Effect of educational attainment on survival in Alzheimer's disease

To test the hypothesis that education may affect clinical course and surviv al in Alzheimer's disease (AD) patients we examined retrospectively a large AD database and obtained information from the National Death Index concern ing these patients. AD patients with >11 years of education thigh school co mplete) were compared with AD patients who had less than or equal to 11 yea rs of education thigh school incomplete) on measures of cognition and overa ll function. As compared with AD patients with high school incomplete, AD p atients with high school complete presented at a significantly earlier aver age age (72.9 +/- 8.6 vs. 75.9 +/- 6.5 years; p<0.001), with less cognitive impairment as indicated by Mini-mental State scores (17.0 +/- 6.2 vs. 14.8 +/- 6.0; p<0.001), but no difference in global functioning as indicated by scores on the Blessed Dementia Rating Scale. Despite their higher cognitiv e scores at entry, AD patients with high school complete had essentially th e same duration of illness and died at a slightly earlier age than those wi th high school incomplete. Survival analysis showed no effect of concomitan t heart disease, hypertension, lung disease, diabetes, thyroid disease, hea d injury or Parkinson symptoms; nor was there an effect of the life style f actors of cigarette smoking or alcohol use.