Williams Benjamin David, Pendleton Neil, Chandola Tarani
Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK.
Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2021 Mar 8:1-21. doi: 10.1080/13825585.2021.1889958.
Education is associated with improved baseline cognitive performance in older adults, but the association with maintenance of cognitive function is less clear. Education may be associated with different types of active cognitive reserve in those following different cognitive trajectories. We used data on n = 5642 adults aged >60 from the English Longitudinal Study of Aging (ELSA) over 5 waves (8 years). We used growth mixture models to test if the association between educational attainment and rate of change in verbal fluency or immediate recall varied by latent class trajectory. For recall, 91.5% (n = 5164) of participants were in a gradual decline class and 8.5% (n = 478) in a rapid decline class. For fluency, 90.0% (n = 4907) were in a gradual decline class and 10.0% (n = 561) were in a rapid decline class. Educational attainment was associated with improved baseline performance for both verbal fluency and recall. In the rapidly declining classes, educational attainment was not associated with rate of change for either outcome. In the verbal fluency gradual decline class, education was associated with higher (an additional 0.05-0.38 words per 2 years) or degree level education (an additional 0.04-0.42 words per 2 years) when compared to those with no formal qualifications. We identified no evidence of a protective effect of education against rapid cognitive decline. There was some evidence of active cognitive reserve for verbal fluency but not recall, which may reflect a small degree of domain-specific protection against age-related cognitive decline.
教育与老年人基线认知能力的提高有关，但与认知功能维持的关联尚不清楚。在遵循不同认知轨迹的人群中，教育可能与不同类型的主动认知储备有关。我们使用了来自英国老龄化纵向研究（ELSA）的5642名年龄大于60岁的成年人在5个时间段（8年）的数据。我们使用生长混合模型来检验教育程度与言语流畅性或即时回忆变化率之间的关联是否因潜在类别轨迹而异。对于回忆，91.5%（n = 5164）的参与者处于逐渐下降类别，8.5%（n = 478）处于快速下降类别。对于流畅性，90.0%（n = 4907）处于逐渐下降类别，10.0%（n = 561）处于快速下降类别。教育程度与言语流畅性和回忆的基线表现改善有关。在快速下降类别中，教育程度与这两个结果的变化率均无关联。在言语流畅性逐渐下降类别中，与没有正规学历的人相比，教育与更高水平（每2年额外增加0.05 - 0.38个单词）或学位水平教育（每2年额外增加0.04 - 0.42个单词）有关。我们没有发现教育对快速认知衰退有保护作用的证据。有一些证据表明存在针对言语流畅性而非回忆的主动认知储备，这可能反映了对年龄相关认知衰退有一定程度的特定领域保护。
