Influence of premorbid IQ and education on progression of Alzheimer's disease.

Full Abstract

BACKGROUND:
Lower education is associated with a higher risk of developing Alzheimer's disease (AD). Years of education and measures of general intellectual function (IQ) are highly correlated. It is important to determine whether there is a relationship between education and AD outcomes that is independent of IQ.

OBJECTIVE:
To test the hypothesis that premorbid IQ is a stronger predictor of cognitive decline, global progression, and overall survival, than education in patients with AD.

METHODS:
The study included 478 probable AD patients (322 women and 156 men, mean age 74.5 years) followed in a large AD referral center for a mean of 3.2 years. Eligible participants had a baseline estimate of premorbid IQ using the American version of the Nelson Adult Reading Test (AMNART) and at least one follow-up visit with complete neuropsychological assessment. We used random effects linear regression analysis, and Cox proportional hazards analysis to determine whether or not education and/or premorbid IQ were independently associated with cognitive decline, global progression of AD, and survival.

RESULTS:
When the baseline AMNART score was included in regression models along with education and other demographic variables, AMNART score, but not education, was associated with a higher baseline score and slower rate of decline in MMSE and ADAS-Cog scores, and the Clinical Dementia Rating sum of boxes score. Neither higher premorbid IQ nor higher education was associated with longer survival.

CONCLUSIONS:
We conclude that a baseline AMNART score is a better predictor of cognitive change in AD than education, but neither variable is associated with survival after diagnosis.Copyright (c) 2006 S. Karger AG, Basel.

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Author information

Author/s: Pavlik, V N (VN); Doody, R S (RS); Massman, P J (PJ); Chan, W (W);

Affiliation: Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098-3926, USA. vpavlik(-atsign-)bcm.tmc.edu

Grants: AGO-8664 (Agency:PHS HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Dementia and geriatric cognitive disorders (Dement Geriatr Cogn Disord), published in Switzerland. (Language: eng)

Reference: 2006-; vol 22 (issue 4) : pp 367-77

Dates: Created 2006/10/26; Completed 2007/01/04; Revised 2008/03/24;

PMID: 16954693, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Aged, 80 and over
Alzheimer Disease - mortality; psychology
Cognition - physiology
Cohort Studies
Disease Progression
Education
Female
Humans

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