Education, APOE ɛ4, and Cognition in Individuals with Subjective Cognitive Decline with Worry in the SILCODE Study
Background: Education could offer a protective effect on cognition in individuals with Subjective Cognitive Decline (SCD), which is considered to be the early stage of Alzheimer’s Dis- ease (AD). However, the effect of education on cognition in SCD individuals with SCD-plus fea- tures is not clear. Objective: The aim of the study was to explore the effect of education on cognition in SCD individ- uals with SCD-plus features. Methods: A total of 234 individuals with SCD were included from the Sino Longitudinal Study on Cognitive Decline (SILCODE). Cognition was assessed across 4 domains (memory, executive, lan- guage, and general cognitive functions). Multiple linear regression models were constructed to ex- amine the effect of education on cognitive scores in individuals without worry (n=91) and with wor- ry (n=143). Furthermore, we assessed differences in effects between APOE ε4 noncarriers and APOE ε4 carriers in both groups. Results : Multiple linear regression analysis showed a positive effect of education on memory, ex- ecutive, and language cognition in individuals without worry and all cognitive domains in individu- als with worry. Furthermore, we found a positive effect of education on executive cognition in APOE ε4 noncarriers without worry and language and general cognition in APOE ε4 carriers with- out worry. Meanwhile, education had a positive effect on all cognitive domains in APOE ε4 noncar- riers with worry and executive, language, and general cognition in APOE ε4 carriers with worry. Conclusion: This study indicates that education has the potential to delay or reduce cognitive dec- line in SCD individuals with SCD-plus features.