Premorbid Reading Activity and Patterns of Cognitive Decline in Alzheimer Disease

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Abstract
PROGRESSIVE DECLINE in cognitive function is a defining feature of Alzheimer disease, but there are substantial differences in rates of progression. As a result, there is much interest in understanding factors that contribute to this variability, especially potentially modifiable ones. Previous research has suggested that level of educational or occupational attainment may be associated with rate of progression of Alzheimer disease,1-5 but the basis of this association is uncertain. One possibility is that educational and occupational attainment are markers for cognitively stimulating experiences occurring over the life span.2,6-10 If this is true, then the amount and nature of these experiences should be independently related to progression, even after considering the effects of education or occupation.