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Impact of differential attrition on the association of education with cognitive change over 20 years of follow-up: the ARIC neurocognitive study.

TitleImpact of differential attrition on the association of education with cognitive change over 20 years of follow-up: the ARIC neurocognitive study.
Publication TypeJournal Article
Year of Publication2014
AuthorsGottesman RF, Rawlings AM, Sharrett ARichey, Albert M, Alonso A, Bandeen-Roche K, Coker LH, Coresh JJ, Couper DJ, Griswold ME, Heiss G, Knopman DS, Patel MD, Penman AD, Power MC, Selnes OA, Schneider ALC, Wagenknecht LE, B Windham G, Wruck LM
Secondary AuthorsMosley TH
JournalAm J Epidemiol
Volume179
Issue8
Pagination956-66
Date Published2014 Apr 15
ISSN1476-6256
KeywordsAged, Aged, 80 and over, Cognition Disorders, Educational Status, Female, Follow-Up Studies, Humans, Linear Models, Male, Middle Aged, Models, Statistical, Neuropsychological Tests, Patient Dropouts, Risk Factors, Time Factors
Abstract

Studies of long-term cognitive change should account for the potential effects of education on the outcome, since some studies have demonstrated an association of education with dementia risk. Evaluating cognitive change is more ideal than evaluating cognitive performance at a single time point, because it should be less susceptible to confounding. In this analysis of 14,020 persons from a US cohort study, the Atherosclerosis Risk in Communities (ARIC) Study, we measured change in performance on 3 cognitive tests over a 20-year period, from ages 48-67 years (1990-1992) through ages 70-89 years (2011-2013). Generalized estimating equations were used to evaluate the association between education and cognitive change in unweighted adjusted models, in models incorporating inverse probability of attrition weighting, and in models using cognitive scores imputed from the Telephone Interview for Cognitive Status for participants not examined in person. Education did not have a strong relationship with change in cognitive test performance, although the rate of decline was somewhat slower among persons with lower levels of education. Methods used to account for selective dropout only marginally changed these observed associations. Future studies of risk factors for cognitive impairment should focus on cognitive change, when possible, to allow for reduction of confounding by social or cultural factors.

DOI10.1093/aje/kwu020
Alternate JournalAm J Epidemiol
PubMed ID24627572
PubMed Central IDPMC3966720
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HL096899 / HL / NHLBI NIH HHS / United States
U01 HL096812 / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
T32 AG027668 / AG / NIA NIH HHS / United States
HL096902 / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
UL1 TR001079 / TR / NCATS NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HL096917 / HL / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
R01-HL70825 / HL / NHLBI NIH HHS / United States
HL096814 / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
R01 HL070825 / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
T32 HL007055 / HL / NHLBI NIH HHS / United States