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

@article{Elkins2006EducationAT,
  title={Education and the cognitive decline associated with MRI-defined brain infarct},
  author={Jacob S. Elkins and William T. Longstreth and Teri A. Manolio and Anne B. Newman and Rafeeque A. Bhadelia and Susan Johnston},
  journal={Neurology},
  year={2006},
  volume={67},
  pages={435 - 440}
}
Objective: To assess whether educational attainment, a correlate of cognitive reserve, predicts the amount of cognitive decline associated with a new brain infarct. Methods: The Cardiovascular Health Study is a population-based, longitudinal study of people aged 65 years and older. Cognitive function was measured annually using the Modified Mini-Mental State Examination (3MS) and the Digit-Symbol Substitution Test (DSST). The authors tested whether education level modified 1) the cross… 
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The effects were independent such that the adverse effects of covert vascular brain injury were not attenuated by higher cognitive reserve, and interventions to both prevent cerebrovascular disease and promote positive lifestyles are needed.
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The relevance of CR in subtending cognitive performances and the presence of CD in MS patients is supported, and only the Expanded Disability Status Scale (EDSS) and VOC were independently correlated with the presence/absence of CD.
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It is concluded that greater cognitive reserve as indexed by either higher premorbid intelligence or more years of education protects against the progression of cognitive dysfunction in MS.
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It is shown that education correlated with mean W‐scores in whole‐brain and temporoparietal masks, indicating that higher education was associated with more CR (i.e. greater atrophy than predicted from cognitive performance).
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TLDR
The hypothesis that educational history as a proxy indicator of cognitive reserve protects against deficits induced by acute stroke is supported, and 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.
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The unique relationship between intellectual enrichment and cerebral efficiency in neurologic patients is consistent with the cognitive reserve hypothesis, which does not posit that enrichment leads to gains in neurocognitive functioning per se; rather, enrichment protects against neuroc cognitive decline secondarily to disease.
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