Influence of schooling and age on cognitive performance in healthy older adults

Abstract

Few studies have examined the influence of a low level of schooling on age-related cognitive decline in countries with wide social and economic inequalities by using the Cambridge Automated Neuropsychological Test Battery (CANTAB). The aim of the present study was to assess the influence of schooling on age-related cognitive decline using unbiased cognitive tests. CANTAB allows cognitive assessment across cultures and education levels with reduced interference of the examiner during data acquisition. Using two-way ANOVA, we assessed the influences of age and education on test scores of old adults (61–84 years of age). CANTAB tests included: Visual Sustained Attention, Reaction Time, Spatial Working Memory, Learning and Episodic Memory. All subjects had a minimum visual acuity of 20/30 (Snellen Test), no previous or current history of traumatic brain/head trauma, stroke, language impairment, chronic alcoholism, neurological diseases, memory problems or depressive symptoms, and normal scores on the Mini Mental State Examination (MMSE). Subjects were grouped according to education level (1 to 7 and ≥8 years of schooling) and age (60–69 and ≥70 years). Low schooling level was associated with significantly lower performance on visual sustained attention, learning and episodic memory, reaction time, and spatial working memory. Although reaction time was influenced by age, no significant results on post hoc analysis were detected. Our findings showed a significantly worse cognitive performance in volunteers with lower levels of schooling and suggested that formal education in early life must be included in the preventive public health agenda. In addition, we suggest that CANTAB may be useful to detect subtle cognitive changes in healthy aging.

Factors associated with cognitive performance in elderly caregivers

“…The influence of lower levels of schooling in older adults is a theme found in current research 27,28 . This is relevant, especially in developing countries where a significant number of older adults have limited education 23,29 .…”

“…A study carried out in Brazil with 167 elderly individuals reported that participants with lower education levels showed worse results for visual attention, reaction time, and learning skills. Moreover, it suggested that lower levels of educational achievement during the early stages of life is a greater risk factor than aging for cognitive decay 27 . Another study, using clinical data from three longitudinal studies in England, Wales and Finland, found that individuals with higher formal education during the early part of their life showed a reduction in the risk of clinical dementia 31 .…”

Trends and predictions for survival and mortality in individuals with Down syndrome in Brazil: A 21‐year analysis

“…2017) and that low level of education may accentuate cognitive decline (Bento‐Torres et al . 2017); measures that enable the full inclusion of children with DS in school represent an important strategy to increase the quality of life of these individuals (Santos et al . 2018).…”

Lifestyle mediates the role of nutrient-sensing pathways in cognitive aging: cellular and epidemiological evidence

“…The correlation between PAL performance and age is supported by existing literature showing an age-dependent decline in episodic memory and by studies using CANTAB PAL both within, and independently of, the TwinsUK cohort [61][62][63] . Increased education also showed significant effects on cognition but despite recent studies, it remains unclear whether this is due to cognitive reserve or a confounding effect of higher cognitive abilities increasing the likelihood of further education [64][65][66][67] .…”