Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Xosé María Suárez Núñez, Campus Sur, Santiago de Compostela, Galicia 15782, Spain; Applied Cognitive Neuroscience and Psychogerontology group, Health Research Institute of Santiago (IDIS), Universidade de Santiago de Compostela, Rúa Xosé María Suárez Núñez, s/n, Campus Vida, Santiago de Compostela 15782, Spain.
Department of Psychiatry, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
Ageing Res Rev. 2024 Nov;101:102487. doi: 10.1016/j.arr.2024.102487. Epub 2024 Sep 5.
Subjective cognitive decline (SCD) is considered a pre-symptomatic stage of dementia characterized by cognitive complaints. The ability of education to reduce the risk of dementia is well known. Our objective is to investigate the influence of education on the risk of progression from SCD to MCI or dementia.
Prospective longitudinal studies of adults (≥50 years) with SCD evaluating progression to objective cognitive decline, MCI, or dementia were selected. Pooled estimates (random effects model) and 95 % confidence intervals were calculated, exploring heterogeneity. Standardized education differences, Odds Ratio, or Hazard Ratio between converters and non-converters were estimated.
The systematic review carried out showed that high education, as well as other cognitive reserve proxies, delays cognitive decline. The first meta-analysis showed a significant association of SCD with conversion in both high and low education strata. A second meta-analysis considering education as a continuous variable found that SCD converters showed two years less education than non-converters.
Our results suggest that education has a delaying effect against cognitive decline progression. The presumed improvement in accurately detecting cognitive decline associated with better metacognitive skills in higher-educated SCD participants does not seem to neutralize the incremental risk of objective cognitive decline associated with lower educational attainment.
主观认知下降（SCD）被认为是痴呆症的一种前驱阶段，其特征是认知主诉。教育降低痴呆风险的能力是众所周知的。我们的目的是研究教育对 SCD 向 MCI 或痴呆进展的风险的影响。
我们选择了对 SCD 患者进行前瞻性纵向研究，这些患者评估其向客观认知下降、MCI 或痴呆的进展。使用随机效应模型计算了汇总估计值（随机效应模型）和 95%置信区间，并探索了异质性。估计了转换者和非转换者之间标准化教育差异、优势比或风险比。
系统综述表明，高教育程度以及其他认知储备指标可延迟认知下降。第一项荟萃分析表明，SCD 与高教育和低教育人群的转换均有显著关联。第二项考虑教育作为连续变量的荟萃分析发现，SCD 转换者的受教育年限比非转换者少两年。
我们的结果表明，教育对认知下降进展有延迟作用。在高教育程度的 SCD 参与者中，与更好的元认知技能相关的更准确检测认知下降的假定改善，似乎并没有中和与较低教育程度相关的客观认知下降的增量风险。
