{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:52:05Z","timestamp":1792155125227,"version":"4.4.0"},"reference-count":47,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["F99\/K00 AG088590"],"award-info":[{"award-number":["F99\/K00 AG088590"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01 AG049953"],"award-info":[{"award-number":["R01 AG049953"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Educational achievement is widely used as a proxy for cognitive reserve\u2014the capacity to sustain cognition despite accumulating neuropathology. Nevertheless, the impact of education on the neuropathology-cognition association has not been assessed in a meta-analytical manner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To meta-analyze studies reporting an education \u00d7 neuropathology interaction term on cognition by pathology, and to determine whether the interaction effect differs by cognitive domains, age, participants\u2019 cognitive diagnosis, and gender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, we searched PubMed, EMBASE, PsycINFO, and Web of Science through March 2026. Seventeen cross-sectional articles contributing 82 effect sizes were pooled using random-effects models with robust variance estimation across four pathology classes (amyloid, phosphorylated tau [pTau], vascular, and structural). All analyses were corrected for multiple comparisons using the Benjamini\u2013Hochberg false-discovery rate (FDR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher education significantly attenuated the amyloid\u2013cognition association (r\u2009=\u20090.114, adjusted-p\u2009=\u20090.012), a trend concentrated in the global cognitive domain (r\u2009=\u20090.108, adjusted-p\u2009=\u20090.060) and in studies with mixed cognitively unimpaired and cognitively impaired participants (r\u2009=\u20090.130, adjusted-p\u2009=\u20090.020). No significant interaction was found for pTau, vascular, or structural pathology (all adjusted-p\u2009&gt;\u20090.100). Funnel plot and Egger's regression showed no evidence of publication bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Education moderated the amyloid\u2013cognition association across the Alzheimer's disease continuum in full-spectrum (mixed-diagnosis) samples. Confirmation in adequately powered, longitudinal designs is warranted.<\/jats:p>\n                    <jats:p>PROSPERO Registration: CRD42023390544.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261496419","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:52:28Z","timestamp":1791910348000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Education as a proxy for cognitive reserve, and its moderating role in the amyloid\u2013cognition relationship across the Alzheimer's disease continuum: A systematic review and meta-analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2138-5811","authenticated-orcid":false,"given":"Yuan","family":"Yang","sequence":"first","affiliation":[{"name":"Stony Brook University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaymie R.","family":"Meliker","sequence":"additional","affiliation":[{"name":"Stony Brook University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6793-5773","authenticated-orcid":false,"given":"Lauren L.","family":"Richmond","sequence":"additional","affiliation":[{"name":"Stony Brook University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan M.","family":"Smith","sequence":"additional","affiliation":[{"name":"Stony Brook University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6124-0329","authenticated-orcid":false,"given":"Sean A.P.","family":"Clouston","sequence":"additional","affiliation":[{"name":"Stony Brook University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"World Population Ageing 2015 - Highlights","author":"United Nations Department of Economic and Social Affairs Population Division","year":"2015","unstructured":"United Nations Department of Economic and Social Affairs Population Division. 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