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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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