The effect of education and occupational complexity on rate of cognitive decline in Alzheimer's patients
Abstract
We explored the effect of education and occupational complexity on the rate of cognitive decline (as measured by the Mini-Mental State Examination) in 171 patients with a confirmed Alzheimer's disease (AD) diagnosis. Complexity was measured as substantive complexity of work and complexity of work with data, people, and things. Average lifetime occupational complexity was calculated based on years at each occupation. Participants were followed for an average of 2.5 years and 3.7 visits. In multivariate mixed-effects models, high education, high substantive complexity, and high complexity of work with data and people predicted faster rates of cognitive decline, controlling for age, gender, native language, dementia severity, and entry into the analyses at initial versus follow-up testing. These results provide support for the concept of cognitive reserve according to which greater reserve may postpone clinical onset of AD but also accelerate cognitive decline after the onset. (JINS, 2006, 12, 147–152.)
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Analyses were adjusted for a priori covariates including age, sex, education, physical activity, smoking status, and components of the Framingham Stroke Risk Profile.
“Because factors such as age, sex, education, physical activity, and smoking status may determine social relationships and also influence BDNF levels, dementia risk, and stroke risk, we parsimoniously adjusted for a priori variables [4], [25], [26].”
From Associations between social relationship measures, serum brain-derived neurotrophic factor, and risk of stroke and dementia (2017) · cites this paper as [25]
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- Authors
- ANDEL, R., VIGEN, C., MACK, W. J., CLARK, L. J., & GATZ, M.
- Affiliations
- University of South Florida (US)
- University of Southern California (US)
- Venue
- Journal of the International Neuropsychological Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2006-01
- Volume
- 12
- Issue
- 1
- Pages
- 147-152
- ISSN
- 1355-6177 (ISSN-L)
- 1469-7661
- OpenAlex
- W2031572198
- Cited by
- 176
- References
- 17
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 8 · 2023: 10 · 2022: 6 · 2021: 16 · 2020: 10 · 2019: 11 · 2018: 6 · 2017: 8 · 2016: 8 · 2015: 7 · 2014: 10 · 2013: 15 · 2012: 7
- FWCI
- 5.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the International Neuropsychological Society (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (P30 AG17265, P50-AG05142, P50AG005142, P30AG017265)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Keywords
- Alzheimer's disease, cognitive decline, educational attainment, occupational complexity, cognitive reserve, job complexity, Mini-Mental State Examination, dementia progression
- MeSH terms
- Aged, Alzheimer Disease, Cognition, Education, Female, Humans, Longitudinal Studies, Male, Models, Psychological, Occupations, Age of Onset
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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