Participant education, spousal education and dementia risk in a diverse cohort of members of an integrated health care delivery system in Northern California.
dementia
epidemiology
public health
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
18 06 2021
18 06 2021
Historique:
entrez:
19
6
2021
pubmed:
20
6
2021
medline:
29
6
2021
Statut:
epublish
Résumé
The role of spousal education on dementia risk and how it may differ by gender or race/ethnicity is unknown. This study examines the association between one's own education separate from and in conjunction with spousal education and risk of dementia. Cohort. Kaiser Permanente Northern California (KPNC), an integrated health care delivery system. 8835 members of KPNC who were aged 40-55, married and reported own and spousal education in 1964-1973. Dementia cases were identified through medical records from 1 January 1996 to 30 September 2017. Own and spousal education was self-reported in 1964-1973 and each was classified as four indicator variables (≤high school, trade school/some college, college degree and postgraduate) and as ≥college degree versus <college degree. Age as timescale weighted Cox proportional hazard models adjusted for demographics and health indicators evaluated associations between participant education, spousal education and dementia risk overall and by gender and race/ethnicity. The cohort was 37% non-white, 46% men and 30% were diagnosed with dementia during follow-up from 1996 to 2017 (mean follow-up=12.7 years). Greater participant education was associated with lower dementia risk independent of spousal education, demographics and health indicators. Greater spousal education was associated with lower dementia adjusting for demographics but became non-significant after further adjustment for participant education. The same pattern was seen for spousal education ≥college degree (not adjusting for participant education HR In a large diverse cohort, we found that higher levels of participant's own education were associated with lower dementia risk regardless of spousal education. An inverse association between spousal education and dementia risk was also present, however, the effects became non-significant after adjusting for participant education.
Identifiants
pubmed: 34145004
pii: bmjopen-2020-040233
doi: 10.1136/bmjopen-2020-040233
pmc: PMC8215232
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e040233Subventions
Organisme : NIA NIH HHS
ID : R01 AG066132
Pays : United States
Organisme : NIA NIH HHS
ID : R00 AG053410
Pays : United States
Organisme : NIA NIH HHS
ID : K01 AG052646
Pays : United States
Organisme : NIA NIH HHS
ID : RF1 AG050782
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG052132
Pays : United States
Organisme : NIA NIH HHS
ID : RF1 AG056519
Pays : United States
Organisme : NIA NIH HHS
ID : RF1 AG052132
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG010129
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD041022
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Neurology. 2005 Jan 25;64(2):277-81
pubmed: 15668425
Nat Rev Endocrinol. 2011 Feb;7(2):108-14
pubmed: 21263438
Race Soc Probl. 2012 Apr;4(1):
pubmed: 24307918
J Epidemiol Community Health. 2014 Sep;68(9):804-10
pubmed: 24764353
Hypertension. 2003 Dec;42(6):1206-52
pubmed: 14656957
Stat Sci. 2010 Feb 1;25(1):1-21
pubmed: 20871802
J Neurol Neurosurg Psychiatry. 2018 Mar;89(3):231-238
pubmed: 29183957
J Gerontol B Psychol Sci Soc Sci. 2020 Aug 13;75(7):e141-e150
pubmed: 30715517
Neurology. 2017 Oct 31;89(18):1886-1893
pubmed: 28978656
Am J Epidemiol. 2007 Apr 15;165(8):882-9
pubmed: 17284723
Adv Health Econ Health Serv Res. 1991;12:19-39
pubmed: 10122802
J Health Soc Behav. 1996 Dec;37(4):311-25
pubmed: 8997887
JAMA. 1994 Apr 6;271(13):1004-10
pubmed: 8139057
Popul Res Policy Rev. 2014 Feb 1;33(1):127-151
pubmed: 24511172
Lancet Neurol. 2012 Nov;11(11):1006-12
pubmed: 23079557
Intern Med J. 2012 May;42(5):484-91
pubmed: 22372522
J Gen Intern Med. 2010 May;25(5):423-9
pubmed: 20108126
J Geriatr Psychiatry Neurol. 2005 Dec;18(4):213-7
pubmed: 16306242
Am J Epidemiol. 2003 Apr 15;157(8):712-20
pubmed: 12697575
Neuroepidemiology. 2006;26(4):226-32
pubmed: 16707907
Am J Public Health. 1992 May;82(5):703-10
pubmed: 1566949
Health Aff (Millwood). 2010 Aug;29(8):1539-48
pubmed: 20576694
Alzheimers Dement. 2016 Mar;12(3):216-24
pubmed: 26874595
Soc Sci Med. 2006 Sep;63(5):1400-13
pubmed: 16644077
Diabetes Res Clin Pract. 2017 Feb;124:41-47
pubmed: 28088029
J Int Neuropsychol Soc. 2002 Mar;8(3):448-60
pubmed: 11939702
Am J Epidemiol. 2017 Oct 1;186(7):805-814
pubmed: 28541410
BMJ. 2013 Dec 19;347:f7051
pubmed: 24355614
Health Aff (Millwood). 2008 Mar-Apr;27(2):361-72
pubmed: 18332490
JAMA Neurol. 2017 Sep 1;74(9):1056-1062
pubmed: 28759663
Soc Sci Med. 2003 Nov;57(10):1901-12
pubmed: 14499514
Soc Sci Med. 2006 Apr;62(8):2014-23
pubmed: 16199120
Ann Neurol. 1992 Sep;32(3):371-5
pubmed: 1416806