Intelligent hide mental decline, US survey reveals

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New York: Highly educated people are better at hiding the signs of dementia which means they go downhill faster in the later stages of Alzheimer’s, says a new report from the Albert Einstein College of Medicine of Yeshiva University.

Alzheimer’s is caused by an accumulation of ‘plaques and tangles’ or protein deposits in the brain which may first lead to difficulty finding words. This progresses to typical symptoms of dementia, loss of memory, confusion and agitation.

Researchers in New York at looked at 117 people who developed dementia out of an original group of 488 from the 1980s onwards.

The study looked at people born between 1894 and 1908, had formal education levels ranging from less than three years’ schooling to postgraduate level. For six years, they were given annual cognitive tests which assessed memory, speech and ability to think.

The results, published in the journal Neurology, found that for each additional year of formal education, the accelerated memory decline associated with oncoming dementia was delayed by approximately two and a half months.

However, once that rapid decline commenced, those with more education saw their rate of decline accelerate 4 per cent faster for each additional year of education.

They found that, for example, a college graduate with 16 years of education, whose dementia is diagnosed at age 85, would have begun to experience accelerated memory decline 3.8 years earlier, at age 81.

A person with just four years of education, who is diagnosed at the same age, would have begun to experience a less rapid rate of decline around age 79, more than six years before diagnosis.

Researcher Charles Hall, an associate professor at Albert Einstein College, said it was well recognised that intelligent dementia victims get symptoms at a later stage than less clever sufferers.

‘Our study showed that a person with 16 years of formal education would experience a rate of memory decline that is 50 per cent faster than someone with just four years education,’ he said.

‘This rapid decline may be explained by how people with more education have a greater cognitive reserve, or the brain’s ability to maintain function in spite of damage.

‘So, while they’re often diagnosed with dementia at a later date – which we believe may be because of their ability to hide the symptoms – there’s still damage to their brain.’

Dr Hall said the better educated did not make a ‘conscious’ effort to hide their failing memory, but were benefiting from greater mental reserves which allowed them to compensate for it in the short-term.

He added that the fact that highly- educated dementia victims experience a period of rapid mental decline will have implications for the families and for the success of new treatments.