Abstract
Objective: The association between higher education and increased mortality in Alzheimer's disease (AD) is controversial. Further it is unknown whether education predicts survival in all dementia subtypes. We assessed mortality rates and death causes of persons with dementia compared to participants without dementia.
Methods: Participants derive from the Neurological Disorders in Central Spain, a prospective population- based cohort study of older adults. We compared 269 persons with dementia to 2944 participants without dementia. We carried out Cox regression models to predict the risk of mortality dependent on the educational attainment adjusting for covariates. Reasons of death were obtained from the National Population Register. Results: During a median follow-up of 5.4 years, 400 individuals died (171 with dementia, 229 without dementia). Among the participants with dementia, those with higher educational attainment had an increased risk of death than those with lower education; the adjusted hazard ratio (HRa) was 1.40 (95% confidence interval [CI], 1.01 to 1.94). When the analysis was restricted to patients with AD the HRa increased to 1.51 (95% CI = 1.01-2.24). By contrast, educational attainment was not associated with increased mortality among participants without dementia (HRa = 0.92, 95% CI = 0.71-1.20, p = 0.55), whereas education did not influence mortality in QD. Conclusion: Our findings suggest that high educational attainment is associated with increased mortality risk in people with dementia. This observation implies that neuropathology is more advanced in patients with higher education at any level of clinical severity, leading these individuals to an earlier death after diagnosis.Keywords: Education, dementia, Alzheimer's disease, cognitive reserve, mortality, population-based study.
Current Alzheimer Research
Title:Is Educational Attainment Associated with Increased Risk of Mortality in People with Dementia? A Population-based Study
Volume: 14 Issue: 5
Author(s): Israel Contador, Yaakov Stern, Felix Bermejo-Pareja, Alvaro Sanchez-Ferro and Julian Benito-Leon
Affiliation:
Keywords: Education, dementia, Alzheimer's disease, cognitive reserve, mortality, population-based study.
Abstract: Objective: The association between higher education and increased mortality in Alzheimer's disease (AD) is controversial. Further it is unknown whether education predicts survival in all dementia subtypes. We assessed mortality rates and death causes of persons with dementia compared to participants without dementia.
Methods: Participants derive from the Neurological Disorders in Central Spain, a prospective population- based cohort study of older adults. We compared 269 persons with dementia to 2944 participants without dementia. We carried out Cox regression models to predict the risk of mortality dependent on the educational attainment adjusting for covariates. Reasons of death were obtained from the National Population Register. Results: During a median follow-up of 5.4 years, 400 individuals died (171 with dementia, 229 without dementia). Among the participants with dementia, those with higher educational attainment had an increased risk of death than those with lower education; the adjusted hazard ratio (HRa) was 1.40 (95% confidence interval [CI], 1.01 to 1.94). When the analysis was restricted to patients with AD the HRa increased to 1.51 (95% CI = 1.01-2.24). By contrast, educational attainment was not associated with increased mortality among participants without dementia (HRa = 0.92, 95% CI = 0.71-1.20, p = 0.55), whereas education did not influence mortality in QD. Conclusion: Our findings suggest that high educational attainment is associated with increased mortality risk in people with dementia. This observation implies that neuropathology is more advanced in patients with higher education at any level of clinical severity, leading these individuals to an earlier death after diagnosis.Export Options
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Cite this article as:
Contador Israel, Stern Yaakov, Bermejo-Pareja Felix, Sanchez-Ferro Alvaro and Benito-Leon Julian, Is Educational Attainment Associated with Increased Risk of Mortality in People with Dementia? A Population-based Study, Current Alzheimer Research 2017; 14 (5) . https://dx.doi.org/10.2174/1567205013666161201200209
DOI https://dx.doi.org/10.2174/1567205013666161201200209 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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