Education, atrophy, and cognitive change in an epidemiological sample in early old age

OBJECTIVES:: To examine one version of the brain reserve hypothesis in a community sample of young-old participants. The authors investigated whether atrophy and white matter hyperintensities (WMH) were associated with cognitive decline, and whether this relationship was modified by the endowment of greater reserve as measured by years of education and brain size (intracranial volume ICV). DESIGN:: Longitudinal cohort study with 4-year follow-up. PARTICIPANTS:: A community sample of 416 adults aged 60-64 years at baseline. MEASUREMENTS:: Years of education and brain size were examined as measures of brain reserve. The association between these measures and brain atrophy and white matter hyperintensities (WMH) on magnetic resonance imaging and change in cognitive function over 4 years was determined. RESULTS:: Changes in cognitive test scores over 4 years had no correlation with years of education, atrophy, WMH, or ICV. There was no interaction of atrophy or level of WMH with education or brain size on cognitive change. CONCLUSION:: In a young-old sample, there is no direct evidence to support the brain reserve hypothesis as operationalized in this study. WMH and atrophy were not associated with cognitive change.