Education aids brain injury recovery

Los Angeles TimesApril 25, 2014 

Having spent more years in the classroom is a powerful aid to recovery following a moderate to severe brain trauma, a new study finds.

Researchers have long known that cognitive reserve – a level of mental engagement that may come from reading books, staying mentally and socially active and pursuing an education – forestalls the appearance of dementia and memory loss symptoms in those whose brains are under attack by Alzheimer’s disease. Mentally active patients living with multiple sclerosis and HIV/AIDS encephalopathy also appear to fare better than those who have developed less brainpower, even as their diseases progress.

The latest study, which followed patients hospitalized after brain injuries, is the first to show that cognitive reserve also matters when the brain is undergoes the shock of injury. It was published this week in the journal Neurology.

Educational attainment is not the only way to build up the kind of “cognitive reserve” that can help the brain function better when under assault from injury or disease. But the mental habits that come with more schooling consistently make the brain more flexible and resilient against insults, allowing a person to devise strategies to compensate for or work around mental impairments. Studies suggest that taking on regular mental challenges – such as reading newspapers, teaching, and doing crossword puzzled –can build a cognitive reserve capable of holding off mental decline.

The study, conducted by researchers at Johns Hopkins University, Tulane University and Imperial College London, used educational attainment as a rough surrogate for mental engagement, and tracked 769 patients hospitalized for brain injuries for a year, to see which ones were most likely to be free of disability 12 months after their accidents.

In all, 214 patients (27.6 percent) regained full function after a year. Among those patients with the least education (fewer than 12 years), 9.7 percent were free of significant disability after a year. For those who completed between 12 and 15 years of education, the proportion of those without major disability after a year was 30.8 percent. And for those with 16 or more years of education–a college or advanced degree – 39.2 percent – had regained their full function.

The researchers also found a “dose response” relationship between education and recovery: Even within the broad categories of educational attainment, the likelihood of being disability-free rose with each additional year of schooling a victim of brain injury had completed.

The researchers acknowledge that a patient’s socioeconomic status can be a powerful influence in recovery, as can individual factors such as motivation to succeed and self-discipline. All those factors tend to slide up and down with educational attainment, making education a rough stand-in for a range of factors important in recovering from brain injury.

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