Home › Research › Caregiving
Education and cognitive reserve in old age
Wilson RS, Yu L, Lamar M, Schneider JA, Boyle PA, Bennett DA.. Neurology, 2019-02-06
Topic: Risk, prevention and care in population studies
Objective To assess the contribution of education to cognitive reserve. Methods Analyses are based on older participants in a longitudinal clinical-pathologic cohort study who had annual cognitive testing (n = 2,899) and subgroups that developed incident dementia (n = 696), died, and underwent a neuropathologic examination from which 10 neurodegenerative and cerebrovascular markers were derived (n = 752), or both (n = 405). Cognitive test scores were converted to a standard scale and averaged to yield composite measures of cognition. Results Participants had a mean of 16.3 years of education (SD = 3.7, range 0-30). In all participants, education was associated with initial level of global cognition but not rate of cognitive change. In those who developed dementia, rate of global cognitive decline accelerated a mean of 1.8 years before the diagnosis, but education was not related to the onset or rate of accelerated decline. In the deceased, rate of global cognitive decline accelerated a mean of 3.4 years before death, but higher educational attainment was related to earlier (not later) onset of accelerated decline and unrelated to rate of acceleration. Higher education was associated with lower likelihood of gross and microscopic cerebral infarcts but not with other neuropathologic markers. Education was not related to global cognitive change not attributable to neuropathologic burden and did not decrease the association of higher neuropathologic burden with more rapid cognitive decline. Conclusion The results suggest that the contribution of education to cognitive reserve is limited to its association with level of cognitive function before old age.
Key findings
- Results Participants had a mean of 16.3 years of education (SD = 3.7, range 0-30).
- In all participants, education was associated with initial level of global cognition but not rate of cognitive change.
- Higher education was associated with lower likelihood of gross and microscopic cerebral infarcts but not with other neuropathologic markers.
- Conclusion The results suggest that the contribution of education to cognitive reserve is limited to its association with level of cognitive function before old age.
Why it matters
In this cohort study, education was associated with a higher initial level of global cognition but not with the rate of cognitive change, and higher education was linked to a lower likelihood of cerebral infarcts but not other neuropathologic markers. The authors conclude that education's contribution to cognitive reserve is limited to its association with the level of cognitive function before decline begins.
New to this subject? Start with our plain-English guide: Caregiving →
Study details
- Study designcohort study
- Participants2,899
- Evidence strengthModerate
How this study scored 65/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 62 of the 96 points we could judge it on, which is 65 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2019 — within 10 year(s) of the newest study here |
| Sample size | 3 / 4 | 2,899 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 266 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 29.6 citations a year over 9 year(s) since 2019 |
| Impact for its field and year | 4 / 6 | Cited 18.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 15 other studies in this library |
| Still being cited | 3 / 4 | Cited 125 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 0 / 3 | Rush University Medical Center: institution h-index 670 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 30728309) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 62 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 62 of the 96 points we could judge it on is 65 out of 100. |
| Total | 65 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Wilson, R. S., Yu, L., Lamar, M., Schneider, J. A., Boyle, P. A., & Bennett, D. A. (2019). Education and cognitive reserve in old age. Neurology. https://doi.org/10.1212/wnl.0000000000007036
Vancouver
Wilson RS, Yu L, Lamar M, Schneider JA, Boyle PA, Bennett DA. Education and cognitive reserve in old age. Neurology. 2019. doi:10.1212/wnl.0000000000007036. PMID: 30728309.
BibTeX
@article{wilson2019-30728309,
author = {Wilson, R. S. and Yu, L. and Lamar, M. and Schneider, J. A. and Boyle, P. A. and Bennett, D. A.},
title = {{Education and cognitive reserve in old age}},
journal = {Neurology},
year = {2019},
doi = {10.1212/wnl.0000000000007036},
pmid = {30728309},
url = {https://doi.org/10.1212/wnl.0000000000007036}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here. Showing 12 of 14.
Later studies that cite this one
15 studies in the alzhub library list this one in their references. Showing the 8 highest-scoring.
Related studies in Caregiving
Also tagged “cognitive-function”
1,118 studies in the library carry the topic tag “cognitive-function”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 1,118 tagged studies.