Education May Not Prevent or Slow Cognitive Decline According to Results of a Large-Scale Longitudinal Cohort Study

Education may have a smaller role in slowing cognitive decline and improving brain health than previously thought, according to new study results published in Nature Medicine. Educational attainment was associated with better cognitive performance in later life, higher memory test scores, and greater intracranial volume but did not appear to slow the rate of age-related cognitive decline or structural brain changes, which challenges the current understanding of education’s assumed neuroprotective effect. 

Researchers conducted a large-scale evaluation using pooled data from 33 Western countries, with memory test scores from over 170,000 participants and MRIs from over 6,000 participants. Each participant was categorized based on attained educational level. The study examined both cross-sectional differences in brain measures and cognition linked to education, as well as longitudinal changes over time.

Key findings from the study include the following:

• More education was not associated with slower memory decline over 1 year according to memory test data (OR<1.005).
• A higher level of baseline educational attainment was associated with better memory test performance.
  • Compared with the “upper secondary” education level group used as a reference, the “no education” group yielded an OR of 0.54 vs 1.55 for the highest education level group (“tertiary second stage”).
• A higher baseline education level was associated with a slightly greater volume of memory-sensitive brain regions and a larger intracranial volume.
• Education level was not found to have an effect on age-related changes in brain volume.

The authors note that the relationship seen between education level and baseline brain volume and memory test score is most likely a result of individuals with higher cognitive and brain structure traits pursuing higher levels of educational attainment.

Source: Fjell, A.M., Rogeberg, O., Sørensen, Ø. et al. Reevaluating the role of education on cognitive decline and brain aging in longitudinal cohorts across 33 Western countries. Nat Med (2025). https://doi.org/10.1038/s41591-025-03828-y