Higher educational attainment is linked to better episodic memory even among adults aged 90 years and older, according to findings published in Alzheimer’s & Dementia.

Previous research has shown that greater education is linked to lower dementia risk and larger hippocampal volumes. However, the influence of education as a protective factor in adults over 90 years of age, particularly across racially and ethnically diverse populations, had not been clearly defined.

Researchers analyzed 277 participants (mean age, 93.1 years; 54.5% women) enrolled in the LifeAfter90 study. Participants represented a diverse population of Asian, Black, Latinx, and White adults. Education was self-reported and categorized by years of formal schooling. Brain structure was assessed using 3T magnetic resonance imaging to measure hippocampal volume adjusted for total intracranial volume, while verbal episodic memory was evaluated using the Spanish and English Neuropsychological Assessment Scales. The researchers used regression, mediation, and moderated mediation models to assess relationships between education, hippocampal volume, and memory performance, controlling for age, sex, and the interval between imaging and cognitive testing.

 

Overall, these findings support a positive influence of prolonged formalized education on memory among the diverse oldest-old adults.

Higher education was significantly associated with better episodic memory performance (β, 0.153; P =.012). Greater hippocampal volume also predicted stronger memory performance (β, 0.171; P =.007). However, education itself was not directly associated with hippocampal volume overall (P =.785).

When examined by race and ethnicity, associations differed. Higher education predicted larger hippocampal volume in Black participants (b, 0.07; 95% CI, 0.011-0.132; P =.021) but smaller hippocampal volume in Latinx participants (b, -0.04; 95% CI, -0.074 to -0.003; P =.03). Among Latinx participants, smaller hippocampal volume mediated the link between higher education and poorer memory performance (indirect effect b, -0.011; 95% CI, -0.027 to -0.001).

Overall, higher education remained positively associated with memory across all groups (b, 0.044; P =.009), suggesting that educational attainment may provide lasting resilience for cognitive health well into advanced age.

Study limitations include a cross-sectional design, possible underpowered subgroup analyses, potential selection bias, and educational differences across racial and ethnic groups.  “Overall, these findings support a positive influence of prolonged formalized education on memory among the diverse oldest-old adults,” concluded the authors.