The effect of educational attainment on cognitive performance and recovery in patients with subarachnoid hemorrhage (SAH).
Item
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Title
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The effect of educational attainment on cognitive performance and recovery in patients with subarachnoid hemorrhage (SAH).
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Identifier
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AAI3213179
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identifier
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3213179
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Creator
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Nakhutina, Luba.
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Contributor
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Adviser: Joan C. Borod
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Date
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2006
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Physiological
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Abstract
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Subarachnoid hemorrhage (SAH) is a sudden and catastrophic event with a high initial mortality rate and lasting cognitive deficits in many patients. Previous studies have investigated numerous disease-related factors and demographic variables in an attempt to identify predictors of cognitive and functional outcome after SAH. However, the effect of educational attainment on cognitive outcome in SAH patients has been largely unexplored. The cognitive reserve model suggests that variables such as education and IQ may moderate the effects of brain injury or disease severity on cognitive functioning. The current study examined the effect of educational attainment on cognitive outcome at 3 months after subarachnoid hemorrhage (SAH) and on recovery of cognitive functioning from 3 to 12 months after SAH. Data were collected from SAH patients (N=113) with a wide range of education levels (0 to 20 years) who were prospectively enrolled in the Columbia University SAH Outcome Project in the Department of Neurology. Seven cognitive domains were examined: attention/concentration, language, verbal memory, visuospatial skills, visual memory, psychomotor speed, and executive functions. After controlling for the influence of age, gender, SAH severity, and specific SAH-related complications, education emerged as a significant predictor of outcome in all domains of cognitive functioning at 3 months post SAH. Education also moderated the relationship between SAH severity and language scores, such that in participants with a lower level of education, the presence of severe SAH was significantly associated with lower performance on language measures. Conversely, in participants with a high level of education, there was no significant association between severity of SAH and language scores. When the impact of educational attainment on recovery of cognitive functioning from 3 to 12 months after SAH was examined in 82 patients who returned for reevaluation, results indicated that higher educational attainment was strongly associated with better recovery rates for all cognitive domains, except for executive functioning. These findings suggest that higher educational attainment mitigates the severity of cognitive decrements associated with SAH and are consistent with the cognitive reserve theory.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
