Evidence map›Paper›PMID 33313373›Full record

ReviewSSM - population health2020

What does (low) education mean in terms of dementia risk? A systematic review and meta-analysis highlighting inconsistency in measuring and operationalising education.

Janet Maccora, Ruth Peters, Kaarin J Anstey

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in SSM - population health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 2 pooled it
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 90 citations in OpenAlex.

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  7. The landscape of dementia in India: Prevalence, risk factors, and opportunities ahead.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Janet MaccoraSchool of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
Ruth PetersSchool of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
Kaarin J AnsteySchool of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
Australian Research Council · AUAustralian National University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Low education is considered an important modifiable risk factor for dementia worldwide, despite the lack of a formal consensus definition of low education. The primary aim of this systematic review was to document and address the inconsistency in measuring and operationalising education in dementia studies. A secondary aim was to consider the dose of education required to reduce dementia risk. The protocol was registered at PROSPERO with registration ID CRD42018096168. CINAHL, Cochrane, PsycInfo, and Pubmed databases were searched using terms related to education, dementia and/or MCI, and incidence. Studies were eligible for inclusion if a risk ratio for education and any dementia, Alzheimer's Disease (AD), Vascular Dementia (VaD) or Mild Cognitive Impairment (MCI) was reported in a population cognitively healthy at baseline. Sample sizes for 65 studies meeting selection criteria ranged from 152 to 12,881, representing populations from 24 countries. Risk of bias, assessed using a tool designed specifically for dementia risk studies, was found to be medium or low for all studies. There were 23 continuous, 29 dichotomous, and 31 categorical operationalisations of education reported. Random effects meta-analyses from continuous operationalisations suggested each year of education reduced risk by eight percent for AD (95% CI:5-12%) and seven percent for any dementia (95% CI:6-9%). Dichotomous operationalisations indicated an increased risk for low education of 45% (95% CI:29-63%) for any dementia and 85% (95% CI:56-118%) for AD, however definitions of low education were heterogeneous, ranging from zero to 12 years. There were too few studies to produce summary ratios for VaD or MCI. We conclude that, while the evidence of an association between low education and dementia incidence is robust, inconsistency in the definition, measurement and operationalisation of education hinders the translation of this evidence into practical policy recommendations to reduce dementia risk.

Indexed as

Dementia riskDementia risk methodologyEducationModifiable risk factors for dementiaSocial determinants of dementia riskSystematic review

Identifiers

PMID33313373
PMCPMC7721642
OpenAlexW3082008956

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.