Relation of education to brain size in normal aging: implications for the reserve hypothesis

Neurology. 1999 Jul 13;53(1):189-96. doi: 10.1212/wnl.53.1.189.

Abstract

Objective: To examine the relations between education and age-related changes in brain structure in a nonclinical sample of elderly adults.

Background: Education may protect against cognitive decline in late life--an observation that has led to the "reserve" hypothesis of brain aging. Little is known, however, about the effect of education on age-related changes in brain structure.

Methods: Quantitative MRI of the brain was performed in 320 elderly volunteers (age range, 66 to 90 years) living independently in the community (Mini-Mental State Examination scores > or =24), all of whom were participants in the Cardiovascular Health Study. Blinded measurements of global and regional brain size were made from T1-weighted axial images using computer-assisted edge detection and trace methodology. High measurement reliabilities were obtained.

Results: Regression analyses (adjusting for the effects of intracranial size, sex, age, age-by-sex interactions, and potential confounders) revealed significant main effects of education on peripheral (sulcal) CSF volume-a marker of cortical atrophy. Each year of education was associated with an increase in peripheral CSF volume of 1.77 mL (p<0.03). As reported previously, main effects of age (but not education) were observed for all of the remaining brain regions examined, including cerebral hemisphere volume, frontal region area, temporoparietal region area, parieto-occipital region area, lateral (Sylvian) fissure volume, lateral ventricular volume, and third ventricle volume.

Conclusions: The authors' findings demonstrate a relation between education and age-related cortical atrophy in a nonclinical sample of elderly persons, and are consistent with the reserve hypothesis as well as with a small number of brain imaging studies in patients with dementia. The neurobiological basis and functional correlates of this education effect require additional investigation.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged / physiology*
  • Aged / psychology
  • Aged, 80 and over / physiology*
  • Aged, 80 and over / psychology
  • Atrophy
  • Brain / anatomy & histology*
  • Brain / growth & development
  • Cerebral Cortex / growth & development
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiology
  • Cerebrospinal Fluid*
  • Educational Status*
  • Female
  • Functional Laterality
  • Health Status
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mental Status Schedule
  • Regression Analysis
  • Sex Characteristics