Influence of education on the relationship between white matter lesions and cognition

Neurology. 2003 Mar 11;60(5):831-6. doi: 10.1212/01.wnl.0000049456.33231.96.


Objective: To test the hypothesis that education level modulates the effects of cerebral white matter hyperintensities (WMH) on cognition in a large population-based study.

Methods: A total of 845 elderly subjects aged 64 to 76 years who enrolled in a longitudinal study on cognitive decline and vascular aging had an MRI examination. Cognitive functions were assessed by Mini-Mental State Examination, Trail Making Test Part B, Digit Symbol Substitution Test of the Wechsler Adult Intelligence Scale-Revised, Finger Tapping Test, Word Fluency Test, and Raven Progressive Matrix. MRI scans were interpreted visually using a standardized scale for rating WMH.

Results: Severe WMH were present in 17% of the participants who had lower performances on tests involving attention tasks. In participants with a lower level of education, presence of severe WMH was significantly associated with lower cognitive performances. This was found for all cognitive tests. Conversely, in participants with a high level of education, there was no significant association between severity of WMH and level of cognitive functions.

Conclusion: Education modulates the consequences of WMH on cognition. Participants with a high level of education were protected against the cognitive deterioration related to vascular insults of the brain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aging / physiology
  • Brain Damage, Chronic / diagnosis*
  • Brain Damage, Chronic / epidemiology*
  • Cerebrovascular Disorders / diagnosis*
  • Cerebrovascular Disorders / epidemiology*
  • Cognition / physiology
  • Cognition Disorders / epidemiology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Educational Status*
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuropsychological Tests / statistics & numerical data
  • Vascular Diseases / epidemiology