Head Circumference, Education and Risk of Dementia: Findings from the Nun Study

@article{Mortimer2003HeadCE,  title={Head Circumference, Education and Risk of Dementia: Findings from the Nun Study},  author={James A. Mortimer and David A. Snowdon and William R. Markesbery},  journal={Journal of Clinical and Experimental Neuropsychology},  year={2003},  volume={25},  pages={671 - 679},  url={https://api.semanticscholar.org/CorpusID:20727671}}
It is suggested that higher education and larger head size, alone or in combination, may reduce the risk of expressing dementia in late life.

289 Citations

Small Head Circumference is Associated With Less Education in Persons at Risk for Alzheimer Disease in Later Life

The findings suggest that small HC limits educational attainment only among individuals who have greater risk of AD owing to their APOE genotype or who are destined to develop this illness later in life.

Smaller Head Circumference Combined with Lower Education Predicts High Risk of Incident Dementia: The Shanghai Aging Study

It is suggested that smaller HC in combination with low education leads to a markedly increased risk of dementia.

Head circumference, atrophy, and cognition

This study suggests that larger head circumference is associated with less cognitive impairment in the face of cerebral atrophy, and supports the notion that head circumference (and presumably brain size) offers protection against AD symptoms through enhanced brain reserve.

Education and Alzheimer disease without dementia

The theory that individuals with greater cognitive reserve, as reflected in years of education, are better able to cope with AD brain pathology without observable deficits in cognition is supported.

Alzheimer's disease and head circumference

The authors observed a smaller HC in AD patients compared to nondemented individuals, but AD per se accounted for little of this difference, and HC was not a statistically significant predictor for conversion to AD in their longitudinal group.

Association of head circumference with cognitive decline and symptoms of depression in elderly: a 3-year prospective study

Head circumference was not associated with cognitive change but was associated with symptoms of depression in non-demented community residents, and interestingly, participants with larger head circumference showed rapid worsening than those with smaller head circumference with marginal significance by ANOVA test.

Education, the brain and dementia: neuroprotection or compensation?

More education did not protect individuals from developing neurodegenerative and vascular neuropathology by the time they died but it did appear to mitigate the impact of pathology on the clinical expression of dementia before death.

Education, cognitive function, and severity of neuropathology in Alzheimer disease

Higher Mini-Mental State Examination scores among more educated persons with mild or no AD may reflect better test-taking skills or cognitive reserve, but these advantages may ultimately be overwhelmed by AD neuropathology.
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46 References

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Low educational attainment was associated with increased risk of non-AD dementia, perhaps because of deleterious smoking habits and other risk factors for stroke in the least-educated individuals.

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The results are consistent with previous studies that suggest that premorbid brain size may influence the age-specific risk for AD and future epidemiologic studies seeking environmental risk factors for AD may benefit by making HC measurements on all subjects to decrease the variance associated with other potential risk factors.

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Improvement in environmental factors in prenatal and early life that partially determine completed brain/head size may have consequences for the late-life expression of Alzheimer's disease in vulnerable individuals.

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Increased educational and occupational attainment may reduce the risk of incident AD, either by decreasing ease of clinical detection of AD or by imparting a reserve that delays the onset of clinical manifestations.

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Female gender, current smoking, and low levels of education, and current smoking increased the risk of AD significantly, while head trauma was not a risk factor for AD, and smoking did not protect against AD.

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The findings suggest that the first decade of life is a critical period for developing dementia later in life, and the decrease in dementia risk may be due to schooling, according to the cerebral reserve hypothesis, or to other factors associated with a higher educational level during childhood.

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This study confirmed a number of previously reported risk factors for AD, but provided little support for others; a new finding was an increased risk for those with occupational exposure to glues as well as pesticides and fertilizers, but this needs further study.

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The incidence of dementia increases with age, even in the oldest age groups, and women have a higher risk of developing dementia than men, especially at very old ages, mainly due to the age and gender distribution of Alzheimer's disease, rather than vascular dementia.

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