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Higher education affects accelerated cortical thinning in Alzheimer's disease: a 5-year preliminary longitudinal study

Published online by Cambridge University Press:  16 September 2014

Hanna Cho ,
Seun Jeon ,
Changsoo Kim ,
Byoung Seok Ye ,
Geon Ha Kim ,
Young Noh ,
Hee Jin Kim ,
Cindy W Yoon ,
Yeo Jin Kim  and
Jung-Hyun Kim
...Show all authors
Hanna Cho
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
Seun Jeon
Affiliation:
Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
Changsoo Kim
Affiliation:
Department of Preventive Medicine and the Institute for Environmental Research
Byoung Seok Ye
Affiliation:
Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
Geon Ha Kim
Affiliation:
Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
Young Noh
Affiliation:
Department of Neurology, Gachon University Gil Medical Center, Incheon, South Korea
Hee Jin Kim
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Cindy W Yoon
Affiliation:
Department of Neurology, Inha University School of Medicine, Incheon, South Korea
Yeo Jin Kim
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Jung-Hyun Kim
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Sang Eon Park
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Sung Tae Kim
Affiliation:
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Jong-Min Lee
Affiliation:
Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
Sue J. Kang
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Mee Kyung Suh
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Juhee Chin
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Duk L. Na
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Dae Ryong Kang
Affiliation:
Biostatics of Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
Sang Won Seo*
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
*
Correspondence should be addressed to: Sang Won Seo, MD, PhD Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, South Korea. Phone: +82-2-3410-1233; Fax: +82-2-3410-0052. Email: [email protected].
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Abstract

Background:

Epidemiological studies have reported that higher education (HE) is associated with a reduced risk of incident Alzheimer's disease (AD). However, after the clinical onset of AD, patients with HE levels show more rapid cognitive decline than patients with lower education (LE) levels. Although education level and cognition have been linked, there have been few longitudinal studies investigating the relationship between education level and cortical decline in patients with AD. The aim of this study was to compare the topography of cortical atrophy longitudinally between AD patients with HE (HE-AD) and AD patients with LE (LE-AD).

Methods:

We prospectively recruited 36 patients with early-stage AD and 14 normal controls. The patients were classified into two groups according to educational level, 23 HE-AD (>9 years) and 13 LE-AD (≤9 years).

Results:

As AD progressed over the 5-year longitudinal follow-ups, the HE-AD showed a significant group-by-time interaction in the right dorsolateral frontal and precuneus, and the left parahippocampal regions compared to the LE-AD.

Conclusion:

Our study reveals that the preliminary longitudinal effect of HE accelerates cortical atrophy in AD patients over time, which underlines the importance of education level for predicting prognosis.

Keywords

educationcortical thicknessAlzheimer’s diseasecognitive reserve theory
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 1 , January 2015 , pp. 111 - 120
Copyright
Copyright © International Psychogeriatric Association 2014 

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