Education and change in cognitive function: The Epidemiologic Catchment Area Study
Education and change in cognitive function: The Epidemiologic Catchment Area Study
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DOI：
10.1016/1047-2797(94)00047-w
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发表时间：
1995-01-01
影响因子：
5.6
通讯作者：
Regier, Darrel A.
中科院分区：
文献类型：
--
作者：
Farmer, Mary E.;Kittner, Steven J.;Regier, Darrel A.
在美国国家精神卫生研究所流行病学集水区研究中，对14,883名18岁及以上的受试者进行了为期1年的教育程度与认知功能下降之间的相关性研究。在两个时间点通过简易精神状态检查（MMSE）评估认知功能;认知下降被编码为二分变量，如果受试者在1年随访访视时的评分较基线MMSE评分下降3分或以上，则定义为1，否则定义为0。在logistic回归模型中，根据年龄组（<65岁，≥ 65岁）和基线MMSE水平（MMSE> 23，MMSE ≤ 23）分层，检查了教育程度和1年以上认知功能下降之间的关联。协变量包括年龄、基线MMSE评分、种族、居住地、酒精或其他药物滥用的终生诊断和性别。在那些基线MMSE gt 23的受试者中，教育是认知能力下降的重要预测因素，不仅在老年人中，而且在年轻受试者中也是如此。在基线MMSE ≤ 23的患者中，教育不是认知功能下降的重要预测因素。事实上，教育提供保护，防止认知能力下降，即使在那些年龄小于65岁，其中的流行率和发病率痴呆症是非常低的，似乎表明，教育或其相关提供保护，防止其他过程，而不是痴呆症，可能会导致测试性能下降的年轻人。
The association between educational attainment and decline in cognitive function over an interval of 1 year was examined for 14,883 subjects 18 years and older in the National Institute of Mental Health Epidemiologic Catchment Area Study. Cognitive function was assessed at both time points by the Mini-Mental State Examination (MMSE); cognitive decline was coded as a dichotomous variable and was defined as 1 if the subject's score had declined 3 or more points from the baseline MMSE score at the 1-year follow-up interview and as 0 otherwise. The association between educational attainment and decline in cognitive function over 1 year was examined in logistic regression models that were stratified by age group ( lt 65 years, gtoreq 65 years) and by baseline MMSE level (MMSE gt 23, MMSE ltoreq 23). Covariates included age, baseline MMSE score, ethnicity, residence, lifetime diagnosis of abuse of alcohol or other drugs, and gender. In those with baseline MMSE gt 23, education was a significant predictor of cognitive decline, not only in the elderly but also in younger subjects. Among those with baseline MMSE ltoreq 23, education was not a significant predictor of cognitive decline. The fact that education provides protection against cognitive decline even in those younger than 65 years, in whom the prevalence and incidence of dementia are very low, would seem to indicate that education or its correlates provides protection against processes other than dementia that might produce a decline in test performance in young persons.