Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies

Annie Robitaille, Ardo van den Hout, Robson J.M. Machado, David A. Bennett, Iva Čukić, Ian J. Deary, Scott M. Hofer, Emiel O. Hoogendijk, Martijn Huisman, Boo Johansson, Andriy V. Koval, Maaike van der Noordt, Andrea M. Piccinin, Judith J.M. Rijnhart, Archana Singh-Manoux, Johan Skoog, Ingmar Skoog, John Starr, Lisa Vermunt, Sean Clouston & 1 others Graciela Muniz Terrera

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. Methods: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. Results: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. Discussion: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.

Original languageEnglish
Pages (from-to)462-472
Number of pages11
JournalAlzheimer's and Dementia
Volume14
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018

Cite this

Robitaille, Annie ; van den Hout, Ardo ; Machado, Robson J.M. ; Bennett, David A. ; Čukić, Iva ; Deary, Ian J. ; Hofer, Scott M. ; Hoogendijk, Emiel O. ; Huisman, Martijn ; Johansson, Boo ; Koval, Andriy V. ; van der Noordt, Maaike ; Piccinin, Andrea M. ; Rijnhart, Judith J.M. ; Singh-Manoux, Archana ; Skoog, Johan ; Skoog, Ingmar ; Starr, John ; Vermunt, Lisa ; Clouston, Sean ; Muniz Terrera, Graciela. / Transitions across cognitive states and death among older adults in relation to education : A multistate survival model using data from six longitudinal studies. In: Alzheimer's and Dementia. 2018 ; Vol. 14, No. 4. pp. 462-472.
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abstract = "Introduction: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. Methods: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. Results: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. Discussion: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.",
keywords = "Cognition, Dementia, Education, Life expectancy, Multistate modeling, Socioeconomic status",
author = "Annie Robitaille and {van den Hout}, Ardo and Machado, {Robson J.M.} and Bennett, {David A.} and Iva Čukić and Deary, {Ian J.} and Hofer, {Scott M.} and Hoogendijk, {Emiel O.} and Martijn Huisman and Boo Johansson and Koval, {Andriy V.} and {van der Noordt}, Maaike and Piccinin, {Andrea M.} and Rijnhart, {Judith J.M.} and Archana Singh-Manoux and Johan Skoog and Ingmar Skoog and John Starr and Lisa Vermunt and Sean Clouston and {Muniz Terrera}, Graciela",
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Robitaille, A, van den Hout, A, Machado, RJM, Bennett, DA, Čukić, I, Deary, IJ, Hofer, SM, Hoogendijk, EO, Huisman, M, Johansson, B, Koval, AV, van der Noordt, M, Piccinin, AM, Rijnhart, JJM, Singh-Manoux, A, Skoog, J, Skoog, I, Starr, J, Vermunt, L, Clouston, S & Muniz Terrera, G 2018, 'Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies' Alzheimer's and Dementia, vol. 14, no. 4, pp. 462-472. https://doi.org/10.1016/j.jalz.2017.10.003

Transitions across cognitive states and death among older adults in relation to education : A multistate survival model using data from six longitudinal studies. / Robitaille, Annie; van den Hout, Ardo; Machado, Robson J.M.; Bennett, David A.; Čukić, Iva; Deary, Ian J.; Hofer, Scott M.; Hoogendijk, Emiel O.; Huisman, Martijn; Johansson, Boo; Koval, Andriy V.; van der Noordt, Maaike; Piccinin, Andrea M.; Rijnhart, Judith J.M.; Singh-Manoux, Archana; Skoog, Johan; Skoog, Ingmar; Starr, John; Vermunt, Lisa; Clouston, Sean; Muniz Terrera, Graciela.

In: Alzheimer's and Dementia, Vol. 14, No. 4, 01.04.2018, p. 462-472.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Transitions across cognitive states and death among older adults in relation to education

T2 - A multistate survival model using data from six longitudinal studies

AU - Robitaille, Annie

AU - van den Hout, Ardo

AU - Machado, Robson J.M.

AU - Bennett, David A.

AU - Čukić, Iva

AU - Deary, Ian J.

AU - Hofer, Scott M.

AU - Hoogendijk, Emiel O.

AU - Huisman, Martijn

AU - Johansson, Boo

AU - Koval, Andriy V.

AU - van der Noordt, Maaike

AU - Piccinin, Andrea M.

AU - Rijnhart, Judith J.M.

AU - Singh-Manoux, Archana

AU - Skoog, Johan

AU - Skoog, Ingmar

AU - Starr, John

AU - Vermunt, Lisa

AU - Clouston, Sean

AU - Muniz Terrera, Graciela

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Introduction: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. Methods: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. Results: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. Discussion: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.

AB - Introduction: This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. Methods: Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. Results: Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. Discussion: This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings.

KW - Cognition

KW - Dementia

KW - Education

KW - Life expectancy

KW - Multistate modeling

KW - Socioeconomic status

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DO - 10.1016/j.jalz.2017.10.003

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EP - 472

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