Inverse relationship between education and amyloid burden in individuals with subjective cognitive decline plus and mild cognitive impairment

Background Higher educated patients with MCI can tolerate more neuropathology than lower educated patients with similar clinical impairment. It is not known whether this observation also accounts for potential preclinical stages of AD, namely subjective cognitive decline plus (SCD+). Method Data of 197 SCD+ individuals, 227 MCI and 157 AD patients were included, which were collected as part of the AMYPAD‐DPMS cohort (https://amypad.eu/). First, median education in years was computed across the AD‐spectrum groups for each of the 8 European sites. Next, using a median split, the SCD+, MCI and AD cohort were separately categorized into a higher and lower educated group, excluding subjects with median education. Afterwards, the higher and lower educated AD‐spectrum groups were matched for age, sex and cognitive function (MMSE) using propensity score matching in R, leading to the following sample (low/high education): 54/54 SCD+, 70/81 MCI and 56/65 AD patients. Global amyloid load was compared between education groups using Centiloid (CL) information derived from Flutemetamol and Florbetaben PET scans. To confirm the results of the stringent group comparison, partial correlations between years of education and CL values correcting for age, sex and tracer type were performed for each AD‐spectrum group. All analyses were conducted in SPSS 28 and significance level was set to p < .05. Result Higher educated SCD+ subjects presented significantly (p