Intelectual demand and formal education as cognitive protection factors in Alzheimer's disease

To investigate the possible association between educational level and previous professional occupation, and objective cognitive and functional evaluation in a sample of elderly patients with Alzheimer's disease. Through retrospective analysis of medical files, 174 patients with probable Alzheimer disease were randomly selected, classified and submitted to analysis according to previous professional occupation and years of formal education. Subjects with lower education and less intellectually-demanding occupations performed worse than higher educated subjects in all cognitive subtests and on the functional scale. Results indicate that not only the total years of education, but also professional occupation has an impact on cognition and functioning in accordance with the hypothesis of cognitive reserve. Our findings confirmed this hypothesis, where subjects with higher education/ higher intellectual demand manifested first symptoms later than low education/ low intellectual demand subjects, with the latter group also exhibiting faster disease progression.