OP50 Education does not moderate the rate of cognitive decline prior to dementia diagnosis: Evidence from the OCTO-Twin longitudinal study
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Résumé
<h3>Background</h3> A current phenomenon is the constant increase in life expectancy with polarised consequences for health. Among these, dementia represents a major public health impact on individuals and governments around the world. The search for modifiable risk factors remains a high priority. Many longitudinal studies have shown that education is associated with cognitive functioning in midlife, but the existing evidence regarding its protection against faster cognitive decline is relatively mixed. The aim of these analyses was to examine cognitive decline on both fluid and crystallised functions in preclinical stages of dementia and the role of education on these trajectories. <h3>Methods</h3> The participants were drawn from the Swedish Octogenarian Twin study, a sample of individuals, aged 80+ years at baseline, who were interviewed biannually up to a maximum of 5 times. Only those who developed dementia after the study entry were included in these analyses (n=205). Cognitive functioning was assessed at each wave with the Mini-Mental State Examination and other neuropsychological tests such as verbal memory, inductive reasoning, language, information task and verbal meaning. Random effects models were fitted to each cognitive outcome as a function of time to dementia diagnosis, accounting for education, age and socio-economic position. The multilevel model was characterised by a fixed part which contained average effects for the intercept (initial status) and slope (rate of change from the baseline to the time to dementia diagnosis) and a random part which contained individual differences (variance) in the intercept, slope, and the within person residual. Sensitivity analysis were conducted (Tobit mixed models) to account for the ceiling/floor effects in the measures of global function. <h3>Results</h3> The results indicate a steeper cognitive decline prior to dementia diagnosis in most of the fluid cognitive abilities measured with MMSE, Prose Recall, Block Design, Digit Symbol, Memory Recognition, Memory Correspondence and Information tests. Education had a significant effect on the level of cognitive functioning at the time of dementia diagnosis on both crystallised cognitive measures: synonym (β=0.80, SE=0.35, <i>p = 0.02)</i> and information tests (β=1.72, SE=0.54, <i>p = 0.001</i>), but not on the rate of cognitive decline in any of the cognitive measures investigated. <h3>Conclusion</h3> These findings suggest that higher education is associated with better cognitive functioning on crystallised cognitive measures (e.g. information and verbal meaning) which tend to be preserved as we age; but did not support the cognitive reserve hypothesis, which stipulates a protective role of education against steeper cognitive decline before dementia diagnosis.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle