Influence of Educational Attainment on Cognition-Based Intervention Programs for Persons with Mild Alzheimer's Disease

Abstract

Objectives: This research retrospectively analyzed the effect of education on cognitive interventions carried out in patients with mild Alzheimer's disease (AD).

Methods: The total sample consisted of 75 patients with mild AD receiving treatment with cholinesterase inhibitors. The participants were divided into two groups: cognitive intervention (IG; n=45) and waiting list (WLG; n=30). Patients in the IG received either the Big Brain Academy (n=15) or the Integrated Psychostimulation Program (n=30) during 12 weeks. The influence of education on intervention effect was analyzed comparing mean change scores of the two study groups in the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog), stratified by educational level. The potential effect of age, sex, cognitive status, and type of intervention was examined using post hoc stratification analyses.

Results: Higher education was associated with faster cognitive decline in the WLG (effect size=0.51; p<.01). However, cognitive evolution was not influenced by education in the IG (effect size=0.12; p=.42).

Conclusions: Our results suggest that cognitive intervention might delay accelerated cognitive decline in higher educated individuals with mild AD.

Keywords: Alzheimer’s disease; Cognitive intervention; Cognitive reserve; Dementia; Educational attainment; Psychosocial approaches.