reserve and modify the relation of neuropathologic indices to dementia. Methods: In this cross-sectional study, we included 675 individuals 50 years of age or older from the Brazilian Aging Brain Study Group. Cognitive abilities were evaluated through a structured interview with an informant at the time of autopsy, including the Clinical Dementia Rating (CDR) scale. Neuropathologic examinations were performed using immunohistochemistry and following internationally accepted criteria. Multivariate linear regression models were conducted to determine whether the association between cognitive abilities (measured by CDR sum of boxes) and years of education was independent of sociodemographic variables and neuropathologic indices, including neuritic plaques, neurofibrillary tangles, lacunar infarctions, small-vessel disease, and Lewy bodies. In addition, interaction models were used to examine whether education modified the relation between neuropathologic indices and cognition. Results: Mean education was 3.9 + or - 3.5 years. Formal education was associated with a lower CDR sum of boxes ([beta] = -0.197; 95% confidence interval -0.343, -0.052; p = 0.008), after adjustment for sociodemographic variables and neuropathologic indices. Furthermore, education modified the relationship of lacunar infarcts with cognitive abilities (p = 0.04). Conclusions: Even a few years of formal education contributes to cognitive reserve. |
| Author | Pasqualucci, Carlos Augusto Farias, Daniela Souza Grinberg, Lea Tenenholz Tampellini, Edilaine Fregni, Felipe Menezes, Paulo Rossi Lima, Luzia Leite, Renata Elaine Paraizo Suemoto, Claudia Kimie Jacob Filho, Wilson Rodriguez, Roberta Diehl Bennett, David A Farfel, Jose Marcelo Nitrini, Ricardo Neves, Ricardo Caires Ferretti, Renata Eloah Lucena |
| AuthorAffiliation | From the Departments of Geriatrics (J.M.F., C.K.S., W.J.F.), Neurology (R.N.), Pathology (L.T.G., R.D.R., C.A.P.), and Preventive Medicine (P.R.M.), Discipline of Physiopathology (L.T.G., R.E.P.L.), and Brazilian Aging Brain Study Group, LIM-22 (R.E.P.L., E.T., L.L., D.S.F., R.C.N.), University of São Paulo Medical School, São Paulo, Brazil; Memory and Aging Center (L.T.G.), Department of Neurology, University of California, San Francisco; Medical-Surgical Nursing Department (R.E.L.F.), University of São Paulo Nursing School, São Paulo; Instituto Israelita de Ensino e Pesquisa (E.T., L.L., D.S.F.), Hospital Israelita Brasileiro Albert Einstein, São Paulo, Brazil; Departments of Physical Medicine and Rehabilitation and Neurology (F.F.), Harvard Medical School, Boston, MA; and Rush Alzheimerʼs Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL |
| AuthorAffiliation_xml | – name: From the Departments of Geriatrics (J.M.F., C.K.S., W.J.F.), Neurology (R.N.), Pathology (L.T.G., R.D.R., C.A.P.), and Preventive Medicine (P.R.M.), Discipline of Physiopathology (L.T.G., R.E.P.L.), and Brazilian Aging Brain Study Group, LIM-22 (R.E.P.L., E.T., L.L., D.S.F., R.C.N.), University of São Paulo Medical School, São Paulo, Brazil; Memory and Aging Center (L.T.G.), Department of Neurology, University of California, San Francisco; Medical-Surgical Nursing Department (R.E.L.F.), University of São Paulo Nursing School, São Paulo; Instituto Israelita de Ensino e Pesquisa (E.T., L.L., D.S.F.), Hospital Israelita Brasileiro Albert Einstein, São Paulo, Brazil; Departments of Physical Medicine and Rehabilitation and Neurology (F.F.), Harvard Medical School, Boston, MA; and Rush Alzheimerʼs Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL |
| Author_xml | – sequence: 1 givenname: Jose surname: Farfel middlename: Marcelo fullname: Farfel, Jose Marcelo organization: From the Departments of Geriatrics (J.M.F., C.K.S., W.J.F.), Neurology (R.N.), Pathology (L.T.G., R.D.R., C.A.P.), and Preventive Medicine (P.R.M.), Discipline of Physiopathology (L.T.G., R.E.P.L.), and Brazilian Aging Brain Study Group, LIM-22 (R.E.P.L., E.T., L.L., D.S.F., R.C.N.), University of São Paulo Medical School, São Paulo, Brazil; Memory and Aging Center (L.T.G.), Department of Neurology, University of California, San Francisco; Medical-Surgical Nursing Department (R.E.L.F.), University of São Paulo Nursing School, São Paulo; Instituto Israelita de Ensino e Pesquisa (E.T., L.L., D.S.F.), Hospital Israelita Brasileiro Albert Einstein, São Paulo, Brazil; Departments of Physical Medicine and Rehabilitation and Neurology (F.F.), Harvard Medical School, Boston, MA; and Rush Alzheimerʼs Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL – sequence: 2 givenname: Ricardo surname: Nitrini fullname: Nitrini, Ricardo – sequence: 3 givenname: Claudia surname: Suemoto middlename: Kimie fullname: Suemoto, Claudia Kimie – sequence: 4 givenname: Lea surname: Grinberg middlename: Tenenholz fullname: Grinberg, Lea Tenenholz – sequence: 5 givenname: Renata Eloah surname: Ferretti middlename: Lucena fullname: Ferretti, Renata Eloah Lucena – sequence: 6 givenname: Renata Elaine surname: Leite middlename: Paraizo fullname: Leite, Renata Elaine Paraizo – sequence: 7 givenname: Edilaine surname: Tampellini fullname: Tampellini, Edilaine – sequence: 8 givenname: Luzia surname: Lima fullname: Lima, Luzia – sequence: 9 givenname: Daniela surname: Farias middlename: Souza fullname: Farias, Daniela Souza – sequence: 10 givenname: Ricardo surname: Neves middlename: Caires fullname: Neves, Ricardo Caires – sequence: 11 givenname: Roberta surname: Rodriguez middlename: Diehl fullname: Rodriguez, Roberta Diehl – sequence: 12 givenname: Paulo surname: Menezes middlename: Rossi fullname: Menezes, Paulo Rossi – sequence: 13 givenname: Felipe surname: Fregni fullname: Fregni, Felipe – sequence: 14 givenname: David surname: Bennett middlename: A fullname: Bennett, David A – sequence: 15 givenname: Carlos surname: Pasqualucci middlename: Augusto fullname: Pasqualucci, Carlos Augusto – sequence: 16 givenname: Wilson surname: Jacob Filho fullname: Jacob Filho, Wilson |
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| Contributor | Silva, Keila Maria Alho, Ana T Nascimento, Camila F Oliveira, Katia C Molina, Mariana Polichiso, Livia Santos, Glaucia A B Guccione, Eliza de Souza, Camila Alves |
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| Copyright | 2013 by AAN Enterprises, Inc. 2014 INIST-CNRS 2013 American Academy of Neurology 2013 American Academy of Neurology |
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| Snippet | OBJECTIVE:We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could... We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could... OBJECTIVEWe conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could... Objective: We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education... |
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| SubjectTerms | Aged Biological and medical sciences Brain - pathology Cognitive Reserve - physiology Cross-Sectional Studies Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes Educational Status Female Humans Immunohistochemistry Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Neuropsychological Tests |
| Title | Very low levels of education and cognitive reserve: A clinicopathologic study |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/23873971 https://search.proquest.com/docview/1443383672 https://search.proquest.com/docview/1544008849 https://pubmed.ncbi.nlm.nih.gov/PMC3775692 |
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