Formal education lessens impact of Alzheimer’s disease
20 August 2009
Researchers at the Department of Psychiatry, Klinikum rechts der Isar,
Technische Universität München have shown that education diminishes the
impact of Alzheimer’s disease on cognition even if a manifest brain
volume loss has already occurred. The results are published in the
Journal of Alzheimer’s Disease .
Dr Robert Perneczky, Department of Psychiatry at Klinikum rechts der
Isar explains: “We know that there is not always a close association
between brain damage due to Alzheimer’s disease and the resulting
symptoms of dementia. In fact, there are individuals with severe brain
pathology with almost no signs of dementia, whereas others with only
minor brain lesions exhibit a considerable degree of clinical symptoms.”
These phenomena are often ascribed to the theoretical concept of
cognitive reserve. A high level of cognitive reserve results in a strong
individual resilience against symptoms of brain damage; cognitive
reserve can therefore be seen as protective against brain damage.
In support of this, previous studies demonstrated that duration of
formal education is associated with cognitive reserve such that
comparison of individuals with the same degree of brain damage shows
that those with more years of formal education suffer from less severe
symptoms of dementia.
Prior to the current study, brain damage was assessed after death
using brain autopsy measures or using very sensitive functional imaging
measures in live individuals.
Perneczky comments: “Our study is the first to show that formal
education also modifies the association between brain damage and
clinical symptoms of dementia in Alzheimer’s disease if brain damage is
defined as volume loss on magnetic resonance imaging scans.
"The relevance of our findings is strengthened by the large sample
including 270 patients with Alzheimer’s disease. Furthermore, factors
with a potential negative influence on cognition and brain volume loss,
such as genetic characteristics, age, gender, and brain infarction were
These research results show for the first time that the modifying
effect of formal education is robust enough to reduce the negative
effects of structural brain damage on cognitive function. Further
studies are planned that will include a larger patient cohort and more
precise measurement of brain volume reduction.
1. Perneczky R, Wagenpfeil S, Lunetta KL, Cupples LA, Green RC,
Decarli C, Farrer LA, Kurz A. Education Attenuates the Effect of Medial
Temporal Lobe Atrophy on Cognitive Function in Alzheimer's Disease: The
MIRAGE Study. J Alzheimers Dis August 2009; 17:4.
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