APH 2005, 63, 279-292:

The incidence of dementia: relationship with educational attainment.

A. Versporten, N. Bossuyt, L. Meulenbergs, F. Baro, H. Van Oyen

Keywords: dementia, educational attainment, general population, survival analysis, cognitive reserve

Objectives: To investigate whether educational attainment influences the development of dementia. The hypothesis is that higher educated persons have a lower incidence rate of dementia than persons with a
lower educational attainment.

Methods:
The project ‘Epidemiology Research on Dementia in Antwerp’ (ERDA) started in 1990 and had two follow-up periods in 1994 and 1996. It is a longitudinal population-based study using a general population in Antwerp (Heist-op-den-Berg), Belgium. Included in the analysis are 937 non-demented persons of 65 years and older at the time of the first follow-up period (1994).

Incidence densities of dementia were calculated per age group and per sex. Dementia-free Kaplan Meier survival analyses and multivariate Cox Proportional Hazards models adjusted for risk factors are used to
estimate relative risk for dementia.

Results: Overall incidence rates of dementia were 4.1/100 person years for men and 3.3/100 person years for women. Lower educated persons (primary education or less) were at higher risk to develop dementia compared to higher educated persons. The adjusted hazard risk is 2.9 (95%CI: 1.0-8.1).

Conclusions: Both men and women survived longer in good cognitive health when belonging to the higher educated group. Educational attainment could act upon the threshold of a cognitive reserve. The study indicates the importance of education at young ages.