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Qualitative and quantitative educational disparities and brain signatures in healthy aging and dementia across global settings
Raúl González-Gómez, Josephine Cruzat, Hernán Guillermo Hernández, Joaquín Migeot, Agustina Legaz, Hernando A Santamaría‐García, Sol Fittipaldi, Marcelo Adrián Maito et al.. EClinicalMedicine, 2025-04-01
Topic: Risk, prevention and care in population studies
Background While education is crucial for brain health, evidence mainly relies on individual measures of years of education (YoE), neglecting education quality (EQ). The effect of YoE and EQ on aging and dementia has not been compared. Methods We conducted a cross-sectional assessment of the effect of EQ and YoE on brain health in 7533 subjects from 20 countries, including healthy controls (HCs), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD). EQ was based on country-level quality indicators provided by the programme for international student assessment (PISA). After applying neuroimage harmonization, we examined its effect, along with YoE, on gray matter volume and functional connectivity. Regression models were adjusted for age, sex, and cognition, controlling for multiple comparisons. The influence of image quality was assessed through sensitivity analysis. Data collection was conducted between June 1 and October 30, 2024. Findings Less EQ and YoE were associated with brain alterations across groups. However, EQ had a stronger influence, mainly targeting the critical areas of each condition. At the whole-brain level, EQ influenced volume (HCs: Δmean = 2·0 [1·9–2·0] × 10 −2 , p < 10 −5 ; AD: Δmean = 0·1 [−0·0 to 0·3] × 10 −2 , p = 0·18; FTLD: Δmean = 3·5 [3·0–4·0] × 10 −2 , p < 10 −5 ; all with 95% confidence intervals) and networks (HCs: Δmean = 13·5 [13·2–13·7] × 10 −2 , p < 10 −5 ; AD: Δmean = 5·9 [5·2–6·7] × 10 −2 , p < 10 −5 ; FTLD: Δmean = 13·2 [11·2–13·7] × 10 −2 , p < 10 −5 ) 1·3 to 7·0 times more than YoE. These effects remain robust despite variations in income and socioeconomic factors at country and individual levels. Interpretation The results support the need to incorporate education quality into studying and improving brain health, underscoring the importance of country-level measures. Funding Multi-partner consortium to expand dementia research in Latin America (ReDLat).
Key findings
- Findings Less EQ and YoE were associated with brain alterations across groups.
- Interpretation The results support the need to incorporate education quality into studying and improving brain health, underscoring the importance of country-level measures.
Why it matters
In 7,533 people across 20 countries, both fewer years of education and lower education quality were associated with brain alterations, with education quality having a stronger influence. It is a cross-sectional study of education and brain health, not a test of treating, curing, or preventing Alzheimer's disease.
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Study details
- Study designcross-sectional
- Participants7,533
- Evidence strengthLow
How this study scored 59/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (EClinicalMedicine) |
| Journal's citation record | 2 / 4 | EClinicalMedicine: journal h-index 150 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| 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 | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 7,533 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 | 3 / 7 | Cited 19 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 12.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 2 / 4 | Cited 19 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Agustín M. Ibáñez: h-index 81 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 26 institution(s) in 10 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40270712) |
| Free to read | 2 / 2 | Free to read |
| Total | 59 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1016/j.eclinm.2025.103187
- PubMed: 40270712
- Original source →
- Free full text: EClinicalMedicine →
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. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
González-Gómez, R., Cruzat, J., Hernández, H. G., Migeot, J., Legaz, A., Santamaría‐García, H. A., et al. (2025). Qualitative and quantitative educational disparities and brain signatures in healthy aging and dementia across global settings. EClinicalMedicine. https://doi.org/10.1016/j.eclinm.2025.103187
Vancouver
González-Gómez R, Cruzat J, Hernández HG, Migeot J, Legaz A, Santamaría‐García HA, et al. Qualitative and quantitative educational disparities and brain signatures in healthy aging and dementia across global settings. EClinicalMedicine. 2025. doi:10.1016/j.eclinm.2025.103187. PMID: 40270712.
BibTeX
@article{gonzalezgomez2025-40270712,
author = {González-Gómez, Raúl and Cruzat, Josephine and Hernández, Hernán Guillermo and Migeot, Joaquín and Legaz, Agustina and Santamaría‐García, Hernando A and Fittipaldi, Sol and Maito, Marcelo Adrián and others},
title = {{Qualitative and quantitative educational disparities and brain signatures in healthy aging and dementia across global settings}},
journal = {EClinicalMedicine},
year = {2025},
doi = {10.1016/j.eclinm.2025.103187},
pmid = {40270712},
url = {https://doi.org/10.1016/j.eclinm.2025.103187}
}
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