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Posted by on Feb 25, 2008 in Neurology

Education and Net Worth May Guard Against Dementia, but not Mortality, in Elderly

Education and Net Worth May Guard Against Dementia, but not Mortality, in Elderly


A longituinal study funded by the National Institute on Aging suggests that cognitive impairment (CI) in the elderly is less likely in persons who have more years of education or greater net worth. The data were published online last month in the journal Alzheimer’s & Dementia.

In individuals aged 70 years or older from the University of Michigan Health and Retirement Study, cognitive function was assessed over 2 years and compared between two cohorts from 1993 and 2002. After adjusting for age and sex differences, investigators found that higher education levels and net worth in the 2002 cohort accounted for approximately 40% of the group’s decreased prevalence of CI (Table). The authors explain their findings, in part, by suggesting that a higher level of education is associated with the development of greater cognitive reserve in the setting of developing memory disorders, like Alzheimer’s disease.



P Value

1993 (n = 7406)

2002 (n = 7104)

Mean age, years




Mean education, years




Mean net worth, 1993 $




Cognitive function








    Mild CI




    Moderate/severe CI




In both cohorts, the 2-year risk of mortality increased significantly with worsening CI (not surprising); however, the mortality risk in individuals with moderate or severe CI was higher in the 2002 cohort than in the 1993 group (adjusted-HR P = .09). In addition, lengthier education was associated with an increased mortality risk in those individuals with CIa finding that was of greater magnitude in the 2002 cohort.

The authors attempt to explain this curious finding by suggesting that the brains of more educated individuals can sustain a greater load of dementia-causing brain pathology, before reaching a clinically important threshold. However, once this clinical threshold is reached, their cognitive decline is more precipitous, and their mortality risk is consequently greater.

bmartin (1127 Posts)

A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on and Twitter.