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Educational attainment and cognitive decline in old age
Wilson RS, Hebert LE, Scherr PA, Barnes LL, Mendes de Leon CF, Evans DA.. Neurology, 2009-02-01
Topic: Risk, prevention and care in population studies
Background Level of education is a well-established risk factor for Alzheimer disease but its relation to cognitive decline, the principal clinical manifestation of the disease, is uncertain. Methods More than 6,000 older residents of a community on the south side of Chicago were interviewed at approximately 3-year intervals for up to 14 years. The interview included administration of four brief tests of cognitive function from which a previously established composite measure of global cognition was derived. We estimated the associations of education with baseline level of cognition and rate of cognitive change in a series of mixed-effects models. Results In an initial analysis, higher level of education was related to higher level of cognition at baseline, but there was no linear association between education and rate of change in cognitive function. In a subsequent analysis with terms to allow for nonlinearity in education and its relation to cognitive decline, rate of cognitive decline at average or high levels of education was slightly increased during earlier years of follow-up but slightly decreased in later years in comparison to low levels of education. Findings were similar among black and white participants. Cognitive performance improved with repeated test administration, but there was no evidence that retest effects were related to education or attenuated education's association with cognitive change. Conclusions The results suggest that education is robustly associated with level of cognitive function but not with rate of cognitive decline and that the former association primarily accounts for education's correlation with risk of dementia in old age.
Key findings
- Results In an initial analysis, higher level of education was related to higher level of cognition at baseline, but there was no linear association between education and rate of change in cognitive function.
- Conclusions The results suggest that education is robustly associated with level of cognitive function but not with rate of cognitive decline and that the former association primarily accounts for education's correlation with risk of dementia in old age.
Why it matters
In more than 6,000 older Chicago residents tested about every 3 years for up to 14 years, people with more education scored higher on memory and thinking tests at the start, but their scores did not fall at a measurably different rate. The pattern was similar in black and white participants and was not explained by people improving with repeated testing. The authors conclude that education's link to dementia risk mainly reflects this higher starting level. The study was observational and tested no treatment or prevention.
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Study details
- Evidence strengthLow
How this study scored 48/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| 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 | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 353 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 18.6 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 4 / 6 | Cited 10.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 10 other studies in this library |
| Still being cited | 2 / 4 | Cited 40 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Denis A. Evans: h-index 77 (OpenAlex, whole career) |
| 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 19188578) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 48 / 100 | — |
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Read the original
- DOI: 10.1212/01.wnl.0000341782.71418.6c
- PubMed: 19188578
- Original source →
- Free full text: Neurology →
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., Hebert, L. E., Scherr, P. A., Barnes, L. L., Mendes de Leon, C. F., & Evans, D. A. (2009). Educational attainment and cognitive decline in old age. Neurology. https://doi.org/10.1212/01.wnl.0000341782.71418.6c
Vancouver
Wilson RS, Hebert LE, Scherr PA, Barnes LL, Mendes de Leon CF, Evans DA. Educational attainment and cognitive decline in old age. Neurology. 2009. doi:10.1212/01.wnl.0000341782.71418.6c. PMID: 19188578.
BibTeX
@article{wilson2009-19188578,
author = {Wilson, R. S. and Hebert, L. E. and Scherr, P. A. and Barnes, L. L. and Mendes de Leon, C. F. and Evans, D. A.},
title = {{Educational attainment and cognitive decline in old age}},
journal = {Neurology},
year = {2009},
doi = {10.1212/01.wnl.0000341782.71418.6c},
pmid = {19188578},
url = {https://doi.org/10.1212/01.wnl.0000341782.71418.6c}
}
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