Education and Occupation as Risk Factors for Dementias of the Alzheimer and Ischemic Vascular Types

Mortel, Karl F.; Meyer, John Stirling; Herod, Brian; Thornby, John

doi:10.1159/000106922

Cited by 68 publications

(74 citation statements)

References 24 publications

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“…An inverse association between plasma fibrinogen levels and education has also been reported previously [38]. Previous studies have suggested that low education might be a risk factor per se for poststroke dementia [4,6], Alzheimer's disease [5,7], and all types of dementia [3,8,9,10]. However, these proposals are difficult to verify, since a low educational level is associated with impaired performance in cognitive tests [39][40][41][42][43], and with the usual diagnostic criteria, dementia may be detected earlier in subjects with a lower premorbid cognitive level.…”

Section: Discussionsupporting

confidence: 57%

“…hypertension, cardiovascular disease, diabetes and smoking. A low educational level is another factor that, according to recent studies, is related to an increased risk of developing a dementia disorder [3][4][5][6][7][8][9][10]. Furthermore, there is a linkage between low education/low socio-economic status and increased vascular risk [11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Cognitive function, vascular risk factors and education. A cross‐sectional study based on a cohort of 70‐year‐old men

Kilander

Nyman

Boberg

et al. 1997

Journal of Internal Medicine

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Objectives.A low level of education is associated with an increased risk of developing a dementia disorder, as well as with a higher risk of cardiovascular disease. The aim of this study was to investigate the association between education and cardiovascular risk factors, and to study the relation between these factors and cognitive function in elderly men. Design. Cross-sectional population-based study. Setting. Uppsala, Sweden. Subjects. 504 men aged 69-74 years, participants in a longitudinal health survey concerning cardiovascular risk factors. Main outcome measure. Cognitive function as measured by a composite score of 13 standard psychometric tests. Results.A low level of education was associated with poorer cognitive performance, as well as with obesity, smoking, diabetes, high concentrations of serum triglycerides and plasma fibrinogen. In the entire cohort, subjects with obesity, smoking, diabetes or hypertriglyceridaemia showed impaired cognitive test results, independent of socio-economic factors. When stroke cases were excluded, obesity and smoking were still related to impaired cognitive function. Conclusions. Smoking and obesity with associated metabolic disturbances are inversely related both to educational level and to cognitive function. Cognitive decline of vascular origin is potentially preventable by treatment of risk factors. The question of whether the increased vascular risk contributes to the higher prevalence of cognitive disorders in individuals with low socio-economic status, needs to be further evaluated in longitudinal population-based studies.

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Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Cognitive function, vascular risk factors and education. A cross‐sectional study based on a cohort of 70‐year‐old men

Kilander

Nyman

Boberg

et al. 1997

Journal of Internal Medicine

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“…Therefore, several reported risk factors for vascular dementia are the same as those for stroke (210). Nonvascular risk factors include psychosocial stress in early life (211) and work in a blue-collar occupation (212). Because vascular dementia is preventable (213), the determination of risk factors for the disease is vitally important (214).…”

Section: Mental Disorders and Neurological Diseasesmentioning

confidence: 99%

Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland

Nurminen¹,

Karjalainen²

2001

Scand J Work Environ Health

261

202

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Objectives This study attempts to estimate the proportion of annual deaths related to occupational factors in Finland and considers related methodological issues and associated uncertainties.Methods Statistics on causes of death, numbers of subjects exposed, and risk ratios obtained from the epidemiologic literature were used to estimate the population attributable fraction and disease burden for causes of death from work-related diseases. Gender-, age-and disease-specific numbers of deaths were provided by Statistics Finland for 1996. Information on the size of the population, broken down by gender, age, occupation, and industry, was acquired from population censuses. A Finnish job-exposure matrix supplied data on the prevalence of exposure for specific agents and the level of exposure among exposed workers. ResultsThe attributable fraction of work-related mortality in the relevant disease and age categories was estimated to be 7% (10% for men and 2% for women), and for all diseases and ages the fraction was 4%. For the main cause-of-death categories, the attributable fraction became 12% for circulatory system diseases, 8% for malignant neoplasms, 4% for respiratory system diseases, 4% for mental disorders, 3% for nervous system diseases, and 3% for accidents and violence. The following estimates were obtained for specific important diseases: 24% for lung cancer, 17% for ischemic heart disease, 12% for chronic obstructive pulmonary disease, and 11% for stroke. Based on these fractions, the total number of work-related deaths that occurred in Finland in 1996 was calculated to be on the order of 1800 (employed work force of 2.1 million); 86% involved men.Conclusions High-quality epidemiologic studies and national survey data are essential for obtaining reliable estimates of the proportion of deaths attributable to occupational factors. The magnitude of work-related mortality is an insufficiently recognized contributor to total mortality in Finland, especially from circulatory diseases and other diseases caused by exposure to agents other than asbestos.Key terms attributable fraction, burden of disease, epidemiologic methods, health statistics, occupational exposure. Global estimates of the burden of disease due to occupational factors have been calculated through the application of Finnish rates of registered work-related diseases (1). The approach is subject to the following two fundamental uncertainties: (i) the validity of the data on disease incidence from the national reporting scheme and (ii) the validity of worldwide extrapolations to different regions with different exposure circumstances. With the exception of studies using workers' compensation records, only a few research projects have estimated the magnitude of morbidity or mortality induced by exposure to hazardous agents or stress factors in the work environment at a state or national level. The investigations conducted in this area have covered New York State (2), the whole of the United States (3), Canada (4), and Australia (5). Given the lack of ...

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“…Premorbid IQ and vocabulary have proven to be strong proxies for CR, in that they are associated with slower rates of cognitive decline in normal aging and reduced risk of developing dementia (e.g., S. M. Albert & Teresi, 1999;Alexander et al, 1997;Corral, Rodríguez, Amenedo, Sánchez, & Díaz, 2006; Solé-Padullés et al, 2007). Similarly, education has been shown to impart reserve over an individual's lifetime (Evans et al, 1993;Mortel, Meyer, Herod, & Thornby, 1995; Rocca et al, 1990;Stern et al, 1994), and individuals with higher levels of education demonstrate slower cognitive and functional decline during normal aging (M. S. Albert et al, 1995;Butler, Ashford, & Snowdon, 1996;Chodosh, Reuben, Albert, & Seeman, 2002;Christensen et al, 1997;Colsher & Wallace, 1991;Farmer, Kittner, Rae, Bartko, & Regier, 1995;Lyketsos, Chen, & Anthony, 1999;Snowdon, Ostwald, & Kane, 1989). Moreover, we have successfully used IQ, vocabulary, and education as proxies for CR in previous behavioral and neuroimaging studies (e.g., Habeck et al, 2005;Scarmeas et al, 2004;Stern et al, 2005Stern et al, , 2008.…”

mentioning

confidence: 99%

The response-signal method reveals age-related changes in object working memory.

Kumar¹,

Rakitin²,

Nambisan³

et al. 2008

Psychology and Aging

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Sixteen healthy young adults (ages 18-32) and 16 healthy older adults (ages 67-81) completed a delayed response task in which they saw the following visual sequence: memory stimuli (2 abstract shapes; 3,000 ms), a blank delay (5,000 ms), a probe stimulus of variable duration (one abstract shape; 125, 250, 500, 1,000, or 2,000 ms), and a mask (500 ms). Subjects decided whether the probe stimulus matched either of the memory stimuli; they were instructed to respond during the mask, placing greater emphasis on speed than accuracy. The authors used D. L. Hintzman & T. 3-parameter compound bounded exponential model of speed-accuracy tradeoff to describe changes in discriminability associated with total processing time. Group-level analysis revealed a higher rate parameter and a higher asymptote parameter for the young adult group, but no difference across groups in x-intercept. Proxy measures of cognitive reserve (Y. Stern et al., 2005) predicted the rate parameter value, particularly in older adults. Results suggest that in working memory, aging impairs both the maximum capacity for discriminability and the rate of information accumulation, but not the temporal threshold for discriminability. Keywords working memory; aging; speed-accuracy tradeoff; cognitive reserve Healthy aging impairs human memory in general and working memory in particular (Grady & Craik, 2000). The present study seeks to characterize the specific attributes of working memory (WM) that deteriorate with age. In a delayed-response task, we used the responsesignal method to compare the tradeoff between processing time and recognition memory discriminability in young and older adults.Working memory suffers an age-related loss of both efficiency (Salthouse & Babcock, 1991) and capacity (Zacks & Hasher, 1993). Previous aging literature has extrapolated from simple measures of task performance to theorize about these broader elements of WM. Efficiency is often measured by reaction time (e.g., Anders, Fozard, & Lillyquist, 1972;Salthouse, 1992), and capacity is often described by the number of items remembered (e.g., Holtzer, Stern, & Rakitin, 2004;Oberauer, 2001). In the present study, we mathematically modeled subjects' NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript task performance to derive quantitative measures of WM retrieval dynamics. These measures characterize broad components of WM and are more directly related to the ideas of efficiency and capacity than simpler measures like reaction time. Our methodology also helps relate theories of WM and aging to the notion of individual differences in reserve against memory loss. Below, we discuss models of WM and how our experimental paradigm relates to these models and to cognitive reserve.WM consists of three distinct processes: encoding, rehearsal, and retrieval (Awh et al., 1996;Jonides, Lacey, & Nee, 2005). Neuroimaging studies have revealed differences between the neural substrates of these processes (e.g., J. R. Anderson, Qin, Jung, & Carte...

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Education and Occupation as Risk Factors for Dementias of the Alzheimer and Ischemic Vascular Types

Cited by 68 publications

References 24 publications

Cognitive function, vascular risk factors and education. A cross‐sectional study based on a cohort of 70‐year‐old men

Cognitive function, vascular risk factors and education. A cross‐sectional study based on a cohort of 70‐year‐old men

Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland

The response-signal method reveals age-related changes in object working memory.

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