Impact of literacy and years of education on the diagnosis of dementia: A population-based study
Impact of literacy and years of education on the diagnosis of dementia: A population-based study
复制标题
DOI：
10.1080/13803395.2016.1204992
复制
发表时间：
2017-01-01
影响因子：
2.2
通讯作者：
Bermejo-Pareja, Felix
中科院分区：
文献类型：
--
作者：
Contador, Israel;del Ser, Teodoro;Bermejo-Pareja, Felix
背景不同教育指标对痴呆临床诊断的影响有待进一步研究。Objective.我们比较了两个教育指数（EI）的不同影响：受教育年限和教育水平（即，无/低识字率，可以读写，小学和中学）对整体认知，功能表现和痴呆症诊断的可能性。法共有3，816名参与者选自基于人群的老年人研究“西班牙中部神经疾病”（NEDICES）。采用37项简易精神状态检查（MMSE-37）和Pfeffer问卷分别评估认知和功能表现。痴呆的诊断由神经科专家根据精神障碍诊断和统计手册第四版（DSM-IV）标准进行。Logistic回归模型调整潜在的混杂因素进行测试之间的关联，这两个EI和痴呆诊断。结果这两种EI与认知和功能评分显著相关，但当这些群体在受教育年限方面进行比较时，零/低识字率的个体在MMSE-37上的表现明显不如识字者。在逻辑模型中，这两个EI也与痴呆症诊断概率增加有关，但教育水平的关联强度比教育年限的关联强度更强。结论识字预测认知表现超过多年的学校教育。较低的教育水平增加了痴呆症诊断的可能性，但不同EI的影响并不一致。
Background. The effect of different educational indices on clinical diagnosis of dementia requires more investigation. Objective. We compared the differential influence of two educational indices (EIs): years of schooling and level of education (i.e., null/low literacy, can read and write, primary school, and secondary school) on global cognition, functional performance, and the probability of having a dementia diagnosis. Method. A total of 3,816 participants were selected from the population-based study of older adults "Neurological Disorders in Central Spain" (NEDICES). The 37-item version of the Mini-Mental State Examination (MMSE-37) and the Pfeffer's questionnaire were applied to assess cognitive and functional performance, respectively. The diagnosis of dementia was performed by expert neurologists according to Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) criteria. Logistic regression models adjusted for potential confounders were carried out to test the association between the two EIs and dementia diagnosis. Results. Both EIs were significantly associated with cognitive and functional scores, but individuals with null/low literacy performed significantly worse on MMSE-37 than literates when these groups were compared in terms of years of schooling. The two EIs were also related to an increased probability of dementia diagnosis in logistic models, but the association's strength was stronger for level of education than for years of schooling. Conclusion. Literacy predicted cognitive performance over and above the years of schooling. Lower education increases the probability of having a dementia diagnosis but the impact of different EIs is not uniform.