Education and reported onset of symptoms among individuals with Alzheimer disease

Objectives: To examine whether reported age at onset of dementia symptoms among participants with Alzheimer disease (AD) is later for those with fewer years of education and, if so, to see if education is attributed to delayed detection of symptoms. Design: Case series. Setting: National Alzheimer's Coordinating Center Minimum Data Set (N=21 880 participants) and Washington University Alzheimer's Disease Research Center (N=1449 participants). Results: Reported age at onset of dementia symptoms is slightly younger in participants with more education. Participants with fewer years of education show greater clinical severity of Alzheimer disease at first assessment. Conclusion: Symptoms of Alzheimer disease are recognized later among those with less education.