Education and the cognitive decline associated with MRI-defined brain infarct

Elkins, Jacob; Longstreth, W. T.; Newman, Anne B.; Bhadelia, R. A.; Johnston, S. C.

doi:10.1212/01.wnl.0000228246.89109.98

Cited by 96 publications

(62 citation statements)

References 30 publications

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“…We also examined whether fluency was associated with age, education and stroke severity. The correlations between verbal fluency scores and age and education are consistent with previous findings in the literature [2,20]. The control group had more robust correlations between both age and education and letter and animal fluency performance.…”

Section: Discussionsupporting

confidence: 90%

Associations between stroke lesion location and verbal fluency tests in a sub-acute stroke population

Babulal¹

2017

Neurol Disord Therap

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Background: In stroke hospitalizations, verbal fluency tests are used to evaluate executive abilities in order to assess the integrity of functioning and language. Prior studies show that clustering and switching during verbal fluency tasks are related to functioning of specific brain regions, such that they are thought to be more sensitive in detecting impairments in frontal regions compared to other brain regions.

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Section: Discussionsupporting

confidence: 90%

Associations between stroke lesion location and verbal fluency tests in a sub-acute stroke population

Babulal¹

2017

Neurol Disord Therap

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“…[21][22][23] The reason why education itself was not associated with mortality in previous studies may be explained by shorter follow-up periods limited to 3 years 21,22 and considerably smaller numbers of patients. 22,34 We consider the effect of educational history to be effective in long-term follow-up modulating patient cooperation and compliance.…”

Section: Strokementioning

confidence: 93%

“…21,22 Educational attainment has been shown to associate with less cognitive decline after stroke. 23 However, direct evidence about the effect of cognitive brain reserve, a surrogate of which is educational history, on stroke outcome in the long-term is lacking. Moreover, it is not known whether WML modify the effect of education on stroke outcome.…”

Section: Strokementioning

confidence: 99%

Educational History Is an Independent Predictor of Cognitive Deficits and Long-Term Survival in Postacute Patients With Mild to Moderate Ischemic Stroke

Ojala-Oksala

Jokinen

Kopsi

et al. 2012

Stroke

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Background and Purpose— Poststroke cognitive decline and white matter lesions (WML) are related to poor poststroke survival. Whether cognitive reserve as reflected by educational history associates with cognitive decline, recurrent strokes, and poststroke mortality independent of WML is not known. Methods— A total of 486 consecutive acute mild/moderate ischemic stroke patients subjected to comprehensive neuropsychological assessment (n=409) and magnetic resonance imaging (n=395) 3 months poststroke were included in the study and followed-up for up to 12 years. Odds ratios (OR) for logistic and hazard ratios for Cox regression analyses are reported (OR and hazard ratio ≤1 indicates a beneficial effect). Results— Long educational history (per tertile) was associated with lower frequency of executive dysfunction in models adjusted for age, sex, marital status, and stroke severity (OR, 0.75; P <0.05) but not when adding WML as a covariate. In contrast, educational history was independently associated with less memory impairment (OR, 0.67; P <0.01), aphasia (OR, 0.69; P <0.05), visuospatial and constructive deficits (OR, 0.70; P <0.05), Mini-Mental State Examination score <25 (OR, 0.53; P <0.0001), and dementia (OR, 0.66; P <0.01). In Cox regression analysis, educational history was not associated with recurrent strokes, but it associated independently with favorable poststroke survival (hazard ratio, 0.86; P <0.05). Conclusions— Long educational history associates with less poststroke cognitive deficits, dementia, and favorable long-term survival independent of age, gender, marital status, stroke severity, and WML in patients with mild/moderate ischemic stroke. This supports the hypothesis that educational history as a proxy indicator of cognitive reserve protects against deficits induced by acute stroke.

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“…Individuals with higher levels of education tend to have a better cognitive outcome in the context of a neurological injury than those with lower levels of education (Barnett et al, 2006;Elkins et al, 2006;Jones et al, 2006;Kesler et al, 2003;McDowell et al, 2007;Stern, 2002). Although brain reserve related to educational level has also been implicated as a protective factor in the development of cognitive deficits in substance use (Fein and Di Sclafani, 2004), to our knowledge, no research has examined the interaction between educational level and cognitive deficits in MA abuse.…”

Section: Educationmentioning

confidence: 99%

An Evaluation of the Evidence that Methamphetamine Abuse Causes Cognitive Decline in Humans

Dean

Groman

Morales

et al. 2012

Neuropsychopharmacol

204

127

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Methamphetamine (MA) is one of the most commonly abused illicit substances worldwide. Among other problems, abuse of the drug has been associated with reduced cognitive function across several domains. However, much of the literature has not attempted to differentiate cognitive difficulties caused by MA abuse from preexisting cognitive difficulties that are likely caused by other factors. Here, we address this question, evaluating evidence for a priori hypotheses pertaining to six lines of research: (a) animal studies; (b) crosssectional human studies; (c) a twin study; (d) studies of changes in cognition with abstinence from MA; (e) studies of changes in brain structure and function with abstinence from MA; and (f) studies of the relationship between the severity of MA abuse and the extent of cognitive deficits observed. Overall the findings were mixed, with some support for a causal relationship between MA abuse and cognitive decline, and other findings suggesting that there is no relationship. The preponderance of the data, however, does support the possibility that MA abuse causes cognitive decline, of unknown duration, in at least some users of the drug. When averaged across individuals, this decline is likely to be mild in early-to-middle adulthood. However, moderator variables are likely to contribute to the presence and/or severity of cognitive decline exhibited by a given individual.

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Education and the cognitive decline associated with MRI-defined brain infarct

Abstract: Education seems to modify an individual's decline on a test of general cognitive function when there is incident brain infarct. These findings are consistent with the hypothesis that cognitive reserve influences the impact of vascular injury in the brain.

Cited by 96 publications

References 30 publications

Associations between stroke lesion location and verbal fluency tests in a sub-acute stroke population

Associations between stroke lesion location and verbal fluency tests in a sub-acute stroke population

Educational History Is an Independent Predictor of Cognitive Deficits and Long-Term Survival in Postacute Patients With Mild to Moderate Ischemic Stroke

An Evaluation of the Evidence that Methamphetamine Abuse Causes Cognitive Decline in Humans

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