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

dc.creatorMakkar, Steve R
dc.creatorLipnicki, Darren M
dc.creatorCrawford, John D
dc.creatorKochan, Nicole A
dc.creatorCosta, Erico de Castro
dc.creatorCosta, Maria Fernanda Furtado de Lima
dc.creatorDiniz, Breno Satler
dc.creatorBrayne, Carol
dc.creatorStephan, Blossom
dc.creatorMatthews, Fiona
dc.creatorLlibre-Rodriguez, Juan J
dc.creatorLlibre-Guerra, Jorge J
dc.creatorValhuerdi-Cepero, Adolfo J
dc.creatorLipton, Richard B
dc.creatorKatz, Mindy J
dc.creatorZammit, Andrea
dc.creatorRitchie, Karen
dc.creatorCarles, Sophie
dc.creatorCarriere, Isabelle
dc.creatorScarmeas, Nikolaos
dc.creatorYannakoulia, Mary
dc.creatorKosmidis, Mary
dc.creatorLam, Linda
dc.creatorFung, Ada
dc.creatorChan, Wai Chi
dc.creatorGuaita, Antonio
dc.creatorVaccaro, Roberta
dc.creatorDavin, Annalisa
dc.creatorKim, Ki Woong
dc.creatorHan, Ji Won
dc.creatorSuh, Seung Wan
dc.creatorRiedel-Heller, Steffi G
dc.creatorRoehr, Susanne
dc.creatorPabst, Alexander
dc.creatorGanguli, Mary
dc.creatorHughes, Tiffany F
dc.creatorJacobsen, Erin P
dc.creatorAnstey, Kaarin J
dc.creatorCherbuin, Nicolas
dc.creatorHaan, Mary N
dc.creatorAiello, Allison E
dc.creatorDang, Kristina
dc.creatorKumagai, Shuzo
dc.creatorNarazaki, Kenji
dc.creatorChen, Sanmei
dc.creatorNg, Tze Pin
dc.creatorGao, Qi
dc.creatorNyunt, Ma Shwe Zin
dc.creatorMeguro, Kenichi
dc.creatorYamaguchi, Satoshi
dc.creatorIshii, Hiroshi
dc.creatorLobo, Antonio
dc.creatorEscolar, Elena Lobo
dc.creatorCámara, Concepción De la
dc.creatorBrodaty, Henry
dc.creatorTrollor, Julian N
dc.creatorLeung, Yvonne
dc.creatorLo, Jessica W
dc.creatorSachdev, Perminder
dc.creatorfor Cohort Studies of Memory in an International Consortium (COSMIC)
dc.date2023-05-23T17:26:03Z
dc.date2023-05-23T17:26:03Z
dc.date2020
dc.date.accessioned2023-09-27T00:11:10Z
dc.date.available2023-09-27T00:11:10Z
dc.identifierMAKKAR, Steve R et al. Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment. Arch Gerontol Geriatr., v. 91, 104112, 2020. doi: 10.1016/j.archger.2020.104112.
dc.identifier0167-4943
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/58590
dc.identifier10.1016/j.archger.2020.104112
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8898301
dc.descriptionBackground: 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.
dc.description2099-12-31
dc.formatapplication/pdf
dc.languageeng
dc.publisherElsevier Biomedical Press
dc.rightsrestricted access
dc.subjectCognitive decline
dc.subjectEducation
dc.subjectAgeing
dc.subjectSex
dc.subjectAge
dc.subjectEthnicity
dc.titleEducation and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment
dc.typeArticle


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