Limited formal education is strongly associated with lower cognitive status, functional disability and frailty status in older adults

Abstract

ABSTRACT. Limited formal education is still common in ageing populations. Although limited formal education seems to be independently and negatively associated with cognition, functional abilities and frailty in ageing, no studies have examined whether the gradient of limited formal education has an impact on health in later life. Objective: to examine the relationship of limited formal education with cognitive status, functional abilities, and frailty status. Methods: a cross-sectional study was conducted involving 540 older adults stratified into groups: no formal education, 12-24 months of education, and 25-48 months of education. Cognitive screening (MMSE), functional abilities (Lawton Index), and frailty (CHS criteria) were measured. Regression analyses were performed. Results: 27% had no formal education, 21% had 12-24 months of formal education, and 55% had 25-48 months of formal education. Limited formal education has a clear gradient of negative impact: No formal education was associated with scoring below MMSE cut-off scores (OR = 7.9), being totally/partially dependent for IADLs (OR = 2.5) and frail (OR = 2.0). Having 12-24 months of education was associated with scoring below MMSE cut-off scores (OR = 5.2) and with being frail (OR = 2.0). The No formal education group was 10.1 times more likely to have worse cognitive scores, worse functional abilities and frailty/pre-frailty status concomitantly (CCoFF), while older adults who had 12-24 months of education had a 4.6 times greater chance of having CCoFF. Conclusion: limited education had a gradient association with cognitive performance, functional disability and frailty. These findings clearly emphasize the importance of prevention through education from childhood to older age.

The prevalence of cognitive frailty and pre-frailty among older people in Bangkok metropolitan area: a multicenter study of hospital-based outpatient clinics

“…Increasing age was associated with cognitive frailty/pre-frailty. This finding was similar to the evidence of Rivan et al and Brigola et al[ 37 , 38 ]. The mean age in the current study was very similar to those for the Rivan et al study and the Brigola et al study.…”

“…Our study found that a low educational level was associated with the cognitive frailty/pre-frailty participants. This result is comparable with that of the work by Brigola et al 38 . The strengths of the association in both our work and that of Brigola et al were high.…”

The Role of Socio-Economic Inequality in Physical Immobility Among Older Adults: Did the Scenario Changed from 2004-05 to 2017-18?

“…Results noticed education as a safety net against the physical immobility among older adults. Higher physical immobility among illiterate's older adults has been found in several previous studies (31,47). Results also noticed that living arrangements impact physical immobility.…”

Accuracy of the semantic fluency test to separate healthy old people from patients with Alzheimer’s disease in a low education population

“…In the present study, stronger correlations were observed between VF and Lawton, especially in the supermarket category. This is expected, considering the association between cognition and education with instrumental activities of daily living (IADL) 26,27 . Indeed, dementia is the leading cause of functional dependence in the elderly and IADL refers to the individual's ability to organize and plan in the environment, be it at home or at the wider community.…”