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  1. Education and incident Alzheimer's disease : a biased association due to selective attrition and use of a two-step diagnostic procedure ?

    Article - En anglais

    Background It is still not clear whether a low level of education increases the risk of developing Alzheimer's disease (AD).

    Two common problems in cohort studies involving an elderly population and a two-step diagnostic procedure are the loss to follow-up without data on the presence of AD, and the fact that, in general, people with higher levels of education perform better on traditional cognitive tests, such as the Mini-Mental State Examination (MMSE).

    Both phenomena may lead to misclassification, resulting in a biased association between level of education and AD.

    This study investigated to what extent these selection mechanisms may influence this association.

    Methods In the community-based Amsterdam Study of the Elderly (AMSTEL) a cohort at risk for AD was selected of 3778 people aged 65-84 years.

    Level of education was expressed in two categories : low (primary education or less) versus high (partial secondary education to completed university education).

    At follow-up, a sub-sample of elderly people was selected for further diagnostic evaluation, using a memory test in addition to the MMSE.

    Clinical diagnoses of AD were made according to DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) criteria.

    To examine the extent to which loss to follow-up may have affected the results, a sensitivity analysis was performed comparing two extreme possibilities. (...)

    Mots-clés Pascal : Démence Alzheimer, Niveau étude, Epidémiologie, Incidence, Facteur risque, Personne âgée, Homme, Pays Bas, Europe, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Maladie dégénérative

    Mots-clés Pascal anglais : Alzheimer disease, Education level, Epidemiology, Incidence, Risk factor, Elderly, Human, Netherlands, Europe, Nervous system diseases, Central nervous system disease, Cerebral disorder, Degenerative disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0339987

    Code Inist : 002B17G. Création : 14/12/1999.