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The effect of education and occupational complexity on rate of cognitive decline in Alzheimer's patients

Published online by Cambridge University Press:  23 January 2006

ROSS ANDEL ,
CHERYL VIGEN ,
WENDY J. MACK ,
LINDA J. CLARK  and
MARGARET GATZ
ROSS ANDEL
Affiliation:
School of Aging Studies, University of South Florida, Tampa, Florida
CHERYL VIGEN
Affiliation:
Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
WENDY J. MACK
Affiliation:
Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
LINDA J. CLARK
Affiliation:
Department of Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA
MARGARET GATZ
Affiliation:
Department of Psychology, University of Southern California, Los Angeles, CA
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Abstract

We explored the effect of education and occupational complexity on the rate of cognitive decline (as measured by the Mini-Mental State Examination) in 171 patients with a confirmed Alzheimer's disease (AD) diagnosis. Complexity was measured as substantive complexity of work and complexity of work with data, people, and things. Average lifetime occupational complexity was calculated based on years at each occupation. Participants were followed for an average of 2.5 years and 3.7 visits. In multivariate mixed-effects models, high education, high substantive complexity, and high complexity of work with data and people predicted faster rates of cognitive decline, controlling for age, gender, native language, dementia severity, and entry into the analyses at initial versus follow-up testing. These results provide support for the concept of cognitive reserve according to which greater reserve may postpone clinical onset of AD but also accelerate cognitive decline after the onset. (JINS, 2006, 12, 147–152.)

Keywords

Alzheimer's diseaseComplexity of workLifetime occupationMini-Mental State ExaminationCognitive reserveMixed-effects models
Type
BRIEF COMMUNICATION
Information
Journal of the International Neuropsychological Society , Volume 12 , Issue 1 , January 2006 , pp. 147 - 152
Copyright
© 2006 The International Neuropsychological Society

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References

REFERENCES

Bennett, D.A., Wilson, R.S., Schneider, J.A., Evans, D.A., Mendes de Leon, C.F., Arnold, S.E., Barnes, L.L., & Bienias, J.L. (2003). Education modifies the relation of AD pathology to level of cognitive function in older persons. Neurology, 60, 1909–1915.Google Scholar
Burke, W.J., Miller, P., Rubin, E.H., Morris, J.C., Coben, L.A., Ducheck, J., Wittels, I.G., & Berg L. (1988). Reliability of the Washington University Clinical Dementia Rating. Archives of Neurology, 45, 31–32.Google Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-Mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Fritsch, T., McClendon, M.J., Smyth, K.A., & Ogrocki, P.K., (2002). Effects of educational attainment and occupational status on cognitive and functional decline in persons with Alzheimer-type dementia. International Journal of Geriatric Psychiatry, 14, 347–363.Google Scholar
Katzman, R. (1993). Education and the prevalence of dementia and Alzheimer's disease. Neurology, 43, 13–20.Google Scholar
Le Carret, N., Auriacombe, S., Letenneur, L., Bergua, V., Datrigues, J.-F., & Fabrigoule, C. (2005). Influence of education on the pattern of cognitive deterioration in AD patients: The cognitive reserve hypothesis. Brain and Cognition, 57, 120–126.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939–944.Google Scholar
Miller, A.R., Treiman, D.J., Cain, P.S., & Roos, P.A. (1980). Work, jobs, and occupations: A critical review of occupational titles. Washington, DC: National Academy Press.
Roos, P.A. & Treiman, D.J. (1980). DOT scales for the 1970 Census classification. In A.R. Miller, D.J. Treiman, P.S Cain, & P.A. Roos (Eds.), Work, jobs, and occupations: A critical review of occupational titles. Washington, DC: National Academy Press.
SAS Institute (2003). SAS System for Microsoft Windows (Version 9) [Computer software]. Cary, NC: SAS Institute Inc.
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8, 448–460.CrossRefGoogle Scholar
Stern, Y., Albert, S., Tang, M.-X., & Tsai, W.-Y. (1999). Rate of memory decline in AD is related to education and occupation: Cognitive reserve? Neurology, 53, 1942–1947.Google Scholar
Stern, Y., Alexander, G.E., Prohovnik, I., & Mayeux, R. (1992). Inverse relationship between education and parietotemporal perfusion deficit in Alzheimer's disease. Annals of Neurology, 32, 371–375.Google Scholar
Stern, Y., Alexander, G.E., Prohovnik, I., Stricks, L., Link, B., Lennon, M.C., & Mayeux, R. (1995). Relationship between lifetime occupation and parietal flow: Implications for a reserve against Alzheimer's disease pathology. Neurology, 45, 55–60.Google Scholar
Stern, Y., Gurland, B., Tatemichi, T.K., Tang, M.X., Wilder, D., & Mayeux, R. (1994). Influence of education and occupation on the incidence of Alzheimer's disease. Journal of the American Medical Association, 271, 1004–1010.CrossRefGoogle Scholar
Taussig, I.M., Henderson, V.W., & Mack W. (1992). Spanish translation and validation of a neuropsychological battery: Performance of Spanish- and English-speaking Alzheimer's disease patients and normal comparison subjects. Clinical Gerontologist, 11, 95–108.Google Scholar
Taussig, I.M., Mack, W.J., & Henderson, V.W. (1996). Concurrent validity of Spanish-language versions of the Mini-Mental State Examination, Mental Status Questionnaire, Information-Memory-Concentration Test, and Orientation-Memory-Concentration Test: Alzheimer's disease patients and nondemented elderly comparison subjects. Journal of the International Neuropsychological Society, 2, 286–298.Google Scholar
Teri, L., McCurry, S.M., Edland, S.D., Kukull, W.A., & Larson, E.B. (1995). Cognitive decline in Alzheimer's disease: A longitudinal investigation of risk factors for accelerated decline. Journal of Gerontology: Medical Sciences, 50A, M49–M55.Google Scholar
Wilson, R.S., Li, Y., Aggarwal, N.T., Barnes, L.L., McCann, J.J., Gilley, D.W., & Evans, D.A. (2004). Education and the course of cognitive decline in Alzheimer disease. Neurology, 63, 1198–1202.Google Scholar