02634nas a2200301 4500008004100000022001400041245008300055210006900138260001600207300001100223490000700234520175200241653002401993653002402017653002802041653002302069653001102092653002502103653003102128653002902159100001702188700002002205700001702225700001702242700001902259700001902278856003502297 2006 eng d a1526-632X00aEducation and the cognitive decline associated with MRI-defined brain infarct.0 aEducation and the cognitive decline associated with MRIdefined b c2006 Aug 08 a435-400 v673 a

OBJECTIVE: To assess whether educational attainment, a correlate of cognitive reserve, predicts the amount of cognitive decline associated with a new brain infarct.

METHODS: The Cardiovascular Health Study is a population-based, longitudinal study of people aged 65 years and older. Cognitive function was measured annually using the Modified Mini-Mental State Examination (3MS) and the Digit-Symbol Substitution Test (DSST). The authors tested whether education level modified 1) the cross-sectional association between cognitive performance and MRI-defined infarct and 2) the change in cognitive function associated with an incident infarct at a follow-up MRI.

RESULTS: In cross-sectional analysis (n = 3,660), MRI-defined infarct was associated with a greater impact on 3MS performance in the lowest education quartile when compared with others (p for heterogeneity = 0.012). Among those with a follow-up MRI who had no infarct on initial MRI (n = 1,433), education level was not associated with the incidence, size, or location of new brain infarct. However, a new MRI-defined infarct predicted substantially greater decline in 3MS scores in the lowest education group compared with the others (6.3, 95% CI 4.4- to 8.2-point decline vs 1.7, 95% CI 0.7- to 2.7-point decline; p for heterogeneity < 0.001). Higher education was not associated with smaller declines in DSST performance in the setting of MRI-defined infarct.

CONCLUSIONS: Education seems to modify an individual's decline on a test of general cognitive function when there is incident brain infarct. These findings are consistent with the hypothesis that cognitive reserve influences the impact of vascular injury in the brain.

10aCerebral Infarction10aCognition Disorders10aCross-Sectional Studies10aEducational Status10aHumans10aLongitudinal Studies10aMagnetic Resonance Imaging10aNeuropsychological Tests1 aElkins, J, S1 aLongstreth, W T1 aManolio, T A1 aNewman, A, B1 aBhadelia, R, A1 aJohnston, S, C uhttps://chs-nhlbi.org/node/911