Janet Maccora|Ruth Peters|Kaarin J. Anstey
What does (low) education mean in terms of dementia risk? A systematic review and meta-analysis highlighting inconsistency in measuring and operationalising education
UNSW Sydney|Neuroscience Research Australia|Australian Research Council|UNSW Sydney|Neuroscience Research Australia|Australian Research Council|UNSW Sydney|Neuroscience Research Australia|Australian National University|Australian Research Council
low education considered important modifiable risk factor dementia worldwide despite lack formal consensus definition low education primary aim systematic review document address inconsistency measuring operationalising education dementia studies secondary aim consider dose education required reduce dementia risk protocol registered prospero registration id crd42018096168 cinahl cochrane psycinfo pubmed databases searched using terms related education dementia andor mci incidence studies eligible inclusion risk ratio education dementia alzheimers disease ad vascular dementia vad mild cognitive impairment mci reported population cognitively healthy baseline sample sizes 65 studies meeting selection criteria ranged 152 12881 representing populations 24 countries risk bias assessed using tool designed specifically dementia risk studies found medium low studies 23 continuous 29 dichotomous 31 categorical operationalisations education reported random effects metaanalyses continuous operationalisations suggested year education reduced risk eight percent ad 95 ci512 seven percent dementia 95 ci69 dichotomous operationalisations indicated increased risk low education 45 95 ci2963 dementia 85 95 ci56118 ad however definitions low education heterogeneous ranging zero 12 years studies produce summary ratios vad mci conclude evidence association low education dementia incidence robust inconsistency definition measurement operationalisation education hinders translation evidence practical policy recommendations reduce dementia risk