Dataset Information

Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment.

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?
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.

SUBMITTER: Makkar SR

PROVIDER: S-EPMC7724926 | biostudies-literature | 2020 Nov/Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment.

Makkar Steve R SR Lipnicki Darren M DM Crawford John D JD Kochan Nicole A NA Castro-Costa Erico E Lima-Costa Maria Fernanda MF Diniz Breno Satler BS Brayne Carol C Stephan Blossom B Matthews Fiona F Llibre-Rodriguez Juan J JJ Llibre-Guerra Jorge J JJ Valhuerdi-Cepero Adolfo J AJ Lipton Richard B RB Katz Mindy J MJ Zammit Andrea A Ritchie Karen K Carles Sophie S Carriere Isabelle I Scarmeas Nikolaos N Yannakoulia Mary M Kosmidis Mary M Lam Linda L Fung Ada A Chan Wai Chi WC Guaita Antonio A Vaccaro Roberta R Davin Annalisa A Kim Ki Woong KW Han Ji Won JW Suh Seung Wan SW Riedel-Heller Steffi G SG Roehr Susanne S Pabst Alexander A Ganguli Mary M Hughes Tiffany F TF Jacobsen Erin P EP Anstey Kaarin J KJ Cherbuin Nicolas N Haan Mary N MN Aiello Allison E AE Dang Kristina K Kumagai Shuzo S Narazaki Kenji K Chen Sanmei S Ng Tze Pin TP Gao Qi Q Nyunt Ma Shwe Zin MSZ Meguro Kenichi K Yamaguchi Satoshi S Ishii Hiroshi H Lobo Antonio A Lobo Escolar Elena E De la Cámara Concepción C Brodaty Henry H Trollor Julian N JN Leung Yvonne Y Lo Jessica W JW Sachdev Perminder P

Archives of gerontology and geriatrics 20200713

<h4>Background</h4>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).<h4>Methods</h4>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 analys ...[more]

PMID: 32738518

Similar Datasets

Project description:BackgroundMany studies have found that engaging in activities, including physical exercise, social interaction, and cognitive training, is beneficial for preventing cognitive decline among older adults; however, the demographic differences in the association between activity engagement and cognitive functions remain understudied. This study investigates: (a) the influence of activity engagement on cognitive functions among Chinese older adults, and (b) the moderating roles of age and gender in these associations .MethodsThe data were derived from the China Health and Retirement Longitudinal Study in 2018, which included 9803 participants aged 60 or older. A multiple regression model was used to test the study hypotheses.ResultsEngaging in physical activity (b = 1.578, p < .001), social interaction (b = 1.199, p < .001), and cognitive activity (b = 1.468, p < .001) was positively associated with cognitive functions, whereas the effect of volunteer activities on cognitive functions was not significant (b = -.167, p = .390). Light- and moderate-intensity activities were beneficial for cognition (light: b = .847, p < .001; moderate: b = 1.189, p < .001), but vigorous-intensity activity was negatively related to cognition (b = -.767, p < .001). In addition, women and participants with advanced age appeared to benefit more from cognitive activities than their male and younger counterparts, respectively (gender: b = 1.217, p = .002; age: b = .086, p = .004). The adverse effects of vigorous-intensity activities (including agricultural work) on cognitive health were stronger for women and younger participants (gender: b = -1.472, p < .001; age: b = .115, p < .001). The protective effects of moderate-intensity activities on people's cognition increased with increasing age (b = .055, p = .012).ConclusionsThe findings indicate that participating in physical, social, and cognitive activities can help older adults to maintain cognitive health. They suggest that older adults should select activities while considering activity intensity and their individual characteristics.

Project description:BackgroundThe prevalence of dementia varies around the world, potentially contributed to by international differences in rates of age-related cognitive decline. Our primary goal was to investigate how rates of age-related decline in cognitive test performance varied among international cohort studies of cognitive aging. We also determined the extent to which sex, educational attainment, and apolipoprotein E ε4 allele (APOE*4) carrier status were associated with decline.Methods and findingsWe harmonized longitudinal data for 14 cohorts from 12 countries (Australia, Brazil, France, Greece, Hong Kong, Italy, Japan, Singapore, Spain, South Korea, United Kingdom, United States), for a total of 42,170 individuals aged 54-105 y (42% male), including 3.3% with dementia at baseline. The studies began between 1989 and 2011, with all but three ongoing, and each had 2-16 assessment waves (median = 3) and a follow-up duration of 2-15 y. We analyzed standardized Mini-Mental State Examination (MMSE) and memory, processing speed, language, and executive functioning test scores using linear mixed models, adjusted for sex and education, and meta-analytic techniques. Performance on all cognitive measures declined with age, with the most rapid rate of change pooled across cohorts a moderate -0.26 standard deviations per decade (SD/decade) (95% confidence interval [CI] [-0.35, -0.16], p < 0.001) for processing speed. Rates of decline accelerated slightly with age, with executive functioning showing the largest additional rate of decline with every further decade of age (-0.07 SD/decade, 95% CI [-0.10, -0.03], p = 0.002). There was a considerable degree of heterogeneity in the associations across cohorts, including a slightly faster decline (p = 0.021) on the MMSE for Asians (-0.20 SD/decade, 95% CI [-0.28, -0.12], p < 0.001) than for whites (-0.09 SD/decade, 95% CI [-0.16, -0.02], p = 0.009). Males declined on the MMSE at a slightly slower rate than females (difference = 0.023 SD/decade, 95% CI [0.011, 0.035], p < 0.001), and every additional year of education was associated with a rate of decline slightly slower for the MMSE (0.004 SD/decade less, 95% CI [0.002, 0.006], p = 0.001), but slightly faster for language (-0.007 SD/decade more, 95% CI [-0.011, -0.003], p = 0.001). APOE*4 carriers declined slightly more rapidly than non-carriers on most cognitive measures, with processing speed showing the greatest difference (-0.08 SD/decade, 95% CI [-0.15, -0.01], p = 0.019). The same overall pattern of results was found when analyses were repeated with baseline dementia cases excluded. We used only one test to represent cognitive domains, and though a prototypical one, we nevertheless urge caution in generalizing the results to domains rather than viewing them as test-specific associations. This study lacked cohorts from Africa, India, and mainland China.ConclusionsCognitive performance declined with age, and more rapidly with increasing age, across samples from diverse ethnocultural groups and geographical regions. Associations varied across cohorts, suggesting that different rates of cognitive decline might contribute to the global variation in dementia prevalence. However, the many similarities and consistent associations with education and APOE genotype indicate a need to explore how international differences in associations with other risk factors such as genetics, cardiovascular health, and lifestyle are involved. Future studies should attempt to use multiple tests for each cognitive domain and feature populations from ethnocultural groups and geographical regions for which we lacked data.

Dataset Information

Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment.

Publications

Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets