Xiangyi Meng|Carl D’Arcy
Education and Dementia in the Context of the Cognitive Reserve Hypothesis: A Systematic Review with Meta-Analyses and Qualitative Analyses
University of Saskatchewan|University of Saskatchewan
cognitive reserve cr brain reserve capacity explains individuals higher iq education occupational attainment lower risks developing dementia alzheimers disease ad vascular dementia vad cr hypothesis postulates cr reduces prevalence incidence ad vad also hypothesizes among greater initial cognitive reserve contrast less reserve greater brain pathology occurs clinical symptoms disease becomes manifest thus clinical disease onset triggers faster decline cognition function increased mortality among initial greater cognitive reserve disease progression follows distinctly separate pathological clinical paths education proxy use metaanalyses qualitative analyses review evidence cr hypothesiswe searched pubmed psycoinfo embase healthstar scopus databases january 1980 june 2011 observational studies clear criteria dementia ad vad education one hundred thirtythree articles variety study designs met inclusion criteria prevalence incidence studies odds ratios ors relative risks original data included metaanalyses studies reviewed qualitatively studies covered 437477 subjects prevalence incidence studies pooled ors 261 95ci 221307 188 95ci 151234 respectively showed low education increased risk dementia heterogeneity sensitivity tests confirmed evidence generally study characteristics effect conclusions qualitative analyses also showed protective effects higher education developing dementia clinical disease onset hastening decline cognition function greater brain pathologythis systematic review metaanalyses covering wide range observational studies diverse settings provides robust support cr hypothesis cr hypothesis suggests several avenues dementia prevention