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Education and the cognitive decline associated with MRI-defined brain infarct.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | Education and the cognitive decline associated with MRI-defined brain infarct. |
| Publication Type | Journal Article |
| Year of Publication | 2006 |
| Authors | Elkins, JS, Longstreth, WT, Manolio, TA, Newman, AB, Bhadelia, RA, Johnston, SC |
| Journal | Neurology |
| Volume | 67 |
| Issue | 3 |
| Pagination | 435-40 |
| Date Published | 2006 Aug 08 |
| ISSN | 1526-632X |
| Keywords | Cerebral Infarction, Cognition Disorders, Cross-Sectional Studies, Educational Status, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Neuropsychological Tests |
| Abstract | <p><b>OBJECTIVE: </b>To assess whether educational attainment, a correlate of cognitive reserve, predicts the amount of cognitive decline associated with a new brain infarct.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p> |
| DOI | 10.1212/01.wnl.0000228246.89109.98 |
| Alternate Journal | Neurology |
| PubMed ID | 16894104 |
| Grant List | K23 NS046302 / NS / NINDS NIH HHS / United States N01 HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States |