Cognitive decline before and after mid-to-late-life continuing education in England: a matched longitudinal analysis of a prospective cohort study.

Abstract

While WHO/Europe guidelines promote life-long learning for healthy ageing generally, whether adult education supports healthy cognitive ageing is unclear. We used a matched longitudinal study design to account for reverse causality seen in previous studies and assess whether cognitive trajectories improved following mid-to-late life education using data from a nationally representative UK-based cohort study. Data were drawn from 3906 participants aged 50-90 years followed up from 2002-03 to 2021-23. At biennial interviews, participants were asked to report whether they had engaged in continuing education in the last 12 months and were split into 'single' (continuing education at one interview) and 'multiple' (continuing education at multiple interviews) continuing education groups. We used piecewise linear mixed models to examine memory and fluency decline four years before and eight years after first report of continuing education (corresponding to the median follow-up period) and during the comparable period in a matched control group. Cognitive trajectories were comparable between continuing education groups and their controls before participation in continuing education. After participation, cognitive trajectories were still similar; e.g., the difference in eight-year memory decline between the single continuing education group and controls was just -0.026 standard deviations (95% CI = -0.081-0.029) or -0.015 standard deviations (95% CI = -0.067-0.037) between the multiple continuing education group and controls. There was no evidence of improvement in cognitive trajectories following continuing education. These findings suggest continuing education should not yet be prioritised as a strategy for long-term cognitive health until further evidence demonstrates a clear benefit. National Institute for Health and Care Research, National Institute on Aging.