RESUMO
BACKGROUND: The incidence of cognitive impairment is increasing with an aging population. Developing effective strategies is essential to prevent dementia. Higher education level is associated with better baseline cognitive performance, and reading activities can slow down cognitive decline. However, it is unclear whether education and reading activities are synergistic or independent contributors to cognitive performance. METHODS: This was a sub-study of an ongoing prospective community cohort of China National Clinical Research Center Alzheimer's Disease and Neurodegenerative Disorder Research (CANDOR). Demographic and clinical information, educational levels, and reading activities were collected. All participants finished neuropsychological testing batteries and brain MRIs. We analyzed cognitive performance and brain structures with education and reading activities. RESULTS: Four hundred fifty-nine subjectively cognitively normal participants were enrolled in the study. One hundred sixty-nine (36.82%) of them had regular reading activities. Participants in the reading group had better performance in all cognitive tests compared with those in the non-reading group, but no difference in brain MRI variables. Participants with higher education levels (more than 13 years) had better cognitive performance and higher hippocampal volumes. In low education groups (less than 12 years), more reading activities were associated with better cognitive test scores. CONCLUSIONS: Both education and reading activities are important and synergistic for baseline cognitive function. Higher education level is associated with larger hippocampal volumes. Education may stimulate the growth and development of the hippocampus. Reading activities help to maintain and improve cognitive function in people with low levels of education. TRIAL REGISTRATION: NCT04320368.