High education, as a proxy of cognitive reserve (CR), has been associated with cognitive advantage amongst old adults and may operate through neuroprotective and/or compensation mechanisms. In neuromaging studies, indirect evidences of neuroprotection can be inferred from positive relationships between CR and brain integrity measures. In contrast, compensation allows high CR elders to sustain greater brain damage. We included 100 cognitively normal old-adults and investigated the associations and interactions between education, speed of processing (SP), memory and two brain integrity measures: cortical thickness (CTh) of gray matter (GM) and fractional anisotropy (FA) in the white matter (WM). High education was associated with better cognitive performance, enlarged CTh in frontal lobe areas and reduced measures of FA in several areas. Better SP performance in higher educated subjects was related to more preserved GM and WM, while memory status amongst high educated elders was better explained by a putative compensatory mechanism and independently from cerebrovascular risk indicators. Moreover, we analyzed the direct effect of age on measures of brain integrity and found a stronger negative effect on WM than in CTh, which was accentuated amongst the high CR sample. Our study suggests that the cognitive advantage associated to high education among healthy aging is related to the coexistence of both neuroprotective and compensatory mechanisms. In particular, high educated elders seem to have greater capacity to counteract a more abrupt age impact on WM integrity.
Trial registration: ClinicalTrials.gov NCT01634841.
Keywords: Aging; Cognitive reserve; Compensation; Education; Memory; Neuroprotection; Speed of processing; Structural changes.