Accelerated clinical decline in well-educated patients with frontotemporal lobar degenerations

Education seems to protect against symptoms of neurodegeneration, but highly educated individuals experience faster cognitive decline after the onset of dementia. No studies on the effects of education on the clinical course in frontotemporal lobar degenerations (FTLD) exist. The aim of the study was to explore the effect of education on the rate of clinical deterioration in patients with FTLD. Thirty-five patients with FTLD were recruited and followed up for 20 months in average. A correlation was calculated between years of education and monthly rate of change on the clinical dementia rating scale sum of the boxes (CDR-SOB). A linear regression analysis with the CDR-SOB monthly rate of change as dependent, and the educational years and other variables possibly associated with the rate of clinical decline as independent variables was performed. There was a significant positive association between education and CDR-SOB monthly rate of change, indicating a faster decline in the well-educated. Education was the only significant predictor of clinical deterioration.