The DOI matches its Crossref record; 16 of the 17 references it cites were found in a registry or an index.
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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Items 101–176 of 176
MacDonald, S. W. S., Karlsson, S., Fratiglioni, L., & Bäckman, L. (2011) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000325666 · Cited by 15
Relationship Between Global Cognitive Decline and Depressive Symptoms in Multiple Sclerosis
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“Such contradictory results cannot be interpreted clearly, but findings similar to those in our study have emerged in elderly populations where education, as a proxy for cognitive reserve, postpones the clinical onset of dementia but also accelerates cognitive decline after onset (Andel, Vigen, Mack, Clark, & Gatz, 200…”
ResultDiferencias entre hombres y mujeres mayores en funcionamiento cognitivo y calidad de vida
Navarro, E., Calero, M. D., & García, M. J. C. (2015) · European Journal of Investigation in Health Psychology and Education · doi:10.30552/ejihpe.v4i3.79 · Cited by 14
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“…(Stern et al., 1995), life activities (Scarmeas et al., 2003), innate intelligence (Alexander et al., 1997), or a combination of these factors (Andel et al., 2006; Stern et al., 2005) are thought to compose aspects of cognitive reserve that help individuals acquire and use the set of skills…”
BackgroundInfluentialFrutos, L., Pérez‐Cruzado, D., Lunsford, D., Orza, S. G., & Cantero‐Téllez, R. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20054177 · Cited by 13
Vascular Risk Factors Aggravate the Progression of Alzheimer's Disease
Qiao, J., Lu, W., Wang, J., Guo, X., & Qu, Q. (2014) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317514522853 · Cited by 13
“Age at onset and education level have been shown to affect the progression of cognitive deterioration.(15) There is evidence in support of the view that vascular risk factors and disorders may be involved in AD.”
BackgroundSheftel, M. G., Goldman, N., Pebley, A. R., Pratt, B., & Park, S. S. (2023) · Work Aging and Retirement · doi:10.1093/workar/waad023 · Cited by 12
Thames, A. D., Foley, Panos, Singer, Hinkin, & El-Saden (2011) · Neurobehavioral HIV Medicine · doi:10.2147/nbhiv.s25203 · Cited by 11
“18 Using positron emission tomography, Stern et al conducted a series of seminal studies demonstrating this phenomenon in patients with Alzheimer’s disease.”
Lojo‐Seoane, C., Facal-Mayo, D., Juncos‐Rabadán, O., & Pereiro, A. X. (2014) · Anales de Psicología · doi:10.6018/analesps.30.3.158481 · Cited by 11
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Hausner, L., on behalf of the ICTUS-EADC study group, Frölich, L., Gardette, V., Reynish, E. L., Ousset, P., Andrieu, S., & Vellas, B. J. (2010) · Journal of Alzheimer s Disease · doi:10.3233/jad-2010-091489 · Cited by 11
“Thus, their lower cognitive performance might be influenced by their lower education level, which impacts MMSE score [35–38], partly via impaired cognitive reserve [39].”
Gyllenhammar, M., Rennie, A., Padilla, D. F., Wallert, J., Rydström, A., Wahlund, L., Eriksdotter, M., Westman, E., & Ekman, U. (2023) · Journal of Alzheimer s Disease · doi:10.3233/jad-220741 · Cited by 10
Veronelli, L., Tosi, G., & Romano, D. (2024) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2024.12.002 · Cited by 11
“These results support the literature demonstrating that higher CR may postpone clinical onset of AD but also accelerate cognitive decline after diagnosis (Andel et al., 2006; Scarmeas et al., 2006; Yoon et al., 2021).”
Huang, X. B., Deng, J., & Liu, W. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1182268 · Cited by 10
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“…is unclear with some groups defining educational attainment by more conservative cutoffs of <8 years of formal education (Stern et al., 1999; Zahodne, Stern, & Manly, 2015) or contemporarily relevant criterion of <12 years (Andel et al., 2006; Zahodne et al., 2011) similar to the present study.”
BackgroundResultHildreth, K. L., Grigsby, J., Bryant, L. L., Wolfe, P., & Baxter, J. (2013) · Journal of Behavioral Medicine · doi:10.1007/s10865-013-9491-z · Cited by 10
“…status (Everson-Rose et al., 2003; Luo & Waite, 2005), migration history (Al Hazzouri et al., 2011; Glymour & Manly, 2008), occupational complexity (Andel et al., 2006) and engagement in cognitively stimulating activities (Wilson et al., 2002) that may reflect cognitive reserve and moderate the…”
BackgroundAichele, S., Payton, A., Robinson, A., & Rabbitt, P. (2024) · Intelligence · doi:10.1016/j.intell.2024.101877 · Cited by 9
Double Compression: A Vision for Compressing Morbidity and Caregiving in Dementia
Cheng, S. (2014) · The Gerontologist · doi:10.1093/geront/gnu015 · Cited by 10
Neural compensation in presymptomatic hAPP mouse models of Alzheimer's diseasePreprint
Ammassari‐Teule, M. (2020) · Learning & Memory · doi:10.1101/lm.050401.119 · Cited by 8
“For example, in contrast with the demonstration that an active lifestyle protects aged patients from dementia (Verghese et al. 2003; Andel et al. 2006), AD patients facing an intense intellectual demand show a rise in Aβ load which accelerates AD progression (Buckner et al.”
ResultCognitive activity at work and the risk of dementia
Martin‐Bassols, N., de New, S. C., Johnston, D. W., & Shields, M. A. (2023) · Health Economics · doi:10.1002/hec.4679 · Cited by 7
Effects of Environmental Enrichment and Training across Life Span in Cognition
Calero, M. D. (2019) · Cambridge University Press eBooks · doi:10.1017/9781316677018.020 · Cited by 9
Contador, I., Fernández‐Calvo, B., Ramos, F., & Olazarán, J. (2016) · Journal of the International Neuropsychological Society · doi:10.1017/s135561771600014x · Cited by 7
“These findings come to corroborate the results of previous investigations (Andel et al., 2006), all Fig.”
ResultMapping computational cognitive profiles of aging to dissociable brain and sociodemographic factors
Marzuki, A. A., Wong, K. Y., Chan, J. K., Na, S. Y., Thanaraju, A., Phon-Amnuaisuk, P., Vafa, S., Yap, J., Lim, W., Yip, W. Z., et al. (2024) · npj Aging · doi:10.1038/s41514-024-00171-3 · Cited by 7
“…‘ SES & Cognitive Reserve ’ as it included mid-to-late adulthood socioeconomic measures and variables contributing to, or thought to be proxies for, cognitive reserve (e.g., education and occupational complexity) 54,55 highest loadings comprised spending time on cognitive and physical activities.”
González, M. F., Facal-Mayo, D., & Yaguas, J. (2013) · Escritos de Psicología / Psychological Writings · doi:10.24310/espsiescpsi.v6i3.13287 · Cited by 6
Social, Behavioral, and Contextual Influences on Cognitive Function and Decline over the Life Course
Leist, A. K., & Mackenbach, J. P. (2014) · International perspectives on aging · doi:10.1007/978-3-319-06650-9_8 · Cited by 5
Khate, K., Chaudhary, V., Longkumer, I., Saraswathy, K. N., & Devi, N. K. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1107152 · Cited by 5
“A higher number of children is also associated with lower economic status and poor education, which, in turn, may affect brain health (Andel et al., 2006).”
BackgroundGupta, M., Bhatia, D., Sinha, T. K., Dogra, S., & Jha, S. K. (2020) · Sensors International · doi:10.1016/j.sintl.2020.100016 · Cited by 6
Jang, Y., Kawachi, I. I., & Lee, S. (2025) · Journal of Aging and Health · doi:10.1177/08982643251370411 · Cited by 4
“Education is a key contributor to cognitive reserve and a strong predictor of late-life cognition (Andel et al., 2006; Lee et al., 2003; Stern, 2002).”
Owens, J. H., Fiala, J. A., Jones, R. N., & Marsiske, M. (2024) · Research on Aging · doi:10.1177/01640275241248825 · Cited by 4
“…decline (Fisher et al., 2014; Pan et al., 2019; Pool et al., 2016; Rodriguez et al., 2021; Then et al., 2015), and others have shown that high occupational complexity may lead to faster rates of cognitive decline (Andel et al., 2006; Finkel et al., 2009; Grotz et al., 2018; Hyun et al., 2021).”
Cognitive reserve in healthy older adults
Grasso, L., Agustina, A. M., Aschiero, M. B., Aguilar, G., Josefina, M., Iglesia, M. F., & López, M. (2021) · MOJ Gerontology & Geriatrics · doi:10.15406/mojgg.2021.06.00266 · Cited by 4
Gao, R., Bae, M. A., Han, S. H., Chang, K. J., & Kim, S. H. (2019) · Advances in experimental medicine and biology · doi:10.1007/978-981-13-8023-5_22 · Cited by 4
tDCS-Induced Memory Reconsolidation Effects: Analysis of Prominent Predicting Factors
Cotelli, M., Ferrari, C., Gobbi, E., Binetti, G. G., Manenti, R., & Sandrini, M. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.814003 · Cited by 5
“A number of studies have demonstrated that cognitive reserve represents a protective factor in subjects at risk for cognitive decline (Stern, 2002, 2009; Whalley et al., 2004; Richards and Deary, 2005; Andel et al., 2006; Roe et al., 2007).”
BackgroundRole of social support in cognitive function among elders in central China.
Hu, J. (2013) · NC Digital Online Collection of Knowledge and Scholarship (The University of North Carolina at Greensboro) · Cited by 4
Reynolds, C. A., & Finkel, D. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-411469-2.00007-8 · Cited by 4
Modelling longitudinal cognitive test data with ceiling effects and left skewness
Григорова, Д., Palejev, D., Gueorguieva, R. V., & Initiative, A. D. N. (2025) · Frontiers in Applied Mathematics and Statistics · doi:10.3389/fams.2025.1617381 · Cited by 3
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“MMSE has been used in prior studies to assess the relationship between education cognitive decline 6,12,13,15,17 or track progression of cognitive impairment.”
Cognitive Reserve In Alzheimer's Disease: Implications for Detection and Prevention
Beelen, M. J. (2009) · Cited by 3
Kato, T., Nishita, Y., Otsuka, R., Inui, Y., Nakamura, A., Kimura, Y., Ito, K., & SEAD-J Study Group (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.932906 · Cited by 4
“Compared with low CR, cognitive decline in high CR has been reported to be faster (Unverzagt et al., 1998; Andel et al., 2006; Scarmeas et al., 2006), slower (Fritsch et al.”
BackgroundBiochemical and Radiological Markers of Alzheimer’s Disease Progression
Dziedzic, T., Pera, J., Klimkowicz‐Mrowiec, A., Mroczko, B., & Słowik, A. (2016) · Journal of Alzheimer s Disease · doi:10.3233/ifs-150578 · Cited by 3
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Howard, K. A., Massimo, L. M., Witrick, B., Zhang, L., Griffin, S. F., Ross, L. A., & Rennert, L. (2025) · Journal of Alzheimer s Disease · doi:10.1177/13872877251326818 · Cited by 2
“13,15,21,22 Based on these fi ndings, as well as the reduced quality of life of patients with AD, there is an urgent need to elucidate experiences and lifestyle factors which contribute to CR such that prevention and early interventions can be maximally effective.”
Forstmeier, S., & Maercker, A. R. A. (2009) · Zeitschrift für Neuropsychologie · doi:10.1024/1016-264x.20.1.47 · Cited by 2
Set for life? Socioeconomic conditions, occupational complexity, and later life health
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Social class, dementia and the fourth age
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Adams, N. A. (2010) · OpenCommons - UConn (University of Connecticut) · Cited by 1
Cognitive Reserve: A Life-Course Perspective
Dekhtyar, S., & Wang, H. (2017) · Contemporary clinical neuroscience · doi:10.1007/978-3-319-52067-4_5 · Cited by 1
Cognitive Reserve: A Life-Course Perspective
Wang, R., Dekhtyar, S., & Wang, H. (2023) · Contemporary clinical neuroscience · doi:10.1007/978-3-031-24930-3_5 · Cited by 2
Recovery of function after lesions of the anterior thalamic nuclei: CA1 neuromorphology
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Sex effects in predictors of memory resilience for carriers of Alzheimer’s genetic risk
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Diferenças no funcionamento cognitivo entre idosos institucionalizados e não institucionalizados
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Long-term effects of economic fluctuations on health and cognition in Europe and the United States
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“…that individuals with a higher educational level, occupational attainment, and/or participation in leisure activities have a reduced risk of developing dementia and AD (Stern et al. 1994; Snowdon et al. 1996; Letenneur et al. 1999; Lindsay et al. 2002; Le Carret et al. 2005; Andel et al. 2006).”
BackgroundPersons with Alzheimer’s disease and their caregivers
Cheng, S. (2013)
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Genetic Susceptibility in Alzheimer’s Disease and the Role of Lipid Metabolism
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Memory decline and Aβ amyloid as markers of neurodegeneration in preclinical Alzheimer's disease
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Higher Level of Cognitive Reserve Reduces the Risk of Cognitive Difficulties in Healthy Adults
Szepietowska, E. M., & Kuzaka, A. (2020) · Psihologijske teme · doi:10.31820/pt.29.2.2
“Longitudinal studies showed that higher CR corresponds to faster cognitive decline in subjects with AD, or more rapid conversion of MCI into AD (Andel et al., 2006; Soldan et al., 2017).”
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“It has been shown that those with higher education have a later onset of clinical AD but quicker rates of cognitive decline after AD onset [41,42].”
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“…dementia diagnosis, and interpreting the results of these studies is complex; some studies reported a faster decline in cognitive function among more educated individuals during the early years after the diagnosis of dementia (Andel et al., 2006; Contador et al., 2017; Lövdén et al., 2020).”
Ye, L., & Chen, Y. (2024) · International Conference on Health Big Data and Intelligent Healthcare (ICHIH) · doi:10.1109/ichih63459.2024.11064740
“Individuals with more years of education typically demonstrate greater cognitive reserve, allowing them to maintain normal cognitive function despite accumulating brain changes that might otherwise lead to impairment[16].”
Relationship Between Occupational Complexity and Dementia Risk in Late-Life: A Population Study
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Metadata
- 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
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › 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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