Less childhood education is a potentially modifiable risk factor for developing incident dementia but it is not known if education in later life is protective. We sought to add to previous work by testing the association between adult education and brain volume as well as exploring the impact of continuing adult education versus intermittent participation. We used data from participants of the UK Biobank cohort, with no prevalent dementia who were asked about adult education participation at baseline and at follow-up. Dementia status was ascertained from self-report or electronic health records. Cox proportional hazards models were built to estimate hazard ratios (HRs) between participation in adult education and dementia risk. In 499,337 participants aged between 40 and 69 at baseline with 13.2 years mean follow-up, in analyses adjusted for age, sex, education, deprivation, ethnicity, hypertension, diabetes, ethnicity, obesity, smoking, alcohol use, physical inactivity and social isolation, we replicated previous findings of a protective effect of adult education on dementia risk (HR 0.82, 95% CI 0.74–0.90, P < 0.001), and showed a trend towards protection against dementia if adult education was continued rather than intermittent. Additionally, adult education did not impact on total brain volume (coefficient − 657.4, 95% CI − 2795.1 to 1480.3, P = 0.547) but it was associated with increased hippocampal volume (coefficient 33.9, 95% CI 8.9 to 59.0, P = 0.008) indicating a potential mechanism for protection against dementia. We have added evidence indicating that continuing adult education participation may be beneficial, although numbers for this analysis were very small. Analysis of brain volume indicated that adult education may have a protective effect by preserving hippocampal size or slowing volume loss, in line with the cognitive reserve hypothesis.

童年教育较少是发生痴呆症的一个潜在的可改变的风险因素，但尚不清楚晚年的教育是否具有保护作用。我们试图通过测试成人教育与脑容量之间的关联以及探索继续成人教育与间歇性参与的影响来补充之前的工作。我们使用了英国生物银行队列参与者的数据，这些参与者没有普遍患有痴呆症，他们被问及基线和随访时的成人教育参与情况。痴呆症状况是通过自我报告或电子健康记录来确定的。建立 Cox 比例风险模型来估计参与成人教育与痴呆风险之间的风险比 (HR)。基线年龄在 40 至 69 岁之间的 499,337 名参与者，平均随访时间为 13.2 年，分析中针对年龄、性别、教育程度、贫困、种族、高血压、糖尿病、种族、肥胖、吸烟、饮酒、缺乏身体活动和社会隔离进行了调整，我们重复了之前关于成人教育对痴呆风险的保护作用的研究结果（HR 0.82，95% CI 0.74-0.90， P < 0.001），并表明如果成人教育持续而不是间歇性的，则有预防痴呆的趋势。此外，成人教育对大脑总体积没有影响（系数 - 657.4，95% CI - 2795.1 至 1480.3， P = 0.547），但与海马体积增加相关（系数 33.9，95% CI 8.9 至 59.0， P = 0.008 ）表明了预防痴呆症的潜在机制。我们添加了证据，表明继续参与成人教育可能是有益的，尽管此分析的数字非常小。 对脑容量的分析表明，成人教育可能通过保持海马体大小或减缓脑容量损失而具有保护作用，这与认知储备假说一致。