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. 2025 Dec 22.
doi: 10.1007/s00702-025-03074-z. Online ahead of print.

Influence of the level of education on cognitive function in Parkinson's disease

Diego Santos-García  1   2   3 , Teresa de Deus Fonticoba  4 , Carlos Cores Bartolomé  5   6 , María Cristina Íñiguez Alvarado  5   6 , Lucía Samaniego  5   6 , Antón López Maside  5 , Lucía Gallego  5 , Laura Couce Barreiro  5 , Javier Rodríguez Caramés  5 , Maria J Feal Painceiras  5 , Jose Manuel Paz González  5   6 , Silvia Jesús  7   8 , Marina Cosgaya  9 , Juan García Caldentey  10 , Nuria Caballol  11 , Ines Legarda  12 , Jorge Hernández Vara  8   13 , Iria Cabo  14 , Lydia López Manzanares  15 , Isabel González Aramburu  8   16 , Maria A Ávila Rivera  17 , Víctor Gómez Mayordomo  18 , Víctor Nogueira  19 , Julio Dotor García-Soto  20 , Carmen Borrué  21 , Berta Solano Vila  22 , María Álvarez Sauco  23 , Lydia Vela  24 , Sonia Escalante  25 , Esther Cubo  26 , Zebenzui Mendoza  27 , Isabel Pareés  28 , Pilar Sánchez Alonso  29 , Maria G Alonso Losada  30 , Nuria López Ariztegui  31 , Itziar Gastón  32 , Jaime Kulisevsky  8   33 , Manuel Seijo  14 , Caridad Valero  34 , Ruben Alonso Redondo  19 , Maria Teresa Buongiorno  35 , Carlos Ordás  36 , Manuel Menéndez-González  37 , Darrian McAfee  38 , Pablo Martinez-Martin  8 , Pablo Mir  7   8   39 ; COPPADIS Study Group
Collaborators, Affiliations

Influence of the level of education on cognitive function in Parkinson's disease

Diego Santos-García et al. J Neural Transm (Vienna). .

Abstract

Level of Education (LoE) is widely used as an indicator of cognitive reserve and is associated with risk of dementia. The aim of the present study was to know the influence of the LoE on cognitive function (CF) in patients with Parkinson´s disease (PD). Controls and PD patients from the Spanish cohort COPPADIS with a disease duration from symptoms onset ≤ 5 years, who were recruited from January/2016 to November/2017 (baseline visit; V0) and evaluated at 2 (V2), 4 (V4) and 5 (V5) years of follow-up were included. Regarding LoE, patients were classified as with primary, secondary and university education. CF was assessed using the Parkinson´s Disease Cognitive Rating Scale (PD-CRS). General linear model (GLM) repeated measure was used to test for changes in the CF. A p value ≤ 0.005 was considered significant. Three hundred and ninety-nine PD patients (61.9 ± 8.9 years old; 58.4% males) and 207 controls (61 ± 8.3 years old; 49.8% males) were included. From V0 to V5, significant differences were observed in PD patients in global and fronto-subcortical (p < 0.0001 in all visits) between LoE groups but not in posterior-cortical (p > 0.05 in all visits) CF. LoE was associated with the change from V0 to V5 in the PD-CRS total score and fronto-subcortical sub-score (p < 0.0001) in PD patients but not in controls. After adjustment for many covariates, primary education was not a predictor of PD dementia (PD-CRS < 65) at V5 (OR = 3.31; p = 0.194). Cognitive function in Parkinson's disease is influenced by the level of education.

Keywords: Cognition; Cognitive reserve; Dementia; Education level; Parkinson’s disease.

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Conflict of interest statement

Declarations. Conflict of interest: Diego Santos-García has received honoraria for educational presentations and advice service by Abbvie, UCB Pharma, Lundbeck, KRKA, Zambon, Bial, Italfarmaco, Teva, Archímedes, Esteve, Stada, Merz, and grants from the Spanish Ministry of Economy and Competitiveness [PI16/01575] co-founded by ISCIII (Concesión de subvenciones de Proyectos de Investigación en Salud de la convocatoria 2020 de la Acción Estratégica en Salud 2017-2020 por el proyecto “PROGRESIÓN NO MOTORA E IMPACTO EN LA CALIDAD DE VIDA EN LA ENFERMEDAD DE PARKINSON”; Concesión de Contrato para la intensificación de la actividad investigadora en el Sistema Nacional de Salud, Convocatoria 2021, Instituto de Salud Carlos III). Teresa de Deus Fonticoba: None. Carlos Cores Bartolomé has received honoraria for educational presentations and advice service by Lundbeck and UCB Pharma. María Cristina Íñiguez Alvarado: None. Lucía Samaniego: None. Antón López Maside: None. Lucía Gallego: None. Laura Couce Barreiro: None. Javier Rodríguez Carames: None. Maria J. Feal Painceiras: None. Jose Manuel Paz González has received honoraria/support for educational presentations and attending meetings from UCB, Abbvie, Zambon, Bial and KRKA. Silvia Jesús has received honoraria from AbbVie, Bial, Merz, UCB, and Zambon and holds the competitive contract "Juan Rodés" supported by the Instituto de Salud Carlos III. She has received grants from the Spanish Ministry of Economy and Competitiveness (PI18/01898) and the Consejería de Salud de la Junta de Andalucía (PI-0459-2018). Marina Cosgaya: None. Juan García Caldentey has received honoraria for educational presentations and advice service by Qualigen, Nutricia, Abbvie, Italfarmaco, UCB Pharma, Lundbeck, Zambon, Bial, and Teva. Nuria Caballol has received honoraria from Bial, Italfármaco, Qualigen, Zambon, UCB, Teva and KRKA and sponsorship from Zambon, TEVA and Abbvie for attending medical conferences. Ines Legarda has received honoraria for educational presentations and advice service by Abbvie, UCB Pharma, Zambon, Bial, and Teva. Jorge Hernández Vara has received travel bursaries and educational grants from Abbvie and has received honoraria for educational presentations from Abbvie, Teva, Bial, Zambon, Italfarmaco, and Sanofi-Genzyme. Iria Cabo has received honoraria for educational presentations and advice service by Abbvie, Zambon, and Bial. Lydia López Manzanares compensated advisory services, consulting, research grant support, or speaker honoraria: AbbVie, Acorda, Bial, Intec Pharma, Italfarmaco, Pfizer, Roche, Teva, UCB, and Zambon. Isabel González Aramburu: None. Maria A. Ávila Rivera has received honoraria from Zambon, UCB Pharma, Qualigen, Bial, and Teva, and sponsorship from Zambon and Teva for attending conferences. Víctor Gómez Mayordomo has received honoraria from Bial, Merz and Zambon for educational lectures. Víctor Nogueira: None. Julio Dotor García-Soto compensated advisory services, consulting, research grant support, or speaker honoraria: Merck, Sanofi-Genzyme, Allergan, Biogen, Roche, UCB and Novartis. Carmen Borrué: None. Berta Solano Vila has received honoraria for educational presentations and advice service by UCB, Zambon, Teva, Abbvie, Bial. María Álvarez Sauco has received honoraria for educational presentations and advice service by Abbvie, UCB Pharma, Zambon, Bial, and Teva. Lydia Vela has received honoraria for educational presentations and advice service by Abbvie, UCB Pharma, Lundbeck, KRKA, Zambon, Bial, and Teva. Sonia Escalante has received honoraria for educational presentations and advice service by Abbvie, Zambon, and Bial. Esther Cubo: Travel grants: Abbvie, Allergan, Boston; Lecturing honoraria: Abbvie, International Parkinson’s disease Movement Disorder Society. Zebenzui Mendoza: None. Isabel Pareés: None. Lundbeck, Krka, TEVA, UCB, Zambon, Allergan, Ipsen, and Merz. Pilar Sánchez Alonso has received honoraria for educational presentations and advice service by Abbvie, UCB Pharma, Lundbeck, KRKA, Zambon, Bial, and Teva. Maria G. Alonso Losada has received honoraria for educational presentations and advice service by Zambon and Bial. Nuria López Ariztegui has received honoraria for educational presentations and advice service by Abbvie, Italfarmaco, Zambon, and Bial. Itziar Gastón has received research support from Abbvie and Zambon and has served as a consultant for Abbvie, Exelts, and Zambon. Jaime Kulisevsky: (1) Consulting fees: Roche, Zambon; (2) Stock/allotment: No; (3) Patent royalties/licensing fees: No; (4) Honoraria (e.g. lecture fees): Zambon, Teva, Bial, UCB; (5) Fees for promotional materials: No; (6) Research funding: Roche, Zambon, Ciberned; Instituto de SaludCarlos III; FundacióLa Maratóde TV3; (7) Scholarship from corporation: No; (8) Corporate laboratory funding: No; (9) Others (e.g. trips, travel, or gifts): No. Manuel Seijo has received honoraria for educational services from KRKA, UCB, Zambon, Bial; travel grants from Daiichi and Roche. Caridad Valero has received honoraria for educational services from Zambon, Abbvie and UCB. Kurtis M. has received honoraria from Bial, the Spanish Neurology Society, and the International and Movement Disorders Society. Ruben Alonso Redondo: None. Maria Teresa Buongiorno: None. Carlos Ordás: None. Manuel Menéndez-González has received consulting honoraria from Eisai Spain and research grants from by Instituto de Salud Carlos III (ISCIII), Fondo Europeo de Desarrollo Regional (FEDER), and Fundación Alimerka. Darrian McAfee: None. Pablo Martinez-Martin has received honoraria from Bial for lecturing in course and from the Parkinson and Movement Disorder Society (MDS) for management of the COA International Program of the Society. Pablo Mir has received honoraria from AbbVie, Abbott, Allergan, Bial, Merz, UCB, and Zambon and have received grants from the Spanish Ministry of Economy and Competitiveness [PI16/01575] co-founded by ISCIII (Subdirección General de Evaluación y Fomento de la Investigación) and by Fondo Europeo de Desarrollo Regional (FEDER), the Consejería de Economía, Innovación, Ciencia y Empleo de la Junta de Andalucía [CVI-02526, CTS-7685], the Consejería de Salud y Bienestar Social de la Junta de Andalucía [PI-0437-2012, PI-0471-2013], the Sociedad Andaluza de Neurología, the Jacques and Gloria Gossweiler Foundation, the Fundación Alicia Koplowitz, the Fundación Mutua Madrileña. The authors declare no competing interests.

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