Annie Robitaille1, Ardo van den Hout2, Robson J M Machado2, David A Bennett3, Iva Čukić4, Ian J Deary4, Scott M Hofer5, Emiel O Hoogendijk6, Martijn Huisman6, Boo Johansson7, Andriy V Koval8, Maaike van der Noordt6, Andrea M Piccinin8, Judith J M Rijnhart6, Archana Singh-Manoux9, Johan Skoog7, Ingmar Skoog10, John Starr11, Lisa Vermunt12, Sean Clouston13, Graciela Muniz Terrera14. 1. Department of Psychology, University of Victoria, Victoria, BC, Canada. Electronic address: robitaille.annie.2@uqam.ca. 2. Department of Statistical Science, University College London, London, UK. 3. Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, US. 4. Department of Psychology, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK. 5. Department of Psychology, University of Victoria, Victoria, BC, Canada; Department of Neurology, Oregon Health & Science University, Portland, OR, US. 6. Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. 7. Department of Psychology and Centre for Health and Ageing AGECAP, University of Gothenburg, Gothenburg, Sweden. 8. Department of Psychology, University of Victoria, Victoria, BC, Canada. 9. Department of Epidemiology & Public Health, University College London, London, UK; INSERM, U1018, Epidemiology of Ageing & Age-related diseases, Villejuif, France. 10. Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Centre for Health and Ageing AGECAP, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 11. Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Clinical and Surgical Sciences, Geriatric Medicine Unit, University of Edinburgh, Edinburgh, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK. 12. Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands. 13. Program in Public Health and Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, US. 14. Department of Psychology, University of Victoria, Victoria, BC, Canada; Centre for Dementia Prevention, The University of Edinburgh, Edinburgh, UK.
Abstract
INTRODUCTION: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. METHODS: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. RESULTS: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. DISCUSSION: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.
INTRODUCTION: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. METHODS: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. RESULTS: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. DISCUSSION: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.
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Authors: Eileen K Graham; Emily C Willroth; Sara J Weston; Graciela Muniz-Terrera; Sean A P Clouston; Scott M Hofer; Daniel K Mroczek; Andrea M Piccinin Journal: Psychol Aging Date: 2021-05-24
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