Public Health

Area of Science:

• Neuroscience
• Public Health
• Gerontology

Background:

• Education is vital for brain health, but research often overlooks educational quality (EQ) in favor of years of education (YoE).
• The combined effects of YoE and EQ on brain aging and dementia remain underexplored.

Purpose of the Study:

• To investigate the distinct and complementary impacts of educational quality (EQ) and years of education (YoE) on brain health.
• To assess how EQ and YoE influence gray matter volume and functional connectivity in healthy controls and individuals with Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD).

Main Methods:

• A cross-national study involving 7,533 participants from 20 countries, including healthy controls (HCs), AD, and FTLD cohorts.
• Utilized country-level indicators for EQ and applied neuroimage harmonization techniques.
• Employed regression models adjusted for age, sex, and cognition, with sensitivity analyses for image quality.

Main Results:

• Lower EQ and YoE were associated with increased brain burden across all participant groups.
• EQ demonstrated a stronger influence on brain structure and networks compared to YoE, affecting vulnerable regions specific to each condition.
• EQ's impact on atrophy and network integrity was 1.3 to 7.0 times greater than YoE's.

Conclusions:

• Findings underscore the critical role of educational quality in brain health, suggesting it is a more potent factor than years of education alone.
• Results advocate for the integration of country-level educational quality measures in brain health research and public health strategies.
• Emphasizes the need to consider EQ for developing targeted interventions to improve cognitive aging and mitigate dementia risk.