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Higher education linked with lower risk for dementia in African-Americans

Study findings demonstrated that higher education level was significantly associated with lower risk for dementia later in life among African-Americans.

"Low education can be a marker for adverse environmental influences in childhood such as the use of home remedies, poor diet, mistrust of the medical system and religious or cultural beliefs on seeking health care," Valerie Smith-Gamble, MD, MSc, of Alvin C. York VA Medical Center in Murfreesboro, Tennessee, said in a press release. "Higher educational attainment may alter these negative influences of childhood by lifestyle changes such as healthy food choices and exercise, and the establishment of trust of the medical system.”

Using a prospective cohort design, researchers examined possible associations of childhood residence, education levels and occupation with declining incidence rates of dementia in two cohorts of African-Americans aged 70 years and older. They enrolled 1,440 participants without dementia living in Indianapolis in 1992 and 1,835 in 2001, then conducted regular evaluations every 2 to 3 years. The investigators compared difference in dementia and Alzheimer’s disease risk between the two cohorts using Cox proportional hazard regression models.

Of the 1,440 participants included in the 1992 cohort, 191 (13.3%) developed incident dementia and 161 (11.2%) developed Alzheimer’s disease. Of the 1,835 included in the 2001 cohort, 94 (5.1%) developed dementia during follow-up and 72 (3.9%) developed Alzheimer’s disease. African-Americans in the 1992 cohort were significantly older, less educated, more likely to report a childhood rural residence and less likely to have a white-collar occupation than those in the 2001 cohort.

Participants in the 2001 cohort had a significantly lower risk for both incident dementia (HR = 0.62) and Alzheimer’s disease (HR = 0.57) compared with those in the 1992 cohort. The researchers found that years of education was linked to lower risk for dementia (HR = 0.93; P = .0011). For participants who lived in rural areas during their childhood, analysis revealed higher education level was significantly linked to lower Alzheimer’s disease risk (HR = 0.87; P = .0477), but this association was not observed for African-Americans who had an urban upbringing. After adjusting for childhood rural residence, lower education and nonwhite-collar occupation, the cohort difference for dementia rates remained significant (HR = 0.75; P = .04).

"This study underscores the potential impact of a deleterious childhood environment on diseases of the elderly including dementia and Alzheimer's disease," Hugh Hendrie, MB, ChB, DSc, of the Center for Aging Research and the department of psychiatry at Indiana University School of Medicine, said in the release. "It is encouraging to note that improving these conditions — such as providing greater childhood education opportunities — may lead to decreases in the incidence of these devastating brain diseases." – by Savannah Demko

Disclosures: The authors report no relevant financial disclosures.