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Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment.
Makkar, Steve R; Lipnicki, Darren M; Crawford, John D; Kochan, Nicole A; Castro-Costa, Erico; Lima-Costa, Maria Fernanda; Diniz, Breno Satler; Brayne, Carol; Stephan, Blossom; Matthews, Fiona; Llibre-Rodriguez, Juan J; Llibre-Guerra, Jorge J; Valhuerdi-Cepero, Adolfo J; Lipton, Richard B; Katz, Mindy J; Zammit, Andrea; Ritchie, Karen; Carles, Sophie; Carriere, Isabelle; Scarmeas, Nikolaos; Yannakoulia, Mary; Kosmidis, Mary; Lam, Linda; Fung, Ada; Chan, Wai Chi; Guaita, Antonio; Vaccaro, Roberta; Davin, Annalisa; Kim, Ki Woong; Han, Ji Won; Suh, Seung Wan; Riedel-Heller, Steffi G; Roehr, Susanne; Pabst, Alexander; Ganguli, Mary; Hughes, Tiffany F; Jacobsen, Erin P; Anstey, Kaarin J; Cherbuin, Nicolas; Haan, Mary N; Aiello, Allison E; Dang, Kristina; Kumagai, Shuzo; Narazaki, Kenji; Chen, Sanmei; Ng, Tze Pin; Gao, Qi; Nyunt, Ma Shwe Zin; Meguro, Kenichi; Yamaguchi, Satoshi.
Afiliação
  • Makkar SR; Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia. Electronic address: stevem@unsw.edu.au.
  • Lipnicki DM; Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
  • Crawford JD; Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
  • Kochan NA; Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
  • Castro-Costa E; Instituto Rene´ Rachou da Fundaçaõ Oswaldo Cruz, Rio de Janeiro, Brazil.
  • Lima-Costa MF; Instituto Rene´ Rachou da Fundaçaõ Oswaldo Cruz, Rio de Janeiro, Brazil.
  • Diniz BS; Department of Psychiatry, Faculty of Medicine University, Toronto, Canada; Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto, ON, Canada.
  • Brayne C; Department of Public Health and Primary Care, Cambridge University, UK.
  • Stephan B; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
  • Matthews F; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
  • Llibre-Rodriguez JJ; Finlay-Albarrán Faculty of Medical Sciences, Medical University of Havana, Cuba.
  • Llibre-Guerra JJ; Institute of Neurology and Neurosurgery Havana, Cuba, Memory and Aging Center, UCSF San Francisco, United States.
  • Valhuerdi-Cepero AJ; Medical University of Matanzas, Cuba.
  • Lipton RB; Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, NY, United States; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York City, NY, United States; Department of Psychiatry and
  • Katz MJ; Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, NY, United States.
  • Zammit A; Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, NY, United States.
  • Ritchie K; Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France; Université de Montpellier, Montpellier, France; Centre for Clinical Brain Sciences, University of Edinburgh, UK.
  • Carles S; Inserm, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, F-75014 France; Paris Descartes University, Paris, France; Univ Paris-Sud, Villejuif, France.
  • Carriere I; Université de Montpellier, Montpellier, France; Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France.
  • Scarmeas N; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Gertrude H Sergievsky Center, Department of Neurology, Columbia University, New York, NY, United S
  • Yannakoulia M; Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens, Greece.
  • Kosmidis M; Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
  • Lam L; Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong.
  • Fung A; Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong.
  • Chan WC; Department of Psychiatry, The University of Hong Kong, Hong Kong.
  • Guaita A; Golgi Cenci Foundation, Corso San Martino 10, 20081 Abbiategrasso, Italy.
  • Vaccaro R; Golgi Cenci Foundation, Corso San Martino 10, 20081 Abbiategrasso, Italy.
  • Davin A; Golgi Cenci Foundation, Corso San Martino 10, 20081 Abbiategrasso, Italy.
  • Kim KW; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Sou
  • Han JW; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
  • Suh SW; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
  • Riedel-Heller SG; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
  • Roehr S; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
  • Pabst A; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
  • Ganguli M; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
  • Hughes TF; Department of Sociology, Anthropology, and Gerontology, Youngstown State University, Youngstown, OH, United States.
  • Jacobsen EP; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
  • Anstey KJ; School of Psychology, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, The Australian National University, Canberra, Australia.
  • Cherbuin N; Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, The Australian National University, Canberra, Australia.
  • Haan MN; University of California, School of Medicine, Department of Epidemiology and Biostatistics, CA, United States.
  • Aiello AE; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Carolina Population Center, Chapel Hill, NC, United States.
  • Dang K; University of California, School of Medicine, Department of Epidemiology and Biostatistics, CA, United States.
  • Kumagai S; Center for Health Science and Counseling, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka, 816-8580, Japan.
  • Narazaki K; Faculty of Socio-Environmental Studies, Department of Socio-Environmental Studies, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka 811-0295, Japan.
  • Chen S; Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo 162-8655, Japan.
  • Ng TP; Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • Gao Q; Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • Nyunt MSZ; Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • Meguro K; Geriatric Behavioral Neurology, Tohoku University, Japan.
  • Yamaguchi S; Geriatric Behavioral Neurology, Tohoku University, Japan.
Arch Gerontol Geriatr ; 91: 104112, 2020.
Article em En | MEDLINE | ID: mdl-32738518
ABSTRACT

BACKGROUND:

We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4).

METHODS:

Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels Incomplete Elementary; Elementary; Middle; and High School.

RESULTS:

Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers.

CONCLUSION:

High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Etnicidade / Disfunção Cognitiva Idioma: En Ano de publicação: 2020 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Etnicidade / Disfunção Cognitiva Idioma: En Ano de publicação: 2020 Tipo de documento: Article