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Brain Behav. Sep 2012; 2(5): 620–627.
Published online Aug 22, 2012. doi:  10.1002/brb3.88
PMCID: PMC3489814
Mild cognitive impairment: effect of education on the verbal and nonverbal tasks performance decline
Konstantinos Vadikolias,1 Anna Tsiakiri-Vatamidis,1 Grigorios Tripsianis,2 Georgios Tsivgoulis,1,5 Panagiotis Ioannidis,3 Aspasia Serdari,4 John Heliopoulos,1 Miltos Livaditis,4 and Charitomeni Piperidou1
1Department of Neurology, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
2Department of Medical Statistics, Democritus University of Thrace, Greece
3Second Department of Neurology, Aristotle University of Thessaloniki, AHEPA University Hospital, Greece
4Department of Psychiatry, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
5International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
Anna Tsiakiri-Vatamidis, Democritus University of Thrace, Medical School, Department of Neurology, Dementia Outpatient Clinic, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece 68100. Tel: +302551030491; Fax: +302551030491; E-mail: anna.neuroduth/at/, kvadikol/at/
Funding Information No funding information provided.
Received May 15, 2012; Revised June 22, 2012; Accepted July 22, 2012.
We sought to longitudinally evaluate the potential association of educational level with performance on verbal and nonverbal tasks in individuals with mild cognitive impairment (MCI). We evaluated patients with MCI, age >50 years, no medication intake, absent vascular risk factors, and no lesions on brain magnetic resonance imaging (MRI). Each patient underwent a clinical assessment packet and a series of neuropsychological tests of the language and constructional praxis subtests of Cambridge Cognitive Examination (CAMGOG) and the Boston naming test (BNT), at baseline, 6 months, and 12 months. Educational levels were defined taking into account the total years of education, the school level, and diplomas. MCI patients with low education level showed a stepwise reduction in scores of naming objects (NO; P = 0.009), definition (DF; P = 0.012), language (LT; P = 0.021), constructional praxis (CD; P = 0.022), confrontation naming skills (BXB; P = 0.033), phonemic help (BFB; P = 0.041), and BNT (P = 0.002). Analysis of covariance, controlling for baseline scores, showed that education was associated with NO score (P = 0.002), DF score (P = 0.005), LT (P = 0.008), CD score (P = 0.008), BXB score (44.36 ± 1.84, P = 0.0001), BFB (P = 0.022), and BNT (P = 0.004). Our findings indicate that education appeared to affect verbal and nonverbal task performance in MCI patients. Despite the fact that higher educated patients are more acquainted with the tasks, slower deterioration in consecutive follow-up examinations could be explained by the cognitive reserve theory. The potential association of this protective effect with delayed onset of symptoms deserves further investigation.
Keywords: Cognitive reserve, mild cognitive impairment, nonverbal, verbal
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