Research Study: School Helps Your Brain Health

That is the hopeful conclusion of a study by the John P. Hussman Institute for Human Genomics at the University of Miami Miller School of Medicine that looked at how cognitive reserve positively affects Alzheimer’s Disease (AD) patients of African descent.

Researchers at the University of Miami Health System found that African-American AD patients with higher educational achievement — a high school degree or higher — were more resilient than those with less education against the functional manifestations of the disease. This was true despite brain changes and lesions typically linked to Alzheimer’s.

The study, recently published in the Journal of Alzheimer’s Disease, supports earlier research that links education-influenced cognitive reserve to a more robust response to the degenerative damage of AD. Those studies, however, involved mainly white patients of European ancestry and measured memory-related outcomes.

The UHealth study focused on Alzheimer’s patients of African descent.

In addition, it measured functional outcomes such as the ability to maintain the daily tasks of self-care rather than memory-related changes.

“Education provides a buffer against the brain changes linked to Alzheimer’s Disease,” says Farid Rajabli, Ph.D., assistant professor of human genetics and first author on the paper. “It offers protection even in the presence of disease-related pathology.”

Dr. Rajabli and a team of Miller School researchers identified more than 400 African American AD patients for their study. They sought those with elevated markers of pTau181, which highly correlates to brain changes associated with Alzheimer’s. They also measured educational achievement and the APOE4 genetic variant, which is considered the strongest risk factor for developing the disease.

Researchers found that those with the APOE4 variant were less likely to benefit from more education.

What’s more, those with low education achievement and the APOE4 variant exhibited more and worse clinical outcomes. That said, “If you have a genetic risk factor, education still helps but not as much as if you didn’t have one,” Dr. Rajabli says.

While the concept of educational achievement as protection is promising, researchers don’t know if more years of schooling alone can affect clinical outcomes. As Dr. Rajabli says, better-educated individuals also tend to consume healthier diets, work less stressful jobs and have more money to ensure better health care. Experts also speculate that education helps increase neural connections that are then used to improvise and find alternate ways to deal with the damage of AD.

More research is also needed to determine the differences, if any, between a high school education and the extra years of schooling required for a graduate or professional degree. He adds, “We need to investigate the quality of education” with larger data sets.

Researchers have long known that genetics plays an important role in the development of AD.

All forms of dementia, including Alzheimer’s, tend to run in families.

For example, a person who has a first-degree relative — parent or sibling — with Alzheimer’s runs a higher risk of developing the disease. But it doesn’t mean this individual is destined to develop the disease automatically. Social determinants and environmental factors affect risk as well, and a growing body of research has shown that a healthy lifestyle can both protect and promote brain health.

About 6.5 million Americans who are 65 and older — or about 1 in 9 — are living with AD, according to the Alzheimer’s Association.

(A very small percentage of the under-65 set develop early-onset AD.) However, the rates of Alzheimer’s are higher among both African Americans and Hispanics: 14% among African Americans and 12% among Hispanics compared to 10% among non-Hispanic Whites.

Research is essential to better understand what can be done to prevent and treat a disorder that leads to progressive memory loss, disorientation, confusion and loss of verbal fluency.

Dr. Rajabli points out that research has already given us some weapons to delay, if not prevent, the symptoms of AD. Hypertension, diabetes, excess weight, smoking and a sedentary lifestyle contribute to the risk of developing Alzheimer’s, so physicians recommend watching your weight, exercising, and eating a Mediterranean style diet.

One more thing: “Keep yourself cognitively engaged,” he says.

“Education doesn’t stop with school. It’s a lifelong process. Read. Take courses. Be socially active.”

Ana Veciana-Suarez is a regular contributor to the University of Miami Health System. She is an acclaimed author and journalist who has worked at The Miami Herald, The Miami News, and The Palm Beach Post. Visit her website at anavecianasuarez.com or follow her on Twitter: @AnaVeciana.

Tags: academic medicine, aging brain, Brain aging, brain health, Dr. Farid Rajabli