To investigate the association of years of education and neighborhood-level deprivation (as drivers of cognitive reserve) with white matter integrity in Alzheimer’s disease (AD) individuals.

Cognitive reserve (CR) is thought to provide compensatory effects against microstructural cortical damage seen in aging and dementia. The strongest contributors of CR are years of education and socioeconomic status, reflected as neighborhood-level deprivation and quantified via area deprivation index (ADI). Greater years of education and lower ADI scores have been shown to increase CR. 

We extracted fractional anisotropy (FA) and mean diffusivity (MD) values from the corpus callosum, fornix, cingulum, and full white matter in AD individuals through the Alzheimer’s Disease Neuroimaging Initiative (ADNI). We examined associations between DTI values and Area Deprivation Index (ADI; n=29, aged 67-98) as well as years of education (n=134, aged 55-86) using linear regression, adjusting for patient age and scanner vendor. 

There was a significant positive correlation between ADI and MD values in full white matter (p = .04), and a positive trend between ADI and MD values throughout the cingulum (p < .10). There were marginally significant correlations between education and both FA (p = .09) and MD (p = .06) values in the fornix, with negative correlation between FA and education and positive correlation between MD and education.

This study examined the associations of education and neighborhood-level deprivation with white matter integrity in Alzheimer’s disease. Increased ADI scores were linked to reduced white matter integrity, though increased years of education correlated with worse integrity in the fornix. Our findings suggest that determinants of cognitive reserve interact with disease progression with variability by brain region, reflecting differential vulnerability or compensatory mechanisms in AD progression.