Poster Session 02 Program Schedule
02/15/2024
08:00 am - 09:15 am
Room: Majestic Complex (Posters 61-120)
Poster Session 02: Aging | MCI | Neurodegenerative Disease - PART 1
Final Abstract #63
Cognitive Reserve, as Measured by Higher Education Level, Predicts Delayed Age of Onset but Higher Deterioration Rate Among Patients with Alzheimer's Disease Receiving Treatment
Anat Marmor, Hadassah Medical Center, Jerusalem, Israel
Eli Vakil, Bar-Ilan University, Ramat Gan, Israel
Zeev Meiner, Hadassah Medical Center, Jerusalem, Israel
Category: Dementia (Alzheimer's Disease)
Keyword 1: cognitive reserve
Keyword 2: dementia - Alzheimer's disease
Objective:
The Cognitive Reserve theory attempts to explain the mismatch often reported between brain damage and its clinical expression. In individuals diagnosed with Alzheimer’s disease it was found that higher years of education, reflecting better cognitive reserve, predicts higher age of diagnosis.
Most of the studies focused on individuals with memory deterioration prior to the diagnosis of dementia. However, the effect of cognitive reserve on clinical deterioration of patients diagnosed with Alzheimer's disease and receiving Cholinesterase inhibitory treatment (CEI) was not excessively investigated.
The current study will try to confirm the hypothesis that Alzheimer’s disease patients with a higher cognitive reserve, deteriorate faster, since their brain pathology is more sever, than patients with lower cognitive reserve. The study will examine the validity of this hypothesis in individuals with higher and lower education.
Participants and Methods:
This is a retrospective study conducted at a Neuro-Geriatrics and Memory clinic and including 642 (361 female) individuals above the age of 65 diagnosed with Alzheimer’s disease and received CEI treatment. The average age is 77.01 (SD = 5.95). Deterioration was evaluated using the Mini Mental State Examination (MMSE) difference between the first and last follow up. Since the MMSE is affected by years of education, the sample was divided into two groups, according to years of education, the first, patients with high education, having nine years of education or more (n = 442, average years of education is 13.93, SD = 3) and the second, patients with low education, having eight years of education or less (n = 141, average years of education is 5.21 SD = 3.08).
Results:
Our results show that in the group of patients with high education, as predicted, higher education level was associated with delayed age of diagnosis. However, in patients with low education, there was no significant correlation between the age of diagnosis and the level of education. Regarding the rate of deterioration, at all levels of education, higher years of education predict steeper deterioration.
Conclusions:
In our study, consistent with previous studies, cognitive reserve as measured by years of education, predicts a delayed age of diagnosis of Alzheimer's disease but only in the high education group. That is, when a person is more educated, he has more cognitive reserve and therefore the clinical manifestation of the dementia will emerge later, while in person with low education, this resilience factor does not exist. However, when patients already develop dementia and receive CEI treatment this protecting effect of cognitive reserve disappears probably due to severe neuronal loss in the brains of these patients. It is interesting that we found this loss of the protecting effect of cognitive reserve, even in patients in the low education group reflecting the severity of brain pathology also in this group.
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