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Education and Risk of Dementia: Dose-Response Meta-Analysis of Prospective Cohort Studies

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Abstract

Educational level has been regarded as one of the most widely accepted risk factors in the epidemiological studies for dementia, despite with discordant qualitative results. However, the dose-response relation between education and incident dementia was still unknown. To quantitatively evaluate the association between exposure level to high and low education and risk of dementia, we searched PubMed, EMBASE, and the Cochrane Library up to November 2014 and references of retrieved literatures. Specific prospective cohort studies, in which educational attainment was categorized into at least three levels, were included. Newcastle-Ottawa scale was used to assess the quality of included studies. Fifteen prospective cohort studies with 55655 for low education and eight prospective cohort studies with 20172 for high education were included. In the qualitative analysis, both low and high education showed a dose-response trend with risk of dementia and Alzheimer’s disease (AD). In the quantitative analysis, the dementia risk was reduced by 7 % for per year increase in education (RR, 0.93; 95 % CI, 0.92–0.94; p for overall trend = 0.000; p for nonlinearity = 0.0643). Nonetheless, we did not find statistically significant association between per year decrease in education and dementia (RR, 1.03; 95 % CI, 0.96–1.10; p for overall trend = 0.283; p for nonlinearity = 0.0041) or AD (RR, 1.03; 95 % CI, 0.97–1.10; p for overall trend = 0.357; p for nonlinearity = 0.0022). Both low and high education showed a trend of dose-response relation with risk of dementia and AD. The dementia risk was reduced by 7 % for per year increase in education.

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Acknowledgments

This work was supported by grants from the National Natural Science Foundation of China (81471309, 81171209), the Shandong Provincial Outstanding Medical Academic Professional Program, Qingdao Key Health Discipline Development Fund, and Qingdao Outstanding Health Professional Development Fund.

Conflicts of Interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, No.5 Donghai Middle Road, Qingdao, China

    Wei Xu, Lan Tan, Meng-Shan Tan, Jie-Qiong Li, Qing-Fei Zhao & Jin-Tai Yu

  2. Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Nanjing, Qingdao, China

    Lan Tan & Hui-Fu Wang

  3. Department of Neurology, Qingdao Municipal Hospital, College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China

    Lin Tan

  4. Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA

    Jin-Tai Yu

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Xu, W., Tan, L., Wang, HF. et al. Education and Risk of Dementia: Dose-Response Meta-Analysis of Prospective Cohort Studies. Mol Neurobiol 53, 3113–3123 (2016). https://doi.org/10.1007/s12035-015-9211-5

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