Editorials

Education and dementia

BMJ 1995; 310 doi: http://dx.doi.org/10.1136/bmj.310.6985.951 (Published 15 April 1995) Cite this as: BMJ 1995;310:951
  1. Martin Orrell,
  2. Barbara Sahakian
  1. Senior lecturer in psychiatry of the elderly Department of Psychiatry, University College London Medical School, London W1N 8AA
  2. Lecturer Department of Psychiatry, University of Cambridge, Cambridge CB2 2QQ

    Research evidence supports the concept “use it or lose it”

    As long ago as the 2nd century BC poets and philosophers considered that an active mental life might forestall or delay the enfeeblement of old age.1 In “De Senecute” Cicero suggested that old men preserved their intellects if they preserved their interests—”the use it or lose it” hypothesis.2 In this week's journal a population based study reports that in elderly people a low level of education was associated with a higher prevalence of dementia, particularly Alzheimer's disease (p 970).3 In addition, several recent studies have indicated that education may protect against dementia.4 5 6 7 Bonaiuto et al found that the prevalence of Alzheimer's disease was 7.2% among illiterate people, 2.8% among those whose education had ceased at the fifth grade, and 0.5% among those who had studied in the fifth grade or over.5

    Jorm suggested that people with high socioeconomic status might have a greater resistance to the effects of the dementing process, either because their better premorbid intellect reflected a higher level of neural reserve or because they tended to seek more stimulating environments, which helped to prevent a decline in cognitive skills.8 Other studies, however, found no link between education and the diagnosis …

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