More educated people who develop dementia lose their memory faster

People with more years of education lose their memory faster than those with less education in the years prior to a diagnosis of dementia, according to a study by researchers at Albert Einstein College of Medicine of Yeshiva University, published in the October 23rd issue of the medical journal Neurology.

The study included 117 people who developed dementia out of an original cohort of 488. The researchers, led by Charles B. Hall, Ph.D., associate professor of epidemiology and population health at Einstein, followed study participants for an average of six years using annual cognitive tests. Study participants ranged in formal education levels of less than three years of elementary school to individuals with postgraduate education.

The study found for each additional year of formal education, the rapid accelerated memory decline associated with oncoming dementia was delayed by approximately two and one half months. However, once that accelerated decline commenced, the people with more education saw their rate of cognitive decline accelerate 4 percent faster for each additional year of education. The latter portion of this finding corroborates previous research, which had shown that people with more education had more rapid memory loss after diagnosis of dementia.

For example, a college graduate with 16 years of education, whose dementia is diagnosed at age 85, would have begun to experience accelerated memory decline 3.8 years earlier, at age 81, while a person with just four years of education, who is diagnosed at the same age, would have begun to experience a less rapid rate of decline around age 79, 6.3 years before diagnosis.

“While higher levels of education delay the onset of dementia, once it begins, the accelerated memory loss is more rapid in people with more education,” said Dr. Hall. “Our study showed that a person with 16 years of formal education would experience a rate of memory decline that is 50% faster than someone with just 4 years education.

“This rapid decline may be explained by how people with more education have a greater cognitive reserve, or the brain's ability to maintain function in spite of damage,” added Hall. “So, while they're often diagnosed with dementia at a later date – which we believe may be because of their ability to hide the symptoms – there's still damage to their brain.”

Hall noted that this is the first study to confirm important predictions of the effects of cognitive reserve in people with preclinical dementia. He also said that the study is limited since the participants were born between 1894 and 1908 and their life experiences and education may not represent that of people entering the study age range today.