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Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies

Artikel i vetenskaplig tidskrift
Författare Annie Robitaille
Ardo van den Hout
Robson J.M. Machado
David A. Bennett
Iva Čukić
Ian J. Deary
Scott M. Hofer
Emiel O. Hoogendijk
Martijn Huisman
Boo Johansson
Andriy V. Koval
Maaike van der Noordt
Andrea M. Piccinin
Judith J.M. Rijnhart
Archana Singh-Manoux
Johan Skoog
Ingmar Skoog
John Starr
Lisa Vermunt
Sean Clouston
Graciela Muniz Terrera
Publicerad i Alzheimer's and Dementia
Volym 14
Nummer/häfte 4
Sidor 462-472
ISSN 15525260
Publiceringsår 2018
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi
Psykologiska institutionen
Centrum för åldrande och hälsa (AgeCap)
Sidor 462-472
Språk en
Ämnesord Cognition, Dementia, Education, Life expectancy, Multistate modeling, Socioeconomic status
Ämneskategorier Psykologi, Äldre och åldrande

Sammanfattning

© 2017 the Alzheimer's Association. 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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