Inverse relationship between education and parietotemporal perfusion deficit in Alzheimer's disease.
A higher prevalence of dementia in individuals with fewer years of education has suggested that education may protect against Alzheimer's disease (AD). We tested whether individuals with more years of education have a more advanced AD before it is clinically evident. As a measure of pathophysiological severity, we quantified regional cerebral blood flow (rCBF), by the 133Xenon inhalation technique; a specific pattern of flow reduction in the parietotemporal cortex corresponds to AD pathology. In 3 groups of patients with probable AD, matched for clinical measures of dementia severity but with varying levels of education, whole-cortex mean flows were comparable. However, the parietotemporal perfusion deficit was significantly greater in the group with the highest level of education, indicating that AD was more advanced in this group. We conclude that education or its covariates or both may provide a reserve that compensates for the neuropathological changes of AD and delays the onset of its clinical manifestations.
Stern
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Department of Neurology, Columbia University, College of Physicians and Surgeons, New York, NY.
Alexander
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GE
Prohovnik
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Mayeux
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R
D000544:Alzheimer Disease / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D002560:Cerebrovascular Circulation; D015986:Confounding Factors, Epidemiologic; D004522:Educational Status; D006801:Humans; D008959:Models, Neurological; D008960:Models, Psychological; D010296:Parietal Lobe / Q000098:blood supply* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D013702:Temporal Lobe / Q000098:blood supply* / Q000000981:diagnostic imaging; D014980:Xenon Radioisotopes
D014980:Xenon Radioisotopes