Session Information
Date: Monday, June 5, 2017
Session Title: Epidemiology
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To examine whether brain reserve plays a role in the severity and progression of motor, cognitive, and non-motor symptoms in Parkinson’s disease (PD), by assessing whether education level is associated with baseline performances or rate of progression.
Background: In elderly people without neurodegenerative diseases, higher education is associated with better cognitive and motor performances but not with slower decline, consistent with a passive reserve hypothesis. In dementia, rate of decline is usually more rapid in patients with greater education. It has been little investigated whether education level is associated with motor or non-motor outcomes in PD patients.
Methods: Data were collected as part of an on-going longitudinal study of consecutive PD patients with 5y or less of disease duration at baseline and followed annually over 6 years (DIG-PD). We examined the relation of education (low: secondary school, 16.5%; middle: high-school, 37.9%; high: university degree, 45.6%) with time to reach Hoehn and Yahr (HY) stage≥3 using Cox regression models, and with baseline severity and progression of motor (UPDRSII-III, gait speed), cognitive (MMSE), and non-motor (depression, anxiety, non-motor symptoms scale, quality of life) symptoms using linear/logistic mixed models. Analyses were adjusted for age, sex, marital status, family history of PD, on/off state.
Results: Analyses are based on 416 patients (40% women; mean age=62.2y, SD=9.8; mean disease duration=2.6y, SD=1.5). Education level was not associated with age at onset or time to diagnosis. Higher education was associated with better motor function at baseline (P<0.001) but not with the rate of motor decline (P>0.20). Similar results were observed for cognition. Education was not associated with non-motor symptoms. Compared to the low education group, incidence of HY≥3.0 was 0.43 times lower (95% CI=0.22-0.82, P<0.001) in the high education group.
Conclusions: Higher education was associated with better baseline motor and cognitive performances in PD patients, but not with rate of decline, and this association may contribute to explain that more educated patients reached HY stage 3 less frequently than less educated patients.
To cite this abstract in AMA style:
P.C. Lee, F. Artaud, F. Cormier, O. Rascol, F. Durif, P. Derkinderen, F. Bourdain, J.-P. Brandel, F. Pico, L. Lacomblez, C. Bonnet, D. Grabli, S. Klebe, G. Mangone, H. You, V. Mesnage, A. Brice, M. Vidailhet, J.-C. Corvol, A. Elbaz. Examining the brain reserve hypothesis in Parkinson’s disease [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/examining-the-brain-reserve-hypothesis-in-parkinsons-disease/. Accessed June 15, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/examining-the-brain-reserve-hypothesis-in-parkinsons-disease/