ArticleAnnals of neurology2023
Educational Attainment and Dementia: Mediation by Mid-Life Vascular Risk Factors.
Article in Annals of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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.
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.
Who cites it
14 citing papers in PubMed, 25 citations in OpenAlex.
- [Incidence of the progression and remission of cognitive decline in older adults].Revista medica del Instituto Mexicano del Seguro Social · 2026Article
- The role of noninfectious comorbidities in the association between severe infections and risk of dementia in Finland: A nationwide registry study.PLoS medicine · 2026Article
- Association of triglyceride-glucose index (TyG) and a body shape index (ABSI) with cognitive decline and dementia risk.PloS one · 2026Article
- Impact of education level on complications and mortalities in type 2 diabetes: A UK biobank prospective cohort study.BMC public health · 2025Article
- Observational
- Investigating the role of chronic stress and perceived discrimination in racial disparities in incident dementia among U.S. older adults.Social science & medicine (1982) · 2025Article
- Mediators of educational differences in dementia risk later in life: evidence from the HUNT study.BMC public health · 2025Article
- Association of psychosocial state with subsequent risk of dementia: a prospective cohort study based on the UK Biobank.Alzheimer's research & therapy · 2024Article
- The effect of diabetes in the multifaceted relationship between education and cognitive function.BMC public health · 2024Article
- Gendered differences in the prevalence and associated factors of dementia in Ghana: a cross-sectional survey.BMC psychiatry · 2024Article
- Role of cardiovascular health factors in mediating social inequalities in the incidence of dementia in the UK: two prospective, population-based cohort studies.EClinicalMedicine · 2024Article
- Parental Education, Midlife Hypertension, and Disparities in Late-Life Cognitive Test Scores: Application of an Equity-Focused Causal Decomposition Approach.Alzheimer disease and associated disordersArticle
- Factors Associated with Cognitive Impairment among Adults of 55 Years and Older in Cameroon.Dementia and geriatric cognitive disorders extraArticle
- Mid-life cardiorespiratory fitness and risk of late-onset dementia incidence.Alzheimer's & dementia (Amsterdam, Netherlands)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 7 institutions in 2 countries.
Funding
Abstract
introductionLower education is associated with higher burden of vascular risk factors in mid-life and higher risk of dementia in late life. We aim to understand the causal mechanism through which vascular risk factors potentially mediate the relationship between education and dementia.
methodsIn a cohort of 13,368 Black and White older adults in the Atherosclerosis Risk in Communities Study, we assessed the relationship between education (grade school, high school without graduation, high school graduate or equivalent, college, graduate/professional school) and dementia among all participants and among those with incident stroke. Cox models were adjusted for age, race-center (a variable stratified by race and field center), sex, apolipoprotein E (APOE) ε4 genotype, and family history of cardiovascular disease. Causal mediation models assessed mediation by mid-life systolic blood pressure, fasting blood glucose, body mass index, and smoking.
resultsMore education was associated with 8 to 44% lower risk of dementia compared to grade school-level education in a dose-response pattern, while the relationship between education and post-stroke dementia was not statistically significant. Up to 25% of the association between education and dementia was mediated through mid-life vascular risk factors, with a smaller percentage mediated for lower levels of education.
interpretationA substantial proportion of the relationship between education and dementia was mediated through mid-life vascular risk factors. However, risk factor modification is unlikely to fully address the large educational disparities in dementia risk. Prevention efforts must also address disparities in socioeconomic resources leading to divergent early-life education and other structural determinants of mid-life vascular risk factors. ANN NEUROL 2023;94:13-26.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.