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Effects of education on the progression of early- versus late-stage mild cognitive impairment.
MedLine Citation:
PMID:  23207181     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT Background: Highly educated participants with normal cognition show lower incidence of Alzheimer's disease (AD) than poorly educated participants, whereas longitudinal studies involving AD have reported that higher education is associated with more rapid cognitive decline. We aimed to evaluate whether highly educated amnestic mild cognitive impairment (aMCI) participants show more rapid cognitive decline than those with lower levels of education. Methods: A total of 249 aMCI patients enrolled from 31 memory clinics using the standard assessment and diagnostic processes were followed with neuropsychological evaluation (duration 17.2 ± 8.8 months). According to baseline performances on memory tests, participants were divided into early-stage aMCI (-1.5 to -1.0 standard deviation (SD)) and late-stage aMCI (below -1.5 SD) groups. Risk of AD conversion and changes in neuropsychological performances according to the level of education were evaluated. Results: Sixty-two patients converted to AD over a mean follow-up of 1.43 years. The risk of AD conversion was higher in late-stage aMCI than early-stage aMCI. Cox proportional hazard models showed that aMCI participants, and late-stage aMCI participants in particular, with higher levels of education had a higher risk of AD conversion than those with lower levels of education. Late-stage aMCI participants with higher education showed faster cognitive decline in language, memory, and Clinical Dementia Rating Sum of Boxes (CDR-SOB) scores. On the contrary, early-stage aMCI participants with higher education showed slower cognitive decline in MMSE and CDR-SOB scores. Conclusions: Our findings suggest that the protective effects of education against cognitive decline remain in early-stage aMCI and disappear in late-stage aMCI.
Authors:
Byoung Seok Ye; Sang Won Seo; Hanna Cho; Seong Yoon Kim; Jung-Sun Lee; Eun-Joo Kim; Yunhwan Lee; Joung Hwan Back; Chang Hyung Hong; Seong Hye Choi; Kyung Won Park; Bon D Ku; So Young Moon; Sangyun Kim; Seol-Heui Han; Jae-Hong Lee; Hae-Kwan Cheong; Duk L Na
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-4
Journal Detail:
Title:  International psychogeriatrics / IPA     Volume:  -     ISSN:  1741-203X     ISO Abbreviation:  Int Psychogeriatr     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007918     Medline TA:  Int Psychogeriatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-10     Citation Subset:  -    
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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