Skip to main content Accessibility help

The Tasmanian Healthy Brain Project (THBP): a prospective longitudinal examination of the effect of university-level education in older adults in preventing age-related cognitive decline and reducing the risk of dementia

  • Mathew J. Summers (a1) (a2), Nichole L.J. Saunders (a2), Michael J. Valenzuela (a3), Jeffery J. Summers (a1), Karen Ritchie (a4) (a5), Andrew Robinson (a2) (a6) and James C. Vickers (a2)...


Background: Differences in the level of cognitive compromise between individuals following brain injury are thought to arise from underlying differences in cognitive reserve. The level of cognitive reserve attained by an individual is influenced by both genetic and life experience factors such as educational attainment and occupational history. The Tasmanian Healthy Brain Project (THBP) is a world-first prospective study examining the capacity of university-level education to enhance cognitive reserve in older adults and subsequently reduce age-related cognitive decline and risk for neurodegenerative disease.

Methods: Up to 1,000 adults aged 50–79 years at the time of entry into the study will be recruited to participate in the THBP. All participants will be healthy and free of significant medical, psychological, or psychiatric illness. Of the participant sample, 90% will undertake a minimum of 12 months part-time university-level study as an intervention. The remaining 10% will act as a control reference group. Participants will complete an annual comprehensive assessment of neuropsychological function, medical health, socialization, and personal well-being. Premorbid estimates of past cognitive, education, occupational, and physical function will be used to account for the mediating influence of prior life experience on outcomes. Potential contributing genetic factors will also be explored.

Results: Participant results will be assessed annually. Participants displaying evidence of dementia on the comprehensive neuropsychological assessment will be referred to an independent psycho-geriatrician for screening and diagnosis.

Conclusions: The THBP commenced in 2011 and is expected to run for 10–20 years duration. To date, a total of 383 participants have been recruited into the THBP.


Corresponding author

Correspondence should be addressed to: Dr M.J. Summers, School of Psychology, Locked Bag 1342, Launceston 7250, Tasmania, Australia. Phone: +61 3 6324 3266; Fax: +61 3 6324 3168. Email:


Hide All
Access Economics. (2004). Delaying the onset of Alzheimer's disease: projections and issues. Report for Alzheimer's Australia (pp. 115). Canberra, Australia.
Access Economics. (2009). Keeping dementia front of mind: incidence and prevalence 2009–2050. Final Report for Alzheimers Australia (pp. 1109). Canberra, Australia.
Beason-Held, L. L., Kraut, M. A. and Resnick, S. M. (2008). I. Longitudinal changes in aging brain function. Neurobiology of Aging, 29, 483496.
Bennett, D. A., Schneider, J. A., Tang, Y. X., Arnold, S. E. and Wilson, R. S. (2006). The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study. Lancet Neurology, 5, 406412.
Bennett, D. al. (2003). Education modifies the relation of AD pathology to level of cognitive function in older persons. Neurology, 60, 19091915.
Bisiacchi, P. S., Borella, E., Bergamaschi, S., Carretti, B. and Mondini, S. (2008). Interplay between memory and executive functions in normal and pathological aging. Journal of Clinical and Experimental Neuropsychology, 30, 723733.
Blizzard, C. al. (2011). Focal damage to the adult rat neocortex induces wound healing accompanied by axonal sprouting and dendritic structural plasticity. Cerebral Cortex, 21, 281291.
Brayne, al. (2010). Education, the brain and dementia: neuroprotection or compensation?: EClipSE Collaborative Members. Brain, 133, 22102216.
Corder, E. al. (1993). Gene dose of apolipoprotein-E type-4 allele and the risk of Alzheimer's disease in late-onset families. Science, 261, 921923.
Deloitte Access Economics. (2011). Dementia across Australia: 2011–2015. Report prepared by Deloitte Access Economics (pp. 115). Canberra, Australia.
Donnell, A. J., Pliskin, N., Holdnack, J., Axelrod, B. N. and Randolph, C. (2007). Rapidly-administered short forms of the Wechsler Adult Intelligence Scale, 3rd edition. Archives of Clinical Neuropsychology, 22, 917924.
Garibotto, al. (2008). Education and occupation as proxies for reserve in aMCI converters and AD: FDG-PET evidence. Neurology, 71, 13421349.
Gu, Y., Janoschka, S. and Ge, S. (2012). Neurogenesis and hippocampal plasticity in adult brain. In Geyer, A. M., Ellenbroek, A. B. and Marsden, A. C. (eds.), Current Topics in Behavioral Neurosciences (pp. 118). Berlin, Heidelberg: Springer.
Harold, al. (2009). Genome-wide association study identifies variants at CLU and PICALM associated with Alzheimer's disease. Nature Genetics, 41, 10881093.
Hollingworth, al. (2011). Common variants at ABCA7, MS4A6A/MS4A4E, EPHA1, CD33 and CD2AP are associated with Alzheimer's disease. Nature Genetics, 43, 429435.
Hu, Y.-S., Xu, P., Pigino, G., Brady, S. T., Larson, J. and Lazarov, O. (2010). Complex environment experience rescues impaired neurogenesis, enhances synaptic plasticity, and attenuates neuropathology in familial Alzheimer's disease-linked APPswe/PS1ΔE9 mice. The FASEB Journal, 24, 16671681.
International Wellbeing Group. (2006). Personal Wellbeing Index, 4th edn.Melbourne: Australian Centre on Quality of Life, Deakin University.
James, B. D., Wilson, R. S., Barnes, L. L. and Bennett, D. A. (2011). Late-life social activity and cognitive decline in old age. Journal of the International Neuropsychological Society, 17, 9981005.
Jankowsky, J. al. (2005). Environmental enrichment mitigates cognitive deficits in a mouse model of Alzheimer's disease. The Journal of Neuroscience, 25, 52175224.
Janssen, al. (2010). An enriched environment improves sensorimotor function post-ischemic stroke. Neurorehabilitation and Neural Repair, 24, 802813.
Johnson, D. K., Storandt, M., Morris, J. C. and Galvin, J. E. (2009). Longitudinal study of the transition from healthy aging to Alzheimer disease. Archives of Neurology, 66, 12541259.
Kasai, H., Fukuda, M., Watanabe, S., Hayashi-Takagi, A. and Noguchi, J. (2010). Structural dynamics of dendritic spines in memory and cognition. Trends in Neurosciences, 33, 121129.
Lambert, al. (2009). Genome-wide association study identifies variants at CLU and CR1 associated with Alzheimer's disease. Nature Genetics, 41, 10941099.
Lezak, M. D., Howieson, D. B., Bigler, E. D. and Tranel, D. (2012). Neuropsychological Assessment, 5th edn.Oxford: Oxford University Press.
Lezak, M. D., Howieson, D. B. and Loring, D. W. (2004). Neuropsychological Assessment, 2nd edn.Oxford: Oxford University Press.
Mehta, K. al. (2009). “Below average” self-assessed school performance and Alzheimer's disease in the Aging, Demographics, and Memory Study. Alzheimers & Dementia, 5, 380387.
Mortimer, J. A., Snowdon, D. A. and Markesbery, W. R. (2003). Head circumference, education and risk of dementia: findings from the Nun study. Journal of Clinical and Experimental Neuropsychology, 25, 671679.
Naj, A. al. (2011). Common variants at MS4A4/MS4A6E, CD2AP, CD33 and EPHA1 are associated with late-onset Alzheimer's disease. Nature Genetics, 43, 436441.
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303308.
Richards, M. and Sacker, A. (2003). Lifetime antecedents of cognitive reserve. Journal of Clinical and Experimental Neuropsychology, 25, 614624.
Ritchie, K., Carrière, I., Ritchie, C. W., Berr, C., Artero, S. and Ancelin, M.-L. (2010). Designing prevention programmes to reduce incidence of dementia: prospective cohort study of modifiable risk factors. BMJ, 341, c3885.
Roe, C. M., Xiong, C. J., Miller, J. P. and Morris, J. C. (2007). Education and Alzheimer disease without dementia: support for the cognitive reserve hypothesis. Neurology, 68, 223228.
Roff, L. L., Burgio, L. D., Gitlin, L., Nicols, L., Chaplin, W. and Harin, J. M. (2004). Positive aspects of Alzheimer's caregiving: the role of race. Journal of Gerontology: Series B: Psychological Science and Social Sciences, 59B, 185190.
Roid, G. H. and Ledbetter, M. F. (2006). WRAT4 Progress Monitoring Version: Professional manual. Lutz, Florida: Psychological Assessment Resources Inc.
Salthouse, T. A., Fristoe, B. N. and Rhee, S. H. (1996). How localized are age-related effects on neuropsychological measures? Neuropsychology, 10, 272285.
Saunders, N. L. J. and Summers, M. J. (2010). Attention and working memory deficits in mild cognitive impairment. Journal of Clinical and Experimental Neuropsychology, 32, 350357.
Saunders, N. L. J. and Summers, M. J. (2011). Longitudinal deficits to attention, executive and working memory in subtypes of Mild Cognitive Impairment. Neuropsychology, 25, 237248.
Scarmeas, N. and Stern, Y. (2003). Cognitive reserve and lifestyle. Journal of Clinical and Experimental Neuropsychology, 25, 625633.
Small, B. J., Rosnick, C. B., Fratiglioni, L. and Bäckman, L. (2004). Apolipoprotein E and cognitive performance: a meta-analysis. Psychology and Aging, 19, 592600.
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8, 448460.
Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47, 20152028.
Strauss, E., Sherman, E. M. S. and Spreen, O. (2006). A Compendium of Neuropsychological Tests: Administrations, Norms, and Commentary, 3rd edn.New York: Oxford University Press.
Summers, M. J. and Saunders, N. L. J. (2012). Neuropsychological measures predict decline to Alzheimer's dementia from mild cognitive impairment. Neuropsychology, 26, 498508.
Suo, al. (2012). Supervisory experience at work is linked to low rate of hippocampal atrophy in late life. Neuroimage, 63, 15421551.
Swainson, al. (2001). Early detection and differential diagnosis of Alzheimer's disease and depression with neuropsychological tasks. Dementia and Geriatric Cognitive Disorders, 12, 265280.
Tailby, C., Wright, L. L., Metha, A. B. and Calford, M. B. (2005). Activity-dependent maintenance and growth of dendrites in adult cortex. Proceedings of the National Academy of Sciences of the United States of America, 102, 46314636.
The Psychological Corporation. (2001). Wechsler Test of Adult Reading. San Antonio, TX: Harcourt Assessment.
Valenzuela, M. J. and Sachdev, P. (2006). Brain reserve and dementia: a systematic review. Psychological Medicine, 36, 441454.
Valenzuela, M. J. and Sachdev, P. (2007). Assessment of complex mental activity across the lifespan: development of the Lifetime of Experiences Questionnaire (LEQ). Psychological Medicine, 37, 10151025.
Verghese, al. (2003). Leisure activities and the risk of dementia in the elderly. New England Journal of Medicine, 348, 25082516.
Wilson, R. al. (2002). Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA, 287, 742748.
Wilson, R. S., Scherr, P. A., Schneider, J. A., Tang, Y. and Bennett, D. A. (2007). Relation of cognitive activity to risk of developing Alzheimer disease. Neurology, 69, 19111920.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed