Kremen William S, Ericsson Malin, Gatz Margaret, Karlsson Ida K, Nygaard Marianne, Pedersen Nancy L, Panizzon Matthew S
Department of Psychiatry, University of California, La Jolla, California, USA.
Center for Behavior Genetics of Aging, University of California, La Jolla, California, USA.
Alzheimers Dement. 2025 Jun;21(6):e70176. doi: 10.1002/alz.70176.
We addressed whether higher education plays a causal role in reducing dementia risk by comparing two indices of cognitive reserve: education and young adult general cognitive ability (GCA).
We conducted a 52-year survival analysis to examine associations of GCA and education with dementia in 16,619 male conscripts identified in Swedish national health registries born between 1936 and 1958 and with available data for models including midlife occupational complexity, physical activity, and socioeconomic status (SES).
Higher GCA was associated with lower dementia risk (hazard ratio = 0.865, 95% confidence interval = 0.756 to 0.990). After accounting for GCA, no other measure contributed significantly to dementia risk.
Putative reserve effects of education or occupational complexity likely reflect largely downstream effects of prior GCA. From a lifespan perspective on reducing dementia risk, the results may suggest favoring interventions aimed at enhancing cognitive development during childhood when there is substantial brain development as opposed to later-life cognitive training.
Education and GCA serve as indices of cognitive reserve. Education is a modifiable risk factor that is associated with dementia risk. The effect of higher education on reduced dementia risk is not directly causal. Education is largely a downstream effect of prior level of GCA. Increasing GCA during childhood may be more effective than later cognitive training.
我们通过比较两个认知储备指标，即教育程度和青年时期的一般认知能力（GCA），来探讨高等教育在降低痴呆症风险方面是否发挥因果作用。
我们进行了一项为期52年的生存分析，以研究在瑞典国家健康登记处中识别出的16619名男性应征入伍者中，GCA和教育程度与痴呆症之间的关联，这些应征入伍者出生于1936年至1958年之间，且有包括中年职业复杂性、身体活动和社会经济地位（SES）等模型的可用数据。
较高的GCA与较低的痴呆症风险相关（风险比=0.865，95%置信区间=0.756至0.990）。在考虑GCA后，没有其他因素对痴呆症风险有显著贡献。
教育或职业复杂性的假定储备效应可能在很大程度上反映了先前GCA的下游效应。从降低痴呆症风险的生命周期角度来看，结果可能表明更倾向于在童年时期进行旨在增强认知发展的干预措施，因为此时大脑有大量发育，而不是后期的认知训练。
教育程度和GCA作为认知储备的指标。教育是一个可改变的风险因素，与痴呆症风险相关。高等教育对降低痴呆症风险的影响不是直接因果关系。教育在很大程度上是先前GCA水平的下游效应。在童年时期提高GCA可能比后期的认知训练更有效。
