Educational level and neuropsychological heterogeneity in dementia of the Alzheimer type

We retrospectively assessed the data from 24 patients with dementia of the Alzheimer type (DAT) who underwent comprehensive neuropsychological evaluations in order to determine whether there is a relationship between neuropsychological heterogeneity and educational level. Postmortem neuropathological examination results were made available for seven cases, confirming the diagnosis of DAT. Thirteen patients had less than or equal to 8 years of schooling (less educated subgroup), and the other ii had greater than or equal to 8 years (higher educated subgroup). There were no significant differences between the two subgroups regarding age and duration of symptoms. Performance within each subgroup was compared with that of a specific set of education-marched elderly controls. In the less educated subgroup, 10 patients evidenced a homogeneous pattern of cognitive impairment, with all cognitive areas being similarly affected. Conversely, 10 higher educated patients had at least one cognitive area relatively preserved in comparison with the others, characterizing a heterogeneous pattern of impairment. These data suggest that a high level of education may lead to a greater capacity to compensate for neuronal damage and determines specific patterns of cognitive impairment in DAT.