Life-long intellectual activities mediate the predictive effect of early education on cognitive impairment in centenarians: A retrospective study

Institute of Psychology, Department of Gerontopsychology, University of Zurich, Schaffhauserstr. 15, CH-8006, Zürich, Switzerland.
Aging and Mental Health (Impact Factor: 1.75). 09/2004; 8(5):430-437. DOI: 10.1080/13607860410001725072
Source: PubMed


The purpose of this study was to examine the hypothesis of whether early education and/or maintaining intellectual activities over the life-course have the power to protect against cognitive impairment even in extremely old adults. Ninety centenarians from the population-based Heidelberg Centenarian Study were assessed with a modified version of the Mini Mental State Exam (MMSE). Data about education, occupational status, and life-long intellectual activities in four selected domains were obtained. Results demonstrated that 52% of the sample showed mild-to-severe cognitive impairment. Analyzing the influence of early education, occupational status, and intellectual activities on cognitive status we applied several (logistic) regression analyses. Results revealed independent, significant and strong influence of both formal school education and intellectual activities on the cognitive status in very late life, even after controlling for occupational status. However, about one fourth of the effect of early education on cognitive status was exerted indirectly via the assessed intellectual activities. In summary, the present study provides first evidence for the conclusion that even with regard to cognitive performance in very old age, both early education and life-long intellectual activities seem to be of importance.

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Available from: Matthias Kliegel
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    • "Specifically, our work is driven by the following assumptions: (1) education will be associated with cognition, such that individuals with higher levels of educational attainment will demonstrate better performance on cognitive measures; (2) older adults with higher levels of educational attainment will report being more active, especially in intellectually demanding activities; (3) intellectual activities will influence cognition, such that participation in intellectually demanding activities (as compared to other forms of activity) will be related to better cognitive performance, independent of education . Consequently, we expect that the association between education and cognition will be attenuated (not completely eliminated) once participation in a wide variety of lifestyle activities is considered [28] [29]. Further, we also expect that the effects will be greatest for intellectually demanding activities, as these may be more strongly associated with both education and cognition [1–5, 10, 12–14]. "
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    ABSTRACT: Although educational attainment has been consistently related to cognition in adulthood, the mechanisms are still unclear. Early education, and other social learning experiences, may provide the skills, knowledge, and interest to pursue intellectual challenges across the life course. Therefore, cognition in adulthood might reflect continued engagement with cognitively complex environments. Using baseline data from the Baltimore Experience Corps Trial, multiple mediation models were applied to examine the combined and unique contributions of intellectual, social, physical, creative, and passive lifestyle activities on the relationship between education and cognition. Separate models were tested for each cognitive outcome (i.e., reading ability, processing speed, memory). With the exception of memory tasks, findings suggest that education-cognition relations are partially explained by frequent participation in intellectual activities. The association between education and cognition was not completely eliminated, however, suggesting that other factors may drive these associations.
    Full-text · Article · Aug 2012 · Journal of aging research
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    • "Nevertheless, in a previous study, Fernández-Ballesteros and Calero25 found significant differences in learning potential (cognitive plasticity) between elders with high and low levels of education. The effect of education in crystalized intelligence is very well known;26 on the clinical field, lack of education is considered a risk factor for accelerated memory decline, on the contrary education is considered a protective factor for cognitive impairment and dementia.27,28 For example, Schmand et al29 examined the decline across life span in the population density of neocortical synapses which do not reach the level found by AD patients. "
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    ABSTRACT: The main goal of the present study is to examine to what extent age and cognitive impairment contribute to learning performance (cognitive plasticity, cognitive modifiability, or learning potential). To address this question, participants coming from four studies (Longitudinal Study of Active Aging, age range, 55-75 years, N = 458; Longitudinal Study in the very old [90+], age range, 90-102, N = 188, and Cognitive Plasticity within the Course of Cognitive Impairment, 97 "Normal", 57 mild cognitive impairment [MCI], and 98 Alzheimer's disease [AD] patients) were examined through a measure of verbal learning (developed from Rey). The results show that all age, MCI, and AD groups learned across the five learning trials of that test, but significant differences were found due to age, pathology, and education. The effects of pathology (MCI and AD) can be expressed in a metric of "years of normal decline by age"; specifically, being MCI means suffering an impairment in performance that is equivalent to the decline of a normal individual during 15 years, whereas the impact of AD is equivalent to 22.7 years. Likewise, the improvement associated with about 5 years of education is equivalent to about 1 year less of normal aging. Also, the two pathological groups significantly differed from "normal" groups in the delayed trial of the test. The most dramatic difference is that between the "normal" group and the AD patients, which shows relatively poorer performance for the AD group in the delayed trial than in the first learning trial. The potential role of this unique effect for quick detection purposes of AD is assessed (in the 75-89 years age range, sensitivity and specificity equal 0.813 and 0.917, respectively).
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    • "The older sample also consisted primarily of individuals in the young–old category of older adults (i.e., between the ages of 65 and 74 years) and it is plausible that the magnitude of the effects reported here may not be generalizable to individuals older than 75 years. In addition, the literature indicates that physical and mental health as well as education are protective factors against cognitive decline associated with aging (Kliegel et al. 2004; Muscari et al. 2010). All of the participants in this study reported being in good physical and mental health. "
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    ABSTRACT: The purpose of the study was to explore age differences in attentional demand in response to driving situations of varying complexity within the context of a simulated assessment protocol. It was hypothesized that as road complexity increased, an indicator of attentional demand (i.e., latency to respond to a secondary task) would increase and, independent of the road complexity, older adults would exhibit greater attentional demand in comparison with younger and middle-aged drivers. Drivers from 3 age categories (i.e., young, middle-aged, and older) completed an assessment protocol in a STISIM driving simulator (Systems Technology, Inc., Hawthorne, CA) during which participants responded to a series of strategically placed secondary tasks (i.e., peripheral detection tasks, PDTs). Situations where secondary tasks occurred were grouped according to whether they were straight-road, crossing-path, or lane-change events. Two global indices of driving safety as well as several cognitive measures external to the driving simulator were also collected. The results supported the hypothesis in that complex driving situations elicited greater attentional demand among drivers of all ages. Older adults showed greater attentional demand in comparison to young and middle-aged adults even after controlling for baseline response time. Older drivers also scored poorer on a global measure of driving safety. The findings are highly consistent with the literature on road complexity and attention that show that increased driving complexity is associated with poorer performance on tasks designed to concurrently assess attention, an effect that is more pronounced for older drivers. The results point to intrinsic and extrinsic factors that contribute to motor vehicle collisions (MVCs) among older drivers. The relevance of these findings is discussed in relation to interventions and future research aimed at improving road safety.
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