Evaluating the role of education in protecting against cognitive decline and memory changes: a cross European study


As research and clinical trials into Alzheimer’s disease continue to move towards focusing on a preclinical and an outwardly healthy population, a new international study evaluates the role of education in later life memory performance. One of the senior academics in the Centre for Dementia Prevention and a Senior Lecturer in Statistics Dr Graciela Muniz-Terrera (pictured) co-authored the paper that explored the cognitive performance of over 11 000 Europeans aged over 65 over an 8 year period in 10 different countries.
The participants were tested at baseline and followed up over two-year intervals. It is understood that the accumulation of neurodegeneration starts to occur in the ageing brain around the age of 65 but does not necessarily become evident. At this stage, an individual might be on a trajectory of memory decline but any symptoms of dementia would not occur for decades. This is why a lot of research effort has been aimed at identifying early risk and protective factors that would stop Alzheimer’s disease progression into a symptomatic stage that would manifest as dementia.
Dr Graciela Muniz-Terrera said: “In this study, we adopted a coordinated perspective of cross-country analyses, employing a similar method of analysing the data, while taking into consideration a similar set of factors, to better understand whether there are common patterns of cognitive decline in all individuals. Our work shows a consistent pattern of results across ten various European countries, where education showed a protective effect on memory in individuals aged 65 and older, but not on the rate of memory decline at ages when people start to exhibit accelerated signs of cognitive decline.”
The results of the paper showed that in most countries, the more educated individuals performed better on both memory tests at baseline, compared to those who were less educated. However, when the same individuals were followed-up and asked to repeat the tests, their level of education did not have an effect on the rate that their memory declined over time. Germany and the Netherlands had the best performance of memory recall at study entry, while Spain had the lowest performance. There was also a gender difference in recall with women performing better than men in most countries, but no gender difference was found in the rate of cognitive decline.
Previous studies have found that people with a higher level of education tend to have lower rates of dementia, but studies looking at the link between education and rates of cognitive decline in healthy older people have produced mixed results. This is one of the largest studies on education and cognitive decline so far and was funded by the Medical Research Council and Alzheimer’s Society.

Cadar, D., Robitaille A., Clouston, S., Hofer, S.M., Piccinin. A.M., Muniz-Terrera G. (2017). An international evaluation of cognitive reserve and memory changes in early old age, in ten European countries. Neuroepidemiology, 48 (1-2)