Never too late: Episodic memory after basic literacy acquisition in illiterate adults

Abstract

AbstractBackgroundFormal education acquired early in life protects against dementia, but whether acquiring education later in life can decrease dementia risk is less clear. Episodic memory impairment is one of the first symptoms of Alzheimer’s Disease. Therefore, we aimed to identify whether a late life literacy training delivered to illiterate adults could improve episodic memory as a mechanism of cognitive reserve enhancement, eventually contributing to prevent dementia in this population.MethodsWe ran a clinical trial with 108 illiterate adults cognitively healthy allocated into two groups at baseline: the intervention group (n = 57) that attended classes focused on learning how to read and write and the control group (n = 51), that attended regular classes (not focused on literacy training), for 6 months. We used the Free and Cued Selective Reminding (FCSRT) test to evaluate the episodic memory. Participants also underwent a thorough neuropsychological investigation and rsfMRI. The primary outcome measure was defined as the change in the free recall sum‐of attempts scores of the FCSRT. We used linear mixed effect models to calculate the change over time and between the intervention and control groups controlling for age and sex. ClinicalTrials.gov Identifier: NCT04473235ResultsSeventy seven participants completed the study. The control group had 38 participants aged 58.5 ±8.5 years, being 78.9 women and 92.1 Blacks. The intervention group had 39 participants aged 59.6 ±9.7 years, 79.5 women and 87.1 Blacks, with no significant differences in demographics between groups. Participants improved their episodic memory over time (FCSRT free recall sum of attempts: F = 21.5, p<0.001, FCSRT delayed recall: F = 27.1, p<0.001 and FCSRT efficacy: F = 26.2, p<0.001, but with no difference between the control and the intervention groups. The rsfMRI measurements are under analysis.ConclusionAttending a late life literacy program in adulthood improved episodic memory, regardless of whether the intervention was focused on learning how to read and write or just attending regular classes. The results shed light into a possible low cost tool to increase cognitive reserve through improving episodic memory, eventually preventing dementia in vulnerable populations.