Protective role of education background in the cognitive function of acute cerebrovascular disease patients

doi:10.3321/j.issn:1673-8225.2004.10.005

Abstract：BACKGROUND: Some researches have proved that the cognitive function after cerebrovascular diseases is affected not only by cerebral impairment itself but also some social economic factors. Education background might be an important factor.OBJECTIVE: To discuss the protective merits of normal education in cognitive impairment through analysing the relationship between educational level and cognitive impairment in acute cerebrovascular disease(ACVD) patients.DESIGN: A case-control study based on diagnosisSETTING and PARTICIPANTS: Totally 183 ACVD patients admitted by Neurology Department of Daping Hospital from January 1997 to June 2002 were selected.METHODS: The cognitive function of ACVD patient was evaluated by the author with scale of elderly cognitive function(SECF) and mini-mental state examination(MMSE). Data was analysed by SPSS 10. 0 software.MAIN OUTCOME MEASURES: Normal education level, SECF scale original score, T score and MMSE scoreRESULTS: SECF scores of ACVD patients were significantly lower than those of control group except acquisition( P ＜ 0. 01 ), and the abnormal rate was between 23.1% and 48.5%, which had significance compared with that of control group(0 - 16.3%, P ＜ 0. 01). The abnormal rate of MMSE was 26%,which had significance compared with the abnormal rate of SECF original score (48.5%, P ＜ 0. 01). Education level had significant positive correlation with SECF original score and T score except digit span in ACVD patients( r =0. 16 - 0. 33, P ＜ 0. 01). The analysis of variance for original score revealed that the scores for four items, orientation, calculation, imitation and classification, were significantly lower in unschooled group than that of in the other four groups( P ＜ 0. 01); the rest of scale in 6-year or less education group were significantly lower than that in more than 6-year education group( P ＜ 0. 05 -0. 000 1). There were no significant differences in digit span and calculation in T score( P ＞ 0. 05). The significant differences of imitating and language were only between one or two groups( P ＜ 0. 01 ), and the rest of the items mainly revealed that scores in 9-year or less education group were distinctly lower than those in 9-year or more education group( P ＜ 0. 01).CONCLUSION: All items of cognitive function in ACVD patients are signfficantly damaged. Education level has no significant effect on immediate memory, attention, language and space cognition. However, short-term,long-term recall and the ability of information abstraction in certain extents are significantly affected by education level. Nine-year or more normal education has protective reaction to these functions.