Does higher educational attainment influence functional capabilities among African Americans with Alzheimer’s disease?

ABSTRACTBackgroundObservational evidence suggests that higher educational attainment is protective for Alzheimer’s disease (AD). It is unclear whether this association is causal or confounded by demographic and socioeconomic characteristics. We examined the causal effect of educational attainment on AD in a two-sample MR framework.MethodsWe extracted all available effect estimates of the 74 single nucleotide polymorphisms (SNPs) associated with years of schooling from the largest genome-wide association study (GWAS) of educational attainment (N=293,723) and the GWAS of AD conducted by the International Genomics of Alzheimer’s Project (n=17,008 AD cases and 37,154 controls). SNP-exposure and SNP-outcome coefficients were combined using an inverse variance weighted approach, providing an estimate of the causal effect of each SD increase in years of schooling on AD. We also performed appropriate sensitivity analyses examining the robustness of causal effect estimates to the various assumptions and conducted simulation analyses to examine potential survival bias of MR analyses.FindingsWith each SD increase in years of schooling (3.51 years), the odds of AD were, on average, reduced by approximately one third (odds ratio= 0.63, 95% confidence interval [CI]: 0.48 to 0.83, p<0.001). Causal effect estimates were consistent when using causal methods with varying MR assumptions or different sets of SNPs for educational attainment, lending confidence to the magnitude and direction of effect in our main findings. There was also no evidence of survival bias in our study.InterpretationOur findings support a causal role of educational attainment on AD, whereby an additional ∼3.5 years of schooling reduces the odds of AD by approximately one third.

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African-Americans Develop Alzheimer's Disease and Other Dementias at Twice the Rate of Africans

PsycEXTRA Dataset ◽

10.1037/e304362003-002 ◽

2001 ◽

Author(s):

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

African Americans

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Association Between the APOE ɛ2/ɛ4 Genotype and Alzheimer’s Disease and Mild Cognitive Impairment Among African Americans

Journal of Alzheimer s Disease ◽

10.3233/jad-201613 ◽

2021 ◽

pp. 1-6

Author(s):

Dianxu Ren ◽

Oscar L. Lopez ◽

Jennifer H. Lingler ◽

Yvette Conley

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

African Americans ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Increased Risk ◽

Similar Risk

We examined the association between APOE ɛ2/ɛ4 with incident Alzheimer’s disease (AD) and mild cognitive impairment (MCI) among African Americans using the national dataset from the National Alzheimer’s Coordinating Center (NACC) from 2005 to September 2019. Compared to ɛ3/ɛ3 carriers, ɛ2/ɛ4 carriers exhibited a similar risk of incident AD (adjusted hazard ratio [aHR] = 0.85, 95% CI [0.39, 1.84]) among the AD cohort and similar risk of incident MCI (aHR = 0.88, 95% CI [0.51, 1.50]) among the MCI cohort. Our findings suggest that, unlike the increased risk of AD and MCI in non-Latino whites, APOE ɛ2/ɛ4 genotype is not associated with the incidence of AD and MCI among African Americans.

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Education, intelligence and Alzheimer’s disease: Evidence from a multivariable two-sample Mendelian randomization study

10.1101/401042 ◽

2018 ◽

Cited By ~ 13

Author(s):

Emma L Anderson ◽

Laura D Howe ◽

Kaitlin H Wade ◽

Yoav Ben-Shlomo ◽

W. David Hill ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Educational Attainment ◽

Mendelian Randomization ◽

Causal Effect ◽

Univariate Analysis ◽

Causal Effects ◽

Training Interventions ◽

Bidirectional Relationship ◽

Years Of Schooling

AbstractObjectivesTo examine whether educational attainment and intelligence have causal effects on risk of Alzheimer’s disease (AD), independently of each other.DesignTwo-sample univariable and multivariable Mendelian Randomization (MR) to estimate the causal effects of education on intelligence and vice versa, and the total and independent causal effects of both education and intelligence on risk of AD.Participants17,008 AD cases and 37,154 controls from the International Genomics of Alzheimer’s Project (IGAP) consortiumMain outcome measureOdds ratio of AD per standardised deviation increase in years of schooling and intelligenceResultsThere was strong evidence of a causal, bidirectional relationship between intelligence and educational attainment, with the magnitude of effect being similar in both directions. Similar overall effects were observed for both educational attainment and intelligence on AD risk in the univariable MR analysis; with each SD increase in years of schooling and intelligence, odds of AD were, on average, 37% (95% CI: 23% to 49%) and 35% (95% CI: 25% to 43%) lower, respectively. There was little evidence from the multivariable MR analysis that educational attainment affected AD risk once intelligence was taken into account, but intelligence affected AD risk independently of educational attainment to a similar magnitude observed in the univariate analysis.ConclusionsThere is robust evidence for an independent, causal effect of intelligence in lowering AD risk, potentially supporting a role for cognitive training interventions to improve aspects of intelligence. However, given the observed causal effect of educational attainment on intelligence, there may also be support for policies aimed at increasing length of schooling to lower incidence of AD.

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Higher educational attainment associated with reduced likelihood of abnormal cervical lesions among Zambian women - a cross sectional study

BMC Cancer ◽

10.1186/s12885-017-3680-z ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 3

Author(s):

Twaambo Euphemia Hamoonga ◽

Rosemary Ndonyo Likwa ◽

Patrick Musonda ◽

Charles Michelo

Keyword(s):

Educational Attainment ◽

Cross Sectional Study ◽

Sectional Study ◽

Cervical Lesions ◽

Cross Sectional ◽

Higher Educational ◽

Higher Educational Attainment

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Abstract 031: Socioeconomic Trajectories Across the Life Course and Risk of All-cause and Cardiovascular Mortality: Prospective Findings From the Moli-sani Study

Circulation ◽

10.1161/circ.137.suppl_1.031 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Marialaura Bonaccio ◽

Augusto Di Castelnuovo ◽

Simona Costanzo ◽

Mariarosaria Persichillo ◽

Chiara Cerletti ◽

...

Keyword(s):

General Population ◽

Educational Attainment ◽

Life Course ◽

Lower Risk ◽

Cox Regression ◽

Low Ses ◽

Increased Risk ◽

Higher Educational ◽

Higher Educational Attainment ◽

The Life Course

Introduction: A life course approach has been suggested as the most appropriated to establish the actual impact of socioeconomic status (SES) on health outcomes. Hypothesis: We assessed the hypothesis that SES trajectories from childhood to adulthood are useful to better evaluate the role of SES towards mortality risk in a large general population-based cohort. Methods: Longitudinal analysis on 22,194 subjects recruited in the general population of the Moli-sani study, Italy (2005-2010). Educational attainment (low/high) and SES in adulthood (measured by a score including occupational social class, housing and overcrowding, and dichotomized as low/high) were used to define four possible trajectories both in low and high SES in childhood (age of 8). Hazard ratios (HR) with 95% confidence intervals (95%CI) were calculated by multivariable Cox regression and competing risk models. Results: Over a median follow-up of 8.3 years (182,924 person-years), 1155 all-cause, of which 414 cardiovascular (CVD), deaths were ascertained. In the group with low SES in childhood, as opposed to those stably low (low education and low SES in adulthood), an upward in both educational attainment and material factors in adulthood was associated with lower risk of both all-cause (HR=0.64; 95%CI 0.52-0.79; Table) and CVD mortality (HR=0.62; 0.43-0.88), respectively. Subjects with high childhood SES experienced an increased risk of total and CVD death in absence of higher educational attainment despite a higher SES in adulthood (HR=1.47; 1.04-2.07 and HR=1.75;1.00-3.05, respectively) as compared to the group with both high education and high SES in adulthood. Conclusions: In conclusion, for individuals with low SES in childhood, an upward of both educational attainment and material factors over the life course is associated with lower risk of total and CVD death. In advantaged groups in childhood, lack of a higher educational attainment, rather than material factors, over the life course appears to be unfavourably associated with survival.

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Alzheimer's Disease and Related Disorders Among African Americans

Neuroepidemiology ◽

10.1016/b978-0-12-504220-8.50016-7 ◽

1993 ◽

pp. 195-210 ◽

Cited By ~ 2

Author(s):

E. Percil Stanford ◽

Barbara Du Bois

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

African Americans

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Health behaviours reported by adults with congenital heart disease across 15 countries

European Journal of Preventive Cardiology ◽

10.1177/2047487319876231 ◽

2019 ◽

Vol 27 (10) ◽

pp. 1077-1087 ◽

Cited By ~ 4

Author(s):

Christina E Holbein ◽

James Peugh ◽

Gruschen R Veldtman ◽

Silke Apers ◽

Koen Luyckx ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Educational Attainment ◽

Health Behaviour ◽

Congenital Heart ◽

Health Behaviours ◽

Self Report ◽

Optimal Health ◽

Higher Educational ◽

Higher Educational Attainment

Background Health behaviours are essential to maintain optimal health and reduce the risk of cardiovascular complications in adults with congenital heart disease. This study aimed to describe health behaviours in adults with congenital heart disease in 15 countries and to identify patient characteristics associated with optimal health behaviours in the international sample. Design This was a cross-sectional observational study. Methods Adults with congenital heart disease ( n = 4028, median age = 32 years, interquartile range 25–42 years) completed self-report measures as part of the Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study (APPROACH-IS). Participants reported on seven health behaviours using the Health Behaviors Scale-Congenital Heart Disease. Demographic and medical characteristics were assessed via medical chart review and self-report. Multivariate path analyses with inverse sampling weights were used to investigate study aims. Results Health behaviour rates for the full sample were 10% binge drinking, 12% cigarette smoking, 6% recreational drug use, 72% annual dental visit, 69% twice daily tooth brushing, 27% daily dental flossing and 43% sport participation. Pairwise comparisons indicated that rates differed between countries. Rates of substance use behaviours were higher in younger, male participants. Optimal dental health behaviours were more common among older, female participants with higher educational attainment while sports participation was more frequent among participants who were younger, male, married, employed/students, with higher educational attainment, less complex anatomical defects and better functional status. Conclusions Health behaviour rates vary by country. Predictors of health behaviours may reflect larger geographic trends. Our findings have implications for the development and implementation of programmes for the assessment and promotion of optimal health behaviours in adults with congenital heart disease.

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