ArticleInternational journal of epidemiology2018
Does selective survival before study enrolment attenuate estimated effects of education on rate of cognitive decline in older adults? A simulation approach for quantifying survival bias in life course epidemiology.
Article in International journal of epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed.
- Risk and protective factors for cognitive decline in older adults from a nationally representative sample in India: Results from the LASI-DAD.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Hearing impairment and cognitive decline: Alternative explanations to causality.Journal of Alzheimer's disease : JAD · 2026Article
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- Methodological innovations in studying marginalized populations in research on neurodegeneration and ageing.Frontiers in aging neuroscience · 2026Review
- Age at immigration and cognitive aging in those with exceptional longevity, does timing matter? The LifeAfter90 Study.Alzheimer's & dementia. Behavior & socioeconomics of aging · 2025Article
- Robust Statistical Approaches to Understanding the Causal Effect of Air Pollution Mixtures.Research report (Health Effects Institute) · 2025Article
- Association of tailpipe-related and nontailpipe-related air pollution exposure with neuroimaging outcomes.Environmental epidemiology (Philadelphia, Pa.) · 2025Article
- Article
- Differential associations between education and blood pressure by gender and race.BMC public health · 2025Article
- Study on the age-period-cohort effects of cognitive abilities among older Chinese adults based on the cognitive reserve hypothesis.BMC geriatrics · 2024Article
- Association of Tailpipe-Related and Nontailpipe-Related Air Pollution Exposure with Cognitive Decline in the Chicago Health and Aging Project.Environmental health perspectives · 2024Article
- Mediating effects of physical activities and cognitive function on the relationship between dietary diversity and all-cause mortality in community-dwelling older adults.Journal of global health · 2024Article
- Educational inequalities in multimorbidity at older ages: a multi-generational population-based study.European journal of public health · 2024Article
- Lead exposure across the life course and age at death.The Science of the total environment · 2024Article
- Selection Bias in Health Research: Quantifying, Eliminating, or Exacerbating Health Disparities?Current epidemiology reports · 2024Article
- Lifetime occupational skill and later-life cognitive function among older adults in the United States, Mexico, India, and South Africa.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Systematic exclusion at study commencement masks earlier menopause for Black women in the Study of Women's Health Across the Nation (SWAN).International journal of epidemiology · 2023Article
- Intergenerational educational trajectories and inequalities in longevity: A population-based study of adults born before 1965 in 14 European countries.SSM - population health · 2023Article
- Estimating the Prevalence of Dementia and Mild Cognitive Impairment in the US: The 2016 Health and Retirement Study Harmonized Cognitive Assessment Protocol Project.JAMA neurology · 2022Article
- Intergenerational educational trajectories and premature mortality from chronic diseases: A registry population-based study.SSM - population health · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Background: The relationship between education and late-life cognitive decline is controversial. Selective survival between early life, when education is typically completed, and late life, when cognitive ageing studies take place, could attenuate effect estimates. Methods: We quantified potential survival bias (collider-stratification bias) in estimation of the effect of education on late-life cognitive decline by simulating hypothetical cohorts of 20-year-olds and applying cumulative mortality from US life tables. For each of four causal scenarios (2000 replications each), we compared the estimated versus causal effect of education on cognitive decline over 9 years, starting at age 60, 75 or 90 in random samples of n = 2000 people who survived to each age. Results: Effects of education on cognitive decline were underestimated when both education and U, another determinant of cognitive decline, influenced mortality (collider-stratification bias). The magnitude of bias was sensitive to the magnitude of the effect of U on cognitive decline and whether there was a multiplicative interaction between education and U on mortality. For example, when there was a multiplicative interaction between education and U on mortality, 95% confidence interval coverage of the causal effect ranged from 83.4% to 50.4% at age 60 and 25.8% to 0.2% at age 90. Conclusions: Selective survival could lead to underestimation of effects of education on late-life cognitive decline. Our simulations map survival bias to testable assumptions about underlying causal structures.
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