%0 Journal Article %J J Alzheimers Dis %D 2024 %T African Ancestry Individuals with Higher Educational Attainment Are Resilient to Alzheimer's Disease Measured by pTau181. %A Rajabli, Farid %A Seixas, Azizi A %A Akgun, Bilcag %A Adams, Larry D %A Inciute, Jovita %A Hamilton, Kara L %A Whithead, Patrice G %A Konidari, Ioanna %A Gu, Tianjie %A Arvizu, Jamie %A Golightly, Charles G %A Starks, Takiyah D %A Laux, Renee %A Byrd, Goldie S %A Haines, Jonathan L %A Beecham, Gary W %A Griswold, Anthony J %A Vance, Jeffery M %A Cuccaro, Michael L %A Pericak-Vance, Margaret A %K Alzheimer Disease %K Apolipoprotein E4 %K Cognitive Dysfunction %K Educational Status %K Humans %K Resilience, Psychological %X

BACKGROUND: Cognitive and functional abilities in individuals with Alzheimer's disease (AD) pathology (ADP) are highly variable. Factors contributing to this variability are not well understood. Previous research indicates that higher educational attainment (EA) correlates with reduced cognitive impairments among those with ADP. While cognitive and functional impairments are correlated, they are distinguishable in their manifestations.

OBJECTIVE: To investigate whether levels of education are associated with functional impairments among those with ADP.

METHODS: This research involved 410 African American (AA) individuals (Institutional Review Boards 20070307, 01/27/2023) to ascertain whether EA correlates with functional resilience and if this effect varies between APOE ɛ4 carriers and non-carriers. Utilizing EA as a cognitive reserve proxy, CDR-FUNC as a functional difficulties measure, and blood pTau181 as an ADP proxy, the non-parametric Mann-Whitney U test assessed the relationship between EA and CDR-FUNC in individuals with advanced pTau181 levels.

RESULTS: The results showed that EA correlated with functional difficulties in AA individuals with high levels of pTau181, such that individuals with high EA are more likely to have better functional ability compared to those with lower EA (W = 730.5, p = 0.0007). Additionally, we found that the effect of high EA on functional resilience was stronger in ɛ4 non-carriers compared to ɛ4 carriers (W = 555.5, p = 0.022).

CONCLUSION: This study extends the role of cognitive reserve and EA to functional performance showing that cognitive reserve influences the association between ADP burden and functional difficulties. Interestingly, this protective effect seems less pronounced in carriers of the strong genetic risk allele ɛ4.

%B J Alzheimers Dis %V 98 %P 221-229 %8 2024 %G eng %N 1 %1 https://www.ncbi.nlm.nih.gov/pubmed/38393909?dopt=Abstract %R 10.3233/JAD-231116 %0 Journal Article %J J Alzheimers Dis %D 2019 %T Education Moderates the Relation Between APOE ɛ4 and Memory in Nondemented Non-Hispanic Black Older Adults. %A Vonk, Jet M J %A Rentería, Miguel Arce %A Medina, Valerie M %A Pericak-Vance, Margaret A %A Byrd, Goldie S %A Haines, Jonathan %A Brickman, Adam M %A Manly, Jennifer J %X

BACKGROUND: The APOEɛ4 allele is a well-known risk factor for Alzheimer's disease (AD). Previous research argues that higher education helps to preserve cognition in older adults with AD pathology because of its key role in cognitive reserve and resilience.

OBJECTIVE: To test if higher educational level buffers the effect of APOEɛ4 on cognition among older non-Hispanic Blacks.

METHODS: Participants were 849 non-demented older non-Hispanic Blacks (38.3% APOEɛ4+), who underwent a comprehensive neuropsychological evaluation. Multiple linear regression models tested the relationship between APOEɛ4 status and twelve cognitive measures with education (up to high school and beyond high school) as a moderator.

RESULTS: Education buffered the effects of the APOEɛ4 allele, such that there was no impact of APOEɛ4 status on word-list memory retention and working memory among participants with more than a high school degree. This pattern was not observed for ten other cognitive measures of verbal and visual episodic memory, semantic memory, executive function, and processing speed-although a similar trend was observed for switching ability in executive functioning. The buffering effect of education was stronger among women than men.

CONCLUSION: Our findings suggest that genetic effects on late-life cognition may be modified by environmental factors such as educational attainment. These results are consistent with the framework of cognitive reserve such that engaging in cognitively enriching activities and acquiring skills and knowledge with more years of education may increase the capacity to maintain cognitive function despite high genetic risk for impairment.

%B J Alzheimers Dis %V 72 %P 495-506 %8 2019 Nov 12 %G eng %N 2 %R 10.3233/JAD-190415