Education is associated with Aβ burden in preclinical familial and sporadic Alzheimer’s disease

Objective. To determine whether years of education and the ε4 risk allele
at APOE influence β-amyloid pathology similarly in asymptomatic
individuals with a family history of sporadic Alzheimer’s disease (AD) and
pre-symptomatic autosomal dominant AD mutation carriers. Methods. We
analyzed cross-sectional data from 106 asymptomatic individuals with a
parental history of sporadic AD (PREVENT-AD cohort; age=67.28±4.72 years)
and 117 pre-symptomatic autosomal dominant AD mutation carriers (DIAN
cohort; age=34.00±9.43 years). All participants underwent structural MRI
and β-amyloid PET imaging. In each cohort we investigated the influence of
years of education, APOE-ε4 status and their interaction on β-amyloid PET.
Results. Asymptomatic individuals with a parental history of sporadic AD
showed increased β-amyloid burden associated with APOE-ε4 carriage and
lower level of education, but no interaction between these.
Pre-symptomatic mutation carriers of autosomal dominant AD showed no
relation between APOE-ε4 and β-amyloid burden, but increasing level of
education was associated with reduced β-amyloid burden. The association
between educational attainment and β-amyloid burden was similar in the two
cohorts. Conclusions. While the APOE-ε4 allele confers increased tendency
toward β-amyloid accumulation in sporadic AD only, protective
environmental factors, like increased education, may promote brain
resistance against β-amyloid pathology   in
both sporadic and autosomal dominant AD.