Education and Occupation as Risk Factors for Dementia: A Population-Based Case-Control Study

Bonaiuto, S.; Rocca, Walter A.; Lippi, Andréa; Giannandrea, E.; Mele, Marta; Cavarzeran, Fabiano; Amaducci, L.

doi:10.1159/000109785

Cited by 81 publications

(49 citation statements)

References 16 publications

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“…However, in this survey of Conselice, as well as in a survey of the neighboring municipality of Granarolo [4], the lack of association between dementia and both manual occupation and professional exposure does not support this hypothesis. A significant association between manual lifetime occupation and dementia in Italian subjects was reported by some investigators [5,11] who, however, did not take into account other potential socioeconomic-related risk factors for dementia such as life habits [9].…”

Section: Discussionmentioning

confidence: 94%

“…In agreement with our results, further Italian prevalence studies [3,4] reported that having low education was associated with both AD and VD dementia. On the other hand, both a population-based case-control study [11] and a prevalence study [5] of Italian subjects suggested that this association might be modulated by other sociocultural variables such as occupation and lifestyles.…”

Section: Discussionmentioning

confidence: 99%

“…Identification of modifiable risk factors represent one approach to the prevention of dementing disorders; but the few Italian studies focusing on the possible relationship of dementia with education and occupation have reported inconsistent results [3][4][5]11] and even fewer are the Italian studies investigating this issue with respect to specific dementia subtypes [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Education, Occupation, and Prevalence of Dementia: Findings from the Conselice Study

Ravaglia

Forti

Maioli

et al. 2002

Dement Geriatr Cogn Disord

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Information about the epidemiology of dementia in Italy is still limited, although this cognitive disorder represents a serious public health concern. We estimated the prevalence of dementia and dementia subtypes in the elderly population of a Northern Italian municipality, Conselice, in the Emilia Romagna region (n = 1,016 subjects aged 65–97 years). The associations of dementia with two modifiable risk factors, education and occupation, were also evaluated. Overall dementia prevalence was 5.9% (95% confidence interval 4.3–7.8), exponentially increased with age, and was higher among women. Of the dementia cases, 50% were Alzheimer’s disease (AD), but an unusually high prevalence (45%) was found for vascular dementia (VD). After adjustment for age and gender, education but not occupation was associated with both AD and VD. This association could not be explained by occupation, life habits, and previous history of hypertension or cardiovascular disease.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Education, Occupation, and Prevalence of Dementia: Findings from the Conselice Study

Ravaglia

Forti

Maioli

et al. 2002

Dement Geriatr Cogn Disord

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“…Although not universal, the majority of these studies have found that lack of education is a major risk factor for Alzheimer's disease (Zhang et al, 1990;Friedland, 1993;Stern et al, 1994;White et al, 1994). Other lifestyle choices, including occupation, leisure activities, and physical exercise, may also modulate the risk of cognitive decline (Stern et al, 1994;Bonaiuto et al, 1995;Friedland et al, 2001) (for review, see Pope et al, 2003;Fratiglioni et al, 2004;Scarmeas and Stern, 2004). These findings have fostered the concept of cognitive reserve as a defense against dementia (Katzman, 1993;Stern, 2002).…”

Section: Introductionmentioning

confidence: 99%

Environmental Enrichment Mitigates Cognitive Deficits in a Mouse Model of Alzheimer's Disease

Jankowsky¹,

Melnikova²,

Fadale³

et al. 2005

J. Neurosci.

458

293

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Epidemiological studies suggest that individuals with greater education or more cognitively demanding occupations have diminished risk of developing dementia. We wanted to test whether this effect could be recapitulated in rodents using environmental enrichment, a paradigm well documented to attenuate behavioral deficits induced by various pathological insults. Here, we demonstrate that learning and memory deficits observed in a transgenic mouse model of Alzheimer's disease can be ameliorated by enrichment. Female transgenic mice overexpressing amyloid precursor protein and/or presenilin-1 and nontransgenic controls were placed into enriched or standard cages at 2 months of age and tested for cognitive behavior after 6 months of differential housing. Enrichment significantly improved performance of all genotypes in the radial water maze and in the classic and repeated-reversal versions of the Morris water maze. However, enrichment did not benefit all genotypes equally. Mice overproducing amyloid-␤ (A␤), particularly those with amyloid deposits, showed weaker memory for the platform location in the classic Morris water maze and learned new platform positions in the repeated-reversals task less quickly than their nontransgenic cagemates. Nonetheless, enrichment normalized the performance of A␤-overproducing mice to the level of standard-housed nontransgenic mice. Moreover, this functional preservation occurred despite increased neuritic plaque burden in the hippocampus of double-transgenic animals and elevated steady-state A␤ levels, because both endogenous and transgene-derived A␤ are increased in enriched animals. These results demonstrate that the generation of A␤ in vivo and its impact on the function of the nervous system can be strongly modulated by environmental factors.

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“…Numerous prevalence studies, performed in both urban and rural populations, provide evidence of a protective effect of education [3][4][5][6][7] and nonmanual occupation [8] for the development of dementia. On the other hand, some report no such association [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of the Prevalence of Dementia in Two Sicilian Communities with Different Psychosocial Backgrounds

et al. 1998

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The role of education and psychosocial environment as factors for the development of dementia is controversial. We carried out a comparative study on the prevalence of dementia among persons over 74 years of age in two Sicilian municipalities, Troina and S. Agata Militello, with different psychosocial backgrounds. A two-stage survey was performed for both samples. In stage 1 the Mini Mental Status Examination (previously validated for the cutoff score with 100% sensitivity and the highest specificity) was used to screen a 50% random sample of persons over 74 years of age. In those referred to stage 2, the diagnosis of dementia was made by a neurologist according to DSM-III R. Three hundred and sixty-five subjects were recruited in Troina and 408 in S. Agata Militello. The minimal estimates of dementia prevalence were 21.9% (21.9% men, 21.9% women) in Troina and 28.4% (26.6% men, 29.6% women) in S. Agata Militello. Although intrasample multiple logistic exact analysis (demented vs. unproven demented) indicated poor formal education and manual occupation as risk factors for dementia, and intersample comparison (Troina vs. S. Agata Militello) showed that these variables were more frequent in Troina, we did not find a higher prevalence of dementia in this community. We discuss this apparently ambiguous result and suggest that psychosocial and cultural variables might be considered multiple interacting factors with different protective or predisposing roles for dementia. Higher or lower risk could then be the result of this complex interaction in different populations.

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Education and Occupation as Risk Factors for Dementia: A Population-Based Case-Control Study

Cited by 81 publications

References 16 publications

Education, Occupation, and Prevalence of Dementia: Findings from the Conselice Study

Education, Occupation, and Prevalence of Dementia: Findings from the Conselice Study

Environmental Enrichment Mitigates Cognitive Deficits in a Mouse Model of Alzheimer's Disease

Comparative Study of the Prevalence of Dementia in Two Sicilian Communities with Different Psychosocial Backgrounds

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