Education Modulates the Impact of White Matter Lesions on the Risk of Mild Cognitive Impairment and Dementia

Marion Mortamais; Florence Portet; Adam Brickman; Frank Provenzano; Jordan Muraskin; Tasnime Akbaraly; Claudine Berr; Jacques Touchon; Alain Bonafé; Emmanuelle Le Bars; Nicolas Menjot de Champfleur; Jerome Maller; Chantal Meslin; Robert Sabatier; Karen Ritchie; Sylvaine Artero

doi:10.1016/j.jagp.2013.06.002

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Education Modulates the Impact of White Matter Lesions on the Risk of Mild Cognitive Impairment and Dementia

Journal article

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Education Modulates the Impact of White Matter Lesions on the Risk of Mild Cognitive Impairment and Dementia

Marion Mortamais, Florence Portet, Adam Brickman, Frank Provenzano, Jordan Muraskin, Tasnime Akbaraly, Claudine Berr, Jacques Touchon, Alain Bonafé, Emmanuelle Le Bars, …

The American journal of geriatric psychiatry, Vol.22(11), pp.1336-45

11/01/2014

DOI: 10.1016/j.jagp.2013.06.002

PMCID: PMC4143478

PMID: 24021219

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Abstract

OBJECTIVES: Conflicting results have been reported regarding the association between white matter lesions (WML) and cognitive impairment. We hypothesized that education, a marker of cognitive reserve (CR), could modulate the effects of WML on the risk of mild cognitive impairment (MCI) or dementia. METHODS: We followed 500 healthy subjects from a cohort of community-dwelling persons aged 65 years and over (ESPRIT Project). At baseline, WML volume was measured using a semi-automatic method on T2-weighted MRI. Standardized cognitive and neurological evaluations were repeated after 2, 4, and 7 years. The sample was dichotomized according to education level into low (≤8 years) and high (>8 years) education groups. Cox proportional hazard models were constructed to study the association between WML and risk of MCI/dementia. RESULTS: The interaction between education level and WML volume reached significance (p = 0.017). After adjustment for potential confounders, the association between severe WML and increased MCI/dementia risk was significant in the low education group (≤8 years) (p = 0.02, hazard ratio [HR]: 3.77 [1.29-10.99]), but not in the high education group (>8 years) (p = 0.82, HR: 1.07 [0.61-1.87]). CONCLUSIONS: Severe WML significantly increases the risk of developing MCI/dementia over a 7-year period in low educated participants. Subjects with higher education levels were seen to be more likely to be resilient to the deleterious effects of severe WML. The CR hypothesis suggests several avenues for dementia prevention.

Life Sciences

Neurons and Cognition

Santé publique et épidémiologie

Details

Title: Subtitle: Education Modulates the Impact of White Matter Lesions on the Risk of Mild Cognitive Impairment and Dementia
Creators: Marion Mortamais - Inserm
Florence Portet - Centre Hospitalier Universitaire de Montpellier
Adam Brickman - Columbia University
Frank Provenzano - Columbia University
Jordan Muraskin - Columbia University
Tasnime Akbaraly - University College London
Claudine Berr - Centre Hospitalier Universitaire de Montpellier
Jacques Touchon - Inserm
Alain Bonafé - Université de Montpellier
Emmanuelle Le Bars - Université de Montpellier
Nicolas Menjot de Champfleur - Université Montpellier 1
Jerome Maller - Monash Alfred Psychiatry Research centre
Chantal Meslin - Australian National University
Robert Sabatier - Université de Montpellier
Karen Ritchie - St Mary's Hospital
Sylvaine Artero - Centre Hospitalier Universitaire de Montpellier
Resource Type: Journal article
Publication Details: The American journal of geriatric psychiatry, Vol.22(11), pp.1336-45
DOI: 10.1016/j.jagp.2013.06.002
PMID: 24021219
PMCID: PMC4143478
NLM abbreviation: Am J Geriatr Psychiatry
ISSN: 1064-7481
eISSN: 1545-7214
Publisher: Elsevier
Number of pages: -1290
Language: English
Date published: 11/01/2014
Academic Unit: Radiology
Record Identifier: 9984848499102771

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