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Cognitive decline and survival in Alzheimer's disease according to education level
A Bruandet1, F Richard, S Bombois
1INSERM, U744, Institut Pasteur de Lille, Université de Lille 2, Lille, France.
Objective:
We tested the hypothesis that a higher education level is associated with faster cognitive decline and lower survival in a cohort of 670 Alzheimer's disease patients, followed for 3.5 years at the Lille-Bailleul memory centre.
Methods:
The patients were categorized in 3 groups according to educational levels: low (
Results:
The adjusted mixed random model showed that MMSE declined faster for patients with high and intermediate educational levels compared with those with a low educational level (p < 0.0001). The mean annually adjusted DRS decline was highest for the groups with the most education (p = 0.05). The mortality risk was not higher in the better-educated groups (high vs. low: RR = 0.84; 95% CI = 0.35-1.99, intermediate vs. low: RR = 0.82; 95% CI = 0.41-1.63).
Conclusion:
In our cohort, highly educated patients had a faster cognitive decline than less educated patients but similar mortality rates. Our findings support the cognitive reserve hypothesis.
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