TY - JOUR
T1 - Education attenuates the effect of medial temporal lobe atrophy on cognitive function in alzheimer's disease
T2 - The mirage study
AU - Perneczky, Robert
AU - Wagenpfeil, Stefan
AU - Lunetta, Kathryn L.
AU - Cupples, L. Adrienne
AU - Green, Robert C.
AU - DeCarli, Charles
AU - Farrer, Lindsay A.
AU - Kurz, Alexander
PY - 2009
Y1 - 2009
N2 - Functional imaging and neuropathological studies suggest that individuals with higher education have better cognitive performance at the same level of brain pathology than less educated subjects. No in vivo studies are available that directly test how education modifies the effect of structural pathology on cognition in Alzheimer's disease (AD). The present study therefore aimed to measure this effect using data from a large multi-center study. 270 patients with AD underwent cognitive testing using the Mini Mental State Examination (MMSE), apolipoprotein E (APOE) genotyping, and cerebral magnetic resonance imaging. A linear regression analysis was used to examine the relation of medial temporal lobe atrophy (MTA), as a proxy of AD pathology, to MMSE score, adjusting for age, gender, APOE, cerebrovascular disease, ethnicity, education, and disease duration. An interaction term for MTA and education was introduced to test the hypothesis that education modifies the effect of MTA on cognition. There was a significant inverse association between MTA and cognition. Most interestingly, the interaction term between education and MTA was significant suggesting that education modifies the relation of MTA to cognition. At any level of pathology, cognition remained higher for better educated individuals.
AB - Functional imaging and neuropathological studies suggest that individuals with higher education have better cognitive performance at the same level of brain pathology than less educated subjects. No in vivo studies are available that directly test how education modifies the effect of structural pathology on cognition in Alzheimer's disease (AD). The present study therefore aimed to measure this effect using data from a large multi-center study. 270 patients with AD underwent cognitive testing using the Mini Mental State Examination (MMSE), apolipoprotein E (APOE) genotyping, and cerebral magnetic resonance imaging. A linear regression analysis was used to examine the relation of medial temporal lobe atrophy (MTA), as a proxy of AD pathology, to MMSE score, adjusting for age, gender, APOE, cerebrovascular disease, ethnicity, education, and disease duration. An interaction term for MTA and education was introduced to test the hypothesis that education modifies the effect of MTA on cognition. There was a significant inverse association between MTA and cognition. Most interestingly, the interaction term between education and MTA was significant suggesting that education modifies the relation of MTA to cognition. At any level of pathology, cognition remained higher for better educated individuals.
KW - Alzheimer's disease
KW - Cognition
KW - Cognitive reserve
KW - Dementia
KW - Education
KW - Hippocampus
KW - Magnetic resonance imaging
KW - Medial temporal lobe atrophy
UR - http://www.scopus.com/inward/record.url?scp=68949146735&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=68949146735&partnerID=8YFLogxK
U2 - 10.3233/JAD-2009-1117
DO - 10.3233/JAD-2009-1117
M3 - Article
C2 - 19542606
AN - SCOPUS:68949146735
VL - 17
SP - 855
EP - 862
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
SN - 1387-2877
IS - 4
ER -