학술논문
Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment
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article
Author
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; Ishii, Hiroshi; Lobo, Antonio; Escolar, Elena Lobo; De la Cámara, Concepción; Brodaty, Henry; Trollor, Julian N; Leung, Yvonne; Lo, Jessica W; Sachdev, Perminder; Consortium, for Cohort Studies of Memory in an International
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Abstract
BackgroundWe 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).MethodsParticipants 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.ResultsCompared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P