Objective: To investigate the influence of education level (EL) on motor and non-motor aspects of Parkinson’s disease (PD) in a Brazilian sample.

Background: Only 30% of older adults (above 60 years) in Brazil have secondary or higher education.  EL has been suggested to influence motor symptoms and cognition in patients with PD. Those with low EL show worse symptoms and are more likely to develop mild cognitive impairment and dementia. However, this topic has been little explored in Brazilian sample.

Methods: Ninety-seven individuals with idiopathic PD were distributed into two groups according to their EL: low EL group (≤ 6 years of education, n = 50) and high EL group (> 6 years of education, n = 47). Participants self-reported how many years of formal education they had during life. Participants were assessed in relation to disease severity (UPDRS I, II, III and total score, and H&Y), global cognition (Mini-Mental), working memory (Weschler forward and backward Digit Span), visuospatial ability (Clox 1), attention (Weschler Symbol Search), executive function (Wisconsin Card Sorting Test and Clox 2), anxiety and depression (Hospital Anxiety and Depression Scale) and stress (Stress Symptoms Inventory- Lipp). Groups were compared using Mann Whitney-test and significance level was set as p<0.05.

Results: Groups were similar for age (p=0.295) and disease duration (p=0.084). Significant between groups differences were observed for UPDRS II (p=0.015), UPDRS III (p=0.027), UPDRS total score (p=0.022), H&Y (p=0.008), attention (p=0.004), working memory (backward digit spam, p=0.001), visuospatial ability (p=0.001) and executive function (Clox 2, p<0.001). The low EL group showed worse score than the high EL group for all these variables.

Conclusions: These results suggest that the EL has an important impact on motor and non-motor aspects of patients with PD. Since groups were paired for age and disease duration, current findings suggest that patients with low EL had a faster disease progression and a more evident decline in cognition than patients with higher EL. A possible explanation is that higher EL may offer/build greater motor and cognitive reserves. Thus, this fact should be considered during the design of interventions to assist the Brazilian population with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-education-level-on-motor-and-non-motor-symptoms-of-brazilian-patients-with-parkinsons-disease/