Education, APOE e4, and Cognition in Individuals with Subjective Cogni- tive Decline with Worry in the SILCODE Study

Background: Education could offer a protective effect on cognition in individuals with Subjective Cognitive Decline (SCD), which is considered to be the early stage of Alzheimer's Dis-ease (AD). However, the effect of education on cognition in SCD individuals with SCD-plus fea-tures is not clear. Objective: The aim of the study was to explore the effect of education on cognition in SCD individ-uals with SCD-plus features. Methods: A total of 234 individuals with SCD were included from the Sino Longitudinal Study on Cognitive Decline (SILCODE). Cognition was assessed across 4 domains (memory, executive, lan-guage, and general cognitive functions). Multiple linear regression models were constructed to ex-amine the effect of education on cognitive scores in individuals without worry (n=91) and with wor-ry (n=143). Furthermore, we assessed differences in effects betweenAPOE epsilon 4 noncarriers and APOE epsilon 4 carriers in both groups. Results: Multiple linear regression analysis showed a positive effect of education on memory, ex-ecutive, and language cognition in individuals without worry and all cognitive domains in individu-als with worry. Furthermore, we found a positive effect of education on executive cognition in APOE epsilon 4 noncarriers without worry and language and general cognition in APOE epsilon 4 carriers with-out worry. Meanwhile, education had a positive effect on all cognitive domains in APOE epsilon 4 noncar-riers with worry and executive, language, and general cognition in APOE epsilon 4 carriers with worry. Conclusion: This study indicates that education has the potential to delay or reduce cognitive dec-line in SCD individuals with SCD-plus features.