Correction to: Community-level educational attainment and dementia: a 6-year longitudinal multilevel study in Japan

Abstract Background:Understanding of the association between community-level socioeconomic status and dementia is insufficient. We examined the contextual effect of community-level prevalence of lower educational attainment on the risk of dementia incidence. This work further explored the potential differences in associations for urban and non-urban areas. Methods:We analyzed a six-year prospective cohort data from the Japan Gerontological Evaluation Study, a nationwide survey between 2010 and 2012 of 49,888 (23,339 men and 26,549 women) physically and cognitively independent individuals aged ≥65 years from 346 communities at 16 municipalities in seven prefectures. Dementia incidence was assessed through the public long-term care insurance system by the Ministry of Health, Labor, and Welfare in Japan. Educational years were dichotomized as ≤9 years and ≥10 years. We classified urban and non-urban areas using a Functional Urban Area defined by the European Union (EU) and Organisation for Economic Co-operation and Development (OECD). We performed a two-level (community- and individual-level) multilevel survival analysis to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results:The cumulative incidence of dementia during the follow-up period was 10.3%. The mean proportion of educational attainment with ≤9 years was 41.1% (range, 4.7%–88.4%). Higher prevalence of community-level lower educational attainment had a significant association with a higher risk of dementia incidence (HR, 1.03; 95% CI, 1.00–1.06, estimated by 10 percentage points of lower educational attainment) post adjusting for individual-level educational years, age, sex, income, residential years, disease, alcohol, smoking, social isolation, and population density. The association was significant in non-urban areas (HR, 1.05; 95% CI, 1.00–1.10). Conclusions:Older people living in communities with a higher prevalence of less educational attainment among their age demographic tended to develop dementia more often than those living in areas with a lower prevalence of less educational attainment after adjusting for individual-level educational attainment and covariates. In particular, the association was more pronounced in non-urban areas than in urban areas. Securing education for adolescence as a life course and population approach could thus be crucial to prevent dementia later in life among all older people living in non-urban areas.

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PW 1526 Associtation between old population traffic accidents and community-level risk factors: a multilevel study

10.1136/injuryprevention-2018-safety.558 ◽

2018 ◽

Author(s):

Jooyeong Kim ◽

Juok Park ◽

Ki-ok Ahn ◽

Seungchul Lee ◽

Hyeah Lee

Keyword(s):

Risk Factors ◽

Traffic Accidents ◽

Community Level ◽

Multilevel Study

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Can Community-Based Interventions on Aspirations Raise Young People's Attainment?

Social Policy and Society ◽

10.1017/s1474746411000054 ◽

2011 ◽

Vol 10 (3) ◽

pp. 321-335 ◽

Cited By ~ 11

Author(s):

Ruth Lupton ◽

Keith Kintrea

Keyword(s):

Educational Attainment ◽

Educational Aspirations ◽

Community Level ◽

Community Based Interventions ◽

Community Based ◽

Wide Range ◽

Neighbourhood Level

Against the background of the ‘Inspiring Communities’ programme to raise ‘community-level’ educational aspirations in England, this article considers whether the existing evidence about place and aspirations suggests that it will be beneficial.We address three questions: Do neighbourhoods have an influence on educational attainment? Are ‘community level’ aspirations a mechanism by which neighbourhoods affect individual aspirations? Is there evidence that aspirations are lower in poor neighbourhoods?The article suggests that the available evidence does not lead to firm conclusions; a key problem is that few studies have measured aspirations at a neighbourhood level. It suggests that limited spending on a pilot is a reasonable response. However, aspirations are shaped by a wide range of other influences. This suggests that any interventions on ‘community’ aspirations’ should be conjoined with other programmes to support schools and to address inequalities between neighbourhoods.

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Community-level educational attainment and dementia: a 6-year longitudinal multilevel study in Japan

BMC Geriatrics ◽

10.1186/s12877-021-02615-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tomo Takasugi ◽

Taishi Tsuji ◽

Masamichi Hanazato ◽

Yasuhiro Miyaguni ◽

Toshiyuki Ojima ◽

...

Keyword(s):

Older People ◽

Educational Attainment ◽

Urban Areas ◽

Evaluation Study ◽

Community Level ◽

Variable Model ◽

Term Care ◽

Individual Level ◽

Dementia Incidence ◽

Individual Survival

Abstract Background As the understanding of the association between community-level education and dementia is insufficient, this study examined the contextual association of community-level prevalence of low educational attainment on the risk of dementia incidence. With this study, we further explored the potential differences in the aforementioned associations for urban and non-urban areas. Methods We analyzed 6 years of prospective cohort data from the Japan Gerontological Evaluation Study, beginning with the baseline data collected between 2010 and 2012, for 51,186 physically and cognitively independent individuals aged ≥65 years (23,785 men and 27,401 women) from 346 communities in 16 municipalities across 7 prefectures. We assessed dementia incidence using available data from the long-term care insurance system in Japan. We dichotomized education years as ≤9 and ≥ 10 years and aggregated individual-level educational attainment as a community-level independent variable. Model 1 covariates were age and sex. Income, residential years, disease, alcohol, smoking, social isolation, and population density were added in Model 2. We conducted multiple imputation to address the missing data. We performed a two-level (community and individual) survival analysis to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results The results indicate that the cumulative incidence of dementia during the follow-up period was 10.6%. The mean proportion with educational attainment of ≤9 years was 40.8% (range: 5.1–87.3%). Low community-level educational attainment was significantly associated with higher dementia incidence (HR: 1.04; 95% CI: 1.01–1.07), estimated by 10 percentage points of low educational attainment after adjusting for individual-level educational years and covariates. While the association was significant in non-urban areas (HR: 1.07; 1.02–1.13), there was no association in urban areas (HR: 1.03; 0.99–1.06). Conclusions Older people living in communities with low educational attainment among their age demographic develop dementia more often compared with those living in areas with high educational attainment after adjusting for individual-level educational attainment and covariates; the association was pronounced in non-urban areas. Securing education for adolescents as a life course and population approach could thus be crucial in preventing dementia later in life among older people living in non-urban areas.

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