The role of education in a vascular pathway to episodic memory: brain maintenance or cognitive reserve?

Laura B. Zahodne, Elizabeth Rose Mayeda, Timothy J. Hohman, Evan Fletcher, Annie M. Racine, Brandon Gavett, Jennifer J. Manly, Nicole Schupf, Richard Mayeux, Adam M. Brickman, Dan M Mungas

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Educational attainment is associated with cognition among older adults, but this association is complex and not well understood. While associated with better cognition among healthy adults, more education predicts faster decline in older adults with cognitive impairment. Education may influence cognitive functioning through mechanisms involving brain maintenance (BM: reduced age-related pathology) or cognitive reserve (CR: altered pathology-cognition association). We examined evidence for each mechanism by quantifying main and interaction effects of education within a well-studied pathway involving systolic blood pressure, white matter hyperintensities (WMH), and episodic memory in 2 samples without dementia at the baseline (total N = 1136). There were no effects of education on systolic blood pressure or WMH, suggesting a lack of evidence for BM. In the sample less likely to progress to dementia, education attenuated the effect of WMH on memory at the baseline. In the sample more likely to progress to dementia, education exacerbated this effect at the baseline. These moderations provide evidence for a CR mechanism and are consistent with previous findings of faster decline once CR is depleted.

Original languageEnglish (US)
Pages (from-to)109-118
Number of pages10
JournalNeurobiology of aging
StatePublished - Dec 1 2019


  • Brain maintenance
  • Cognitive aging
  • Cognitive reserve
  • Episodic memory
  • Moderation
  • White matter hyperintensities

ASJC Scopus subject areas

  • Neuroscience(all)
  • Aging
  • Clinical Neurology
  • Developmental Biology
  • Geriatrics and Gerontology


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