Alzheimer's tied to education level

Smith and Greenaway
Dr. Glenn Smith is the Director of Research Pyschometrics Resource at Mayo Clinic. He and Dr. Melanie Greenaway are studying ways to preserve independence during MCI
MPR Photo/Sea Stachura

The condition is called Mild Cognitive Impairment. It's not the usual 'I forgot my keys,' 'Where is the garage door opener?' sorts of befuddlements some people face with age. It's more systemic.

For example, let's say a mom always makes her adult son his favorite biscuits when he visits. She's done this almost all his life, and suddenly she forgets to do it. That's an expression of Mild Cognitive Impairment. A person can function independently, but forgets things that were once deeply imbedded.

Ronald Petersen
Dr. Ronald Petersen is an expert in Alzheimer's disease.
Image courtesy Mayo Clinic

MCI has only come to researchers' attention in the last few years. This Mayo study is the first to take a random sample of community members and determine how many had M-C-I. Doctor Ron Petersen is the lead researcher. His team evaluated nearly 4,000 people in Olmsted County.

"And the results indicated that it looks like 12 to 15 percent of the population ages 70 to 90 have this condition," Petersen says.

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Another eight percent already had Alzheimer's. The study mainly involved caucasians, which does limit the implications for people of other colors.

But the findings are thorough. Petersen says he had access to nearly complete medical records of participants. So he was able to look at what each of them had in common. That will continue as Petersen works with smaller participant samples.

One commonality that has already come out is education level. Twenty-five percent of those with an eighth grade education or less had MCI. The disease only showed up in eight and a half percent of participants with more than a college degree. "We're asking the question now, is low education a risk for developing mild cognitive impairment as well. And it appears at this point in time that is the case," he says.

The study was funded by the National Institute on Aging. Neil Buckholtz is Chief of the Dementias of Aging Branch. He says education is a tricky risk factor to study, because you can't put it into a clinical trial or greatly modify it.

"Age is still the best risk factor that we know of for Alzheimer's Disease," Buckholtz says. "But certainly we can't modify someone's age. So it's important to understanding the process, potentially understanding the process that's going on, but it's not something that we can intervene in."

Doctors could use neuro-imaging to examine what the brain looks like when a person has MCI and little education. Doctor Petersen says this study serves as a warning on the potential number of people who will have Alzheimer's in the future.

"We're asking the question now, is low education a risk for developing mild cognitive impairment as well. And it appears at this point in time that is the case."

"And as the Baby Boomers age into this period of risk, 20 percent of the population is really huge," Petersen says.

Petersen says people with Alzheimer's require expensive long-term care. Some suggest the cost of care could bankrupt the health system.

Doctors are looking to slow MCI's progression in a number of ways. Remember the story of the mom who forgets to bake her special biscuits for her son? That woman was a participant of a related MCI study taking place at Mayo.

The study teaches participants to use a calendar to write down daily activities, to-do lists and other information. Learning and remembering is challenging for people with MCI, so doctors help them develop a habit of using the calendar. Habit comes from a different part of the brain.

Melanie Greenaway is a neuropsychology fellow and one of the project's leaders. She says the calendar has helped that particular mom keep up with her daily activities and feel better about herself.

"When his next visit was due, she wanted very much to remember to do this," Greenaway says. "So she wrote out a reminder for herself. Even to the point of, take this out the day before, let it rise. She had it available for him. And it was huge to the family."

Greenaway says this technique won't stop the progression of the disease, but it will hopefully keep people functioning independently for longer periods. The memory compensation study is still looking for participants in the Twin Cities and Rochester area.