Alzheimer’s dementia: continuing education in adulthood may be protective

  • Matyas N & al.
  • BMJ Open
  • 2 Jul 2019

  • International Clinical Digest
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  • Continuing education during middle or older age may boost cognitive reserve and thereby reduce dementia risk.

Why this matters

  • Rising prevalence of dementia and limited preventive interventions.

Key results

  • At 4 years, relative to controls, adults participating in continuing education (minimum 12 months of part-/full-time university study) were more likely to have an increase in cognitive reserve (92.5% vs 55.7%; P<.01>
  • Language processing increased in continuing education group, decreased in control group (P<.01>
  • Groups not significantly different on episodic memory, working memory, executive function.
  • All systematic reviews found participation in cognitively stimulating leisure activities associated with reduced dementia incidence, improved cognitive test performance.

Study design

  • Study focusing on adults aged ≥45 years with normal cognition:
    • Systematic review of 2 publications from ongoing prospective cohort study of continuing education among 459 adults (mean age, 59.6 years in education group, 62.4 years in control group).
    • Overview of 5 systematic reviews of cognitive leisure activities and dementia (913 to 24,554 adults).
  • Main outcomes: mild cognitive impairment, Alzheimer’s dementia.
  • Funding: Danube University Krems, Austria.


  • Low certainty of evidence.
  • Wide variation in measurement, types of cognitive leisure activities.
  • Quantitative analyses often not possible.
  • Majority of systematic reviews had methodologic issues.

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