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A Life-Course Study of Cognitive Reserve in Dementia-From Childhood to Old Age.

Dekhtyar, Serhiy; Wang, Hui; Scott, Kirk LU ; Goodman, Anna; Koupil, Ilona and Herlitz, Agneta (2015) In The American Journal of Geriatric Psychiatry 23(9). p.885-896
Abstract
Objective

To test a life-course model of cognitive reserve in dementia and examine if school grades around age 10 years, formal educational attainment, and lifetime occupational complexity affect the risk of dementia in old age.



Methods

7,574 men and women from the Uppsala Birth Cohort Multigenerational Study were followed for 21 years. Information on school performance, formal education, and occupational attainment was collected prospectively from elementary school archives and population censuses. Dementia diagnosis was extracted from the two Swedish registers. Discrete-time Cox proportional hazard models were estimated.



Results

Dementia was diagnosed in 950 individuals... (More)
Objective

To test a life-course model of cognitive reserve in dementia and examine if school grades around age 10 years, formal educational attainment, and lifetime occupational complexity affect the risk of dementia in old age.



Methods

7,574 men and women from the Uppsala Birth Cohort Multigenerational Study were followed for 21 years. Information on school performance, formal education, and occupational attainment was collected prospectively from elementary school archives and population censuses. Dementia diagnosis was extracted from the two Swedish registers. Discrete-time Cox proportional hazard models were estimated.



Results

Dementia was diagnosed in 950 individuals (12.5%). Dementia risk was lower among individuals with higher childhood school grades (hazard ratio [HR]: 0.79; 95% confidence interval [CI]: 0.68 to 0.93) and was lower among individuals in data-complex occupations (HR: 0.77; 95% CI: 0.64 to 0.92). Professional/university education predicted lower risk of dementia in minimally adjusted models (HR: 0.74; 95% CI: 0.60 to 0.91), although the effect faded with adjustment for occupational complexity. Lowest risk was found in the group with both higher childhood school performance and high occupational complexity with data (HR: 0.61; 95% CI: 0.50 to 0.75). Importantly, high occupational complexity could not compensate for the effect of low childhood grades. In contrast, dementia risk was reduced in those with higher school grades, irrespective of occupational complexity.



Conclusion

Higher childhood school performance is protective of dementia risk, particularly when preserved through complex work environments in adulthood, although it will remain protective even in the absence of later-life educational or occupational stimulation. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dementia, cognitive reserve, life course
in
The American Journal of Geriatric Psychiatry
volume
23
issue
9
pages
885 - 896
publisher
Elsevier
external identifiers
  • pmid:25746486
  • wos:000359420300002
  • scopus:84942772469
ISSN
1545-7214
DOI
10.1016/j.jagp.2015.02.002
language
English
LU publication?
yes
id
fd2c35bb-7ecb-4b50-bb3a-9d4546991666 (old id 5265119)
date added to LUP
2015-04-17 13:42:26
date last changed
2017-10-22 03:06:08
@article{fd2c35bb-7ecb-4b50-bb3a-9d4546991666,
  abstract     = {Objective<br/><br>
To test a life-course model of cognitive reserve in dementia and examine if school grades around age 10 years, formal educational attainment, and lifetime occupational complexity affect the risk of dementia in old age.<br/><br>
<br/><br>
Methods<br/><br>
7,574 men and women from the Uppsala Birth Cohort Multigenerational Study were followed for 21 years. Information on school performance, formal education, and occupational attainment was collected prospectively from elementary school archives and population censuses. Dementia diagnosis was extracted from the two Swedish registers. Discrete-time Cox proportional hazard models were estimated.<br/><br>
<br/><br>
Results<br/><br>
Dementia was diagnosed in 950 individuals (12.5%). Dementia risk was lower among individuals with higher childhood school grades (hazard ratio [HR]: 0.79; 95% confidence interval [CI]: 0.68 to 0.93) and was lower among individuals in data-complex occupations (HR: 0.77; 95% CI: 0.64 to 0.92). Professional/university education predicted lower risk of dementia in minimally adjusted models (HR: 0.74; 95% CI: 0.60 to 0.91), although the effect faded with adjustment for occupational complexity. Lowest risk was found in the group with both higher childhood school performance and high occupational complexity with data (HR: 0.61; 95% CI: 0.50 to 0.75). Importantly, high occupational complexity could not compensate for the effect of low childhood grades. In contrast, dementia risk was reduced in those with higher school grades, irrespective of occupational complexity.<br/><br>
<br/><br>
Conclusion<br/><br>
Higher childhood school performance is protective of dementia risk, particularly when preserved through complex work environments in adulthood, although it will remain protective even in the absence of later-life educational or occupational stimulation.},
  author       = {Dekhtyar, Serhiy and Wang, Hui and Scott, Kirk and Goodman, Anna and Koupil, Ilona and Herlitz, Agneta},
  issn         = {1545-7214},
  keyword      = {Dementia,cognitive reserve,life course},
  language     = {eng},
  number       = {9},
  pages        = {885--896},
  publisher    = {Elsevier},
  series       = {The American Journal of Geriatric Psychiatry},
  title        = {A Life-Course Study of Cognitive Reserve in Dementia-From Childhood to Old Age.},
  url          = {http://dx.doi.org/10.1016/j.jagp.2015.02.002},
  volume       = {23},
  year         = {2015},
}