Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov;20(11):7686-7697.
doi: 10.1002/alz.14236. Epub 2024 Sep 10.

Factors associated with cognitive reserve according to education level

Yeshin Kim  1 , Yaakov Stern  2 , Sang Won Seo  3   4   5 , Duk L Na  3   6 , Jae-Won Jang  1 , Hyemin Jang  7 ; Cognitive Reserve Research Group of Korea Dementia Association
Collaborators, Affiliations

Factors associated with cognitive reserve according to education level

Yeshin Kim et al. Alzheimers Dement. 2024 Nov.

Abstract

Introduction: We investigated distinctive factors associated with cognitive reserve (CR) based on education level.

Methods: Among 1247 participants who underwent neuropsychological assessment, amyloid positron emission tomography, and brain magnetic resonance imaging, 336 participants with low education (≤6 years) and 697 with high education (≥12 years) were selected. CR was measured as the difference between the predicted and observed value of cognitive function based on cortical thickness. Multiple linear regression was conducted in each group after controlling for age and sex.

Results: In the low-education group, low literacy, long sleep duration(>8 h/day), and diabetes were negatively associated with CR, whereas cognitive and physical activity were positively associated with CR. In the high-education group, cognitive activity was positively related to CR, whereas low literacy, long sleep duration (> 8 h/day), and depression were negatively related to CR.

Discussion: This study provides insights into different strategies for enhancing CR based on educational background.

Highlights: Factors associated with cognitive reserve (CR) varied according to the education level. Diabetes and physical activity were associated with CR in the low-education group. Depression was related to CR in the high-education group. Low literacy, sleep duration, and cognitive activity were associated with CR in both groups. Dementia-prevention strategies should be tailored according to educational level.

Keywords: Alzheimer's disease; cognitive reserve; education; risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
Flow diagram for study participants ADD, Alzheimer's disease dementia; CU, cognitively unimpaired; MCI, mild cognitive impairment.
FIGURE 2
FIGURE 2
Measurement of cognitive reserve. Cognitive reserve (= CR_rsd) was defined as the difference between the observed and predicted value of cognitive composite score (residuals) from the regression on cortical thickness (Cth) after adjusting for age, sex, and global amyloid uptake represented by Centiloid value.
FIGURE 3
FIGURE 3
Representative cases. Representative cases from Figure 2 are depicted. Amyloid uptake is represented by Centiloid value.
See this image and copyright information in PMC

References

    1. Kang SH, Kim ME, Jang H, et al. Amyloid positivity in Alzheimer/subcortical‐vascular spectrum. Neurology. 2021/03/17 ed. Epub 2021 Mar 15.
    1. Liu CC, Li CY, Sun Y, Hu SC. Gender and age differences and the trend in the incidence and prevalence of dementia and Alzheimer's disease in Taiwan: a 7‐year national population‐based study. Biomed Res Int. 2019;2019:5378540. 20191111th ed.. - PMC - PubMed
    1. Jack CR, Wiste HJ, Vemuri P, et al. Brain beta‐amyloid measures and magnetic resonance imaging atrophy both predict time‐to‐progression from mild cognitive impairment to Alzheimer's disease. Brain. 2010;133:3336‐3348. - PMC - PubMed
    1. Sperling RA, Aisen PS, Beckett LA, et al. Toward defining the preclinical stages of Alzheimer's disease: recommendations from the National Institute on Aging‐Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:280‐292. - PMC - PubMed
    1. Stern Y, Arenaza‐Urquijo EM, Bartrés‐Faz D, et al. Whitepaper: defining and investigating cognitive reserve, brain reserve, and brain maintenance. Alzheimers Dement. 2020;16:1305‐1311. - PMC - PubMed