{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:21:15Z","timestamp":1777396875042,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2024,3,5]]},"abstract":"<jats:p>Background: Cognitive and functional abilities in individuals with Alzheimer\u2019s disease (AD) pathology (ADP) are highly variable. Factors contributing to this variability are not well understood. Previous research indicates that higher educational attainment (EA) correlates with reduced cognitive impairments among those with ADP. While cognitive and functional impairments are correlated, they are distinguishable in their manifestations. Objective: To investigate whether levels of education are associated with functional impairments among those with ADP. Methods: This research involved 410 African American (AA) individuals (Institutional Review Boards 20070307, 01\/27\/2023) to ascertain whether EA correlates with functional resilience and if this effect varies between APOE \u025b4 carriers and non-carriers. Utilizing EA as a cognitive reserve proxy, CDR-FUNC as a functional difficulties measure, and blood pTau181 as an ADP proxy, the non-parametric Mann-Whitney U test assessed the relationship between EA and CDR-FUNC in individuals with advanced pTau181 levels. Results: The results showed that EA correlated with functional difficulties in AA individuals with high levels of pTau181, such that individuals with high EA are more likely to have better functional ability compared to those with lower EA (W\u200a=\u200a730.5, p\u200a=\u200a0.0007). Additionally, we found that the effect of high EA on functional resilience was stronger in \u025b4 non-carriers compared to \u025b4 carriers (W\u200a=\u200a555.5, p\u200a=\u200a0.022). Conclusion: This study extends the role of cognitive reserve and EA to functional performance showing that cognitive reserve influences the association between ADP burden and functional difficulties. Interestingly, this protective effect seems less pronounced in carriers of the strong genetic risk allele \u025b4.<\/jats:p>","DOI":"10.3233\/jad-231116","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T11:21:52Z","timestamp":1708428112000},"page":"221-229","source":"Crossref","is-referenced-by-count":4,"title":["African Ancestry Individuals with Higher Educational Attainment Are Resilient to Alzheimer\u2019s Disease Measured by pTau181"],"prefix":"10.1177","volume":"98","author":[{"given":"Farid","family":"Rajabli","sequence":"first","affiliation":[{"name":"John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA"},{"name":"Department of Human Genetics, Dr. John T. 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Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takiyah D.","family":"Starks","sequence":"additional","affiliation":[{"name":"Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renee","family":"Laux","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goldie S.","family":"Byrd","sequence":"additional","affiliation":[{"name":"Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan L.","family":"Haines","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary W.","family":"Beecham","sequence":"additional","affiliation":[{"name":"John P. 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