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Less Than Eight Years of Education Associated with Alzheimer's
A DGReview of :"The Influence of Education on Clinically Diagnosed Dementia Incidence and Mortality Data From the Kungsholmen Project"
Archives of Neurology
12/17/2001
By Elda Hauschildt
Low levels of education are associated with increased risk of developing clinical Alzheimer's disease or dementia.
Increased risk is seen particularly in women and in younger old-age of from 75 to 84 years, Swedish researchers point out.
In five years of follow-up, they found people with less than eight years of education had a 2.6 relative risk for developing Alzheimer's and 1.7 for developing dementia.
"In addition, a low level of education was related to increased mortality of all causes but not to mortality of subjects with Alzheimer's or dementia in the general population," investigators say.
"These results imply that education may affect the clinical expression rather than the pathologic course of Alzheimer's or dementia.
"These findings may be accounted for by the cognitive reserve hypothesis but could also affect the fact that subjects with dementia who were less educated may be clinically diagnosed at an earlier pathologic stage of the disease (detection bias)."
They explain that the cognitive reserve hypothesis suggests people with higher educational and occupational levels could cope with advanced pathologic disease changes more effectively by maintaining function longer.
Investigators from the Karolinska Institute and the Stockholm Gerontology Research Centre in Stockholm and Uppsala University say the relationship between education and Alzheimer's or dementia has been examined widely. But earlier results were mixed.
They studied a community-based, dementia-free cohort of 1,296 people aged 75 years and older. They used the Diagnostic and Statistical Manual of Mental Disorders-III to diagnose Alzheimer's and dementia in 983 participants still living at five years" follow-up.
"Over an average of 2.8 years of follow-up, 147 subjects were diagnosed as having dementia, with 109 subjects diagnosed as having Alzheimer's," the researchers report.
Among those clinically examined at follow-up, 88 died with dementia (68 with Alzheimer's) within five years.
"Association between a low level of education and an increased risk of Alzheimer's or dementia was more evident in women than in men and in the younger old-age group than in the oldest old-age group (85 years and older)," they comment.
Archives of Neurology, 2001; 58: 2034-2039.
"The Influence of Education on Clinically Diagnosed Dementia Incidence and Mortality Data From the Kungsholmen Project"
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