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School attainment in childhood is an independent risk factor of dementia in late life: results from a Brazilian sample

Published online by Cambridge University Press:  04 August 2011

Ana Beatriz Costa Bezerra ,
Evandro Silva Freire Coutinho ,
Maria Lage Barca ,
Knut Engedal ,
Eliasz Engelhardt  and
Jerson Laks
Ana Beatriz Costa Bezerra
Affiliation:
Centre for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil. State University of Rio de Janeiro, Brazil
Evandro Silva Freire Coutinho
Affiliation:
National School of Public Health – Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Maria Lage Barca
Affiliation:
Centre for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil. State University of Rio de Janeiro, Brazil Norwegian Centre for Dementia Research, Centre for Ageing and Health, Department of Geriatric Medicine, Ullevaal University Hospital, and Faculty of Medicine, University of Oslo, Norway
Knut Engedal
Affiliation:
Norwegian Centre for Dementia Research, Centre for Ageing and Health, Department of Geriatric Medicine, Ullevaal University Hospital, and Faculty of Medicine, University of Oslo, Norway
Eliasz Engelhardt
Affiliation:
Centre for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil. State University of Rio de Janeiro, Brazil
Jerson Laks*
Affiliation:
Centre for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil. State University of Rio de Janeiro, Brazil
*
Correspondence should be addressed to: Jerson Laks, Av. Copacabana, 749/802; 22051-000 Rio de Janeiro, RJ – Brazil. Phone: +55 21 2255 3454; Fax: +55 21 2548 4510. Email: [email protected].
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Abstract

Background: This study sought to assess whether lower school performance in childhood is a risk factor for dementia in old age.

Methods: Participants aged 60 years or more (n = 111) with documented proof from schools were included. Grades in three subjects – Portuguese, mathematics, and geography – were recorded and the mean final grade in all disciplines were assessed. Dementia was diagnosed using DSM-IV criteria. Sociodemographic data, school performance, and years of education were ascertained by checking documents issued by schools. Health status (hypertension and diabetes) were self reported. Regression models were used to assess the role of school performance and years of education on the risk of dementia.

Results: Dementia was diagnosed in 22 subjects. Higher school performance and years of education decreased the chance of dementia by 79% (OR = 0.21; CI 0.08–0.58) and 21% (OR = 0.79; CI 0.69–0.91), respectively. After adjustments for sociodemographic and clinical variables, only school performance remained statistically significant (OR = 0.06; CI 0.01–0.71).

Conclusions: Education in early life should be viewed as a health issue over the life course. School attainment in certain basic disciplines may be important for cognitive reserve and prevention of dementia in the elderly.

Keywords

educationdementiacognitive reserveelderlyAlzheimer's
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 1 , January 2012 , pp. 55 - 61
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Addae, J. I., Youssef, F. F. and Stone, T. W. (2003). Neuroprotective role of learning in dementia: a biological explanation. Journal of Alzheimer's Disease, 5, 91–104.Google Scholar
American Psychiatric Association (1995). Manual de diagnóstico e estatística de distúrbios mentais (DSMIV). 4th edn. Porto Alegre: Artes Médicas.Google Scholar
Bloss, C. S., Delis, D. C., Salmon, D. P. and Bondi, M. W. (2008). Decreased cognition in children with risk factors for Alzheimer's disease. Biological Psychiatry, 64, 904–906. doi:10.1016/j.biopsych.2008.07.004.Google Scholar
Bottino, C. M. C., Almeida, O. P., Tamai, S., Fortalenza, O. V., Scalco, M. Z. and Carvalho, I. A. M. (1999). CAMDEX: The Cambridge Examination for Mental Disorders of the Elderly: tradução e adaptação para o português. Projeto terceira idade (PROTER). São Paulo: Instituto e Departamento de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.Google Scholar
Bottino, C. M. C., Lopes, M. A., Moreno, M. P. Q., Hototian, S. R., Azevedo, D. Jr. and Tatsch, M. F. (2005). Prevalence of dementia and MCI in São Paulo, Brazil. International Psychogeriatrics, 17 (Suppl. 2), 80.Google Scholar
Bottino, C. M. C. et al. (2008). Estimate of dementia prevalence in a community sample from sao paulo, brazil. Dementia and Geriatric Cognitive Disorders, 26, 291–299. doi: 10.1159/000161053Google Scholar
Bourne, V. J., Fox, H. C., Deary, I. J. and Whalley, L. J. (2007). Does childhood intelligence predict variation in cognitive change in later life? Personality and Individual Differences, 42, 1551–1559. doi:10.1016/j.paid.2006.10.030.Google Scholar
Brayne, C. et al. (2010). Education, the brain and dementia: neuroprotection or compensation? Brain, 133, 2210–2216. doi:10.1093/brain/awq185.Google Scholar
Christensen, H. et al. (1997). Education and decline in cognitive performance: compensatory but not protective. International Journal of Geriatric Psychiatry, 12, 323–330. doi: 10.1002/(SICI)1099-1166(199703)12:3<323::AID-GPS492>3.0.CO;2-N.Google Scholar
Deary, I. J., Starr, J. M., and MacLennan, W. J. (1999). Is age kinder to the initially more able? Differential aging of verbal ability in the HOPE study. Intelligence, 26, 357–375.Google Scholar
Dufouil, C., Alpérovitch, A. and Tzourio, C. (2003). Influence of education on the relationship between white matter lesions and cognition. Neurology, 60, 831–836.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Fritsch, T., McCledom, M. J., Smyth, K. A. and Ogrocki, P. K. (2002). Effects of educational attainment and occupational status on cognitive and functional decline in persons with Alzheimer-type dementia. International Psychogeriatrics, 14, 347–363. doi:10.1017/S1041610202008554.Google Scholar
Instituto Brasileiro de Geografia e Estatística (2005). Perfil dos idosos responsáveis pelos domicílios. Available at: http://www.ibge.gov.br/home/estatistica/populacao/perfilidoso; last accessed 26 November 2010.Google Scholar
Jones, R. N., Yang, F. M., Zhang, Y., Kiely, D. K., Marcantonio, E. R. and Inouye, S. K. (2006). Does educational attainment contribute to risk for delirium? A potential role for cognitive reserve. Journal of Gerontology, Biological Sciences and Medical Sciences, 61, 1307–1311.Google Scholar
Laks, J. et al. (2005). Prevalence of cognitive and functional impairment in community-dwelling elderly: importance of evaluating activities of daily living. Arquivos de Neuropsiquiatria, 63, 207–212.Google Scholar
Lee, S., Kawachi, I., Berkman, L. F. and Grodstein, F. (2003). Education, other socioeconomic indicators, and cognitive function. American Journal of Epidemiology, 157, 712–720. doi:10.1093/aje/kwg042Google Scholar
Market Research Society (2010). Occupation Groupings: A Job Dictionary. London. http:/www.mrs.org.uk/publications/publications.htmGoogle Scholar
Pavlik, V. N., Doody, R. S., Massman, P. J. and Chan, W. (2006). Influence of premorbid IQ and education on progression of Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 22, 367–377. doi: 10.1159/000095640.Google Scholar
Piaget, J. (1950) Introduction à l'Épistémologie Génétique. Paris: Press Universitaire.Google Scholar
Richards, M., Shipley, B., Fuhrer, R. and Wadsworth, M. E. (2004). Cognitive ability in childhood and cognitive decline in mid-life: longitudinal birth cohort study. BMJ, 328, 552. doi:10.1136/bmj.37972.513819.EE.Google Scholar
Roe, C. M., Xiong, C., Miller, P. and Morris, J. C. (2007). Education and Alzheimer disease without dementia: support for the cognitive reserve hypothesis. Neurology, 68, 223–228. doi:10.1212/01.wnl.0000251303.50459.8a.Google Scholar
Roth, M., Tum, B. K., Mountjoy, C. Q., Huppert, F. A., Hendrie, H. and Verma, S. (1986). CAMDEX: a standardized instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 608–709.Google Scholar
Scarmeas, N., Albert, S. M., Manly, J. J. and Stern, Y. (2006). Education and rates of cognitive decline in incident Alzheimer's disease. Journal of Neurology, Neurosugery, and Psychiatry, 77, 308–316. doi:10.1136/jnnp.2005.072306.Google Scholar
Scazufca, M. et al. (2008). Risk factors across the life course and dementia in a Brazilian population: results from the São Paulo Ageing & Health Study (SPAH). International Journal of Epidemiology, 37, 879–890. doi:10.1093/ije/dyn125.Google Scholar
Smyth, K. A., Fritsch, T., Cook, T. B., McClendon, M. J., Santillan, C. E. and Friedland, R. P. (2004). Worker functions and traits associated with occupations and the development of AD. Neurology, 63, 498–503.Google Scholar
Snowdon, D. A., Kemper, S. J., Mortimer, J. A., Greiner, L. H., Wekstein, D. R. and Markesbery, W. R. (1996). Linguistic ability in early life and cognitive function and Alzheimer's disease in late life – Findings from the nun study. JAMA, 275, 528–532.Google Scholar
Whalley, L. J., Starr, J. M., Athawes, R., Hunter, D., Pattie, A. and Deary, I. J. (2000). Childhood mental ability and dementia. Neurology, 55, 1455–1459.Google Scholar
Wight, R. G., Aneshensel, C. S. and Seeman, T. E. (2002). Educational attainment, continued learning experience, and cognitive function among older age. Journal of Aging and Health, 14, 211–236. doi:10.1177/089826430201400203.Google Scholar
Wilson, R. S. et al. (2002). Cognitive activity and incident AD in a population-based sample of older persons. Neurology, 59, 1910–1914.Google Scholar