Neurology 1999;53:189
© 1999 American Academy of Neurology
Articles
Relation of education to brain size in normal aging
Implications for the reserve hypothesis
C. E. Coffey, MD,
J. A. Saxton, PhD,
G. Ratcliff, PhD,
R. N. Bryan, MD, PhD and
J. F. Lucke, PhD
From the Departments of Psychiatry and of Neurology (Dr. Coffey), Henry Ford Health System, Detroit, MI; the University of Pittsburgh Medical Center (Drs. Saxton, Ratcliff, and Lucke), Pittsburgh, PA; HealthSouth Harmarville Rehabilitation Hospital (Dr. Ratcliff), Pittsburgh, PA; the Department of Radiology (Dr. Bryan), Clinical Center, NIH, Washington, DC; and the University of Pittsburgh School of Nursing (Dr. Lucke), Pittsburgh, PA.
Address correspondence and reprint requests to Dr. C. Edward Coffey, Department of Psychiatry, Henry Ford Health System, 1 Ford Place, Detroit, MI 48202; e-mail: ecoffey1{at}hfhs.org
OBJECTIVE: To examine the relations between education and age-related changes in brain structure in a nonclinical sample of elderly adults. Background: Education may protect against cognitive decline in late life—an observation that has led to the "reserve" hypothesis of brain aging. Little is known, however, about the effect of education on age-related changes in brain structure.
METHODS: Quantitative MRI of the brain was performed in 320 elderly volunteers (age range, 66 to 90 years) living independently in the community (Mini-Mental State Examination scores  24), all of whom were participants in the Cardiovascular Health Study. Blinded measurements of global and regional brain size were made from T1-weighted axial images using computer-assisted edge detection and trace methodology. High measurement reliabilities were obtained.
RESULTS: Regression analyses (adjusting for the effects of intracranial size, sex, age, age-by-sex interactions, and potential confounders) revealed significant main effects of education on peripheral (sulcal) CSF volume—a marker of cortical atrophy. Each year of education was associated with an increase in peripheral CSF volume of 1.77 mL (p < 0.03). As reported previously, main effects of age (but not education) were observed for all of the remaining brain regions examined, including cerebral hemisphere volume, frontal region area, temporoparietal region area, parieto-occipital region area, lateral (Sylvian) fissure volume, lateral ventricular volume, and third ventricle volume.
CONCLUSIONS: The authors’ findings demonstrate a relation between education and age-related cortical atrophy in a nonclinical sample of elderly persons, and are consistent with the reserve hypothesis as well as with a small number of brain imaging studies in patients with dementia. The neurobiological basis and functional correlates of this education effect require additional investigation.
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