Caamaño-Isorna Francisco, Corral Montserrat, Montes-Martínez Agustín, Takkouche Bahi
Department of Public Health, Faculty of Medicine, Santiago de Compostela, Spain.
Neuroepidemiology. 2006;26(4):226-32. doi: 10.1159/000093378. Epub 2006 May 16.
Considerable controversy exists about the role of education in the risk of dementia. Individual studies have not been conclusive so far. To examine the hypothesis that lower education is associated with a higher risk of dementia, we carried out a meta-analysis. Observational studies published as of October 2005 that examined the association between education and risk of dementia were systematically reviewed. Relative risks (RRs) and odds ratios were extracted from cohort and case-control studies. We first compared the risk of dementia in subjects with high level of education with the risk of dementia in those with low educational level. In a subsequent analysis, we compared the risk of persons with high education with the risk of subjects with education level other than high (medium, low). We weighted log RRs for cohort studies or odds ratios by the inverse of their variances. Nineteen studies were included in our meta-analysis (13 cohort and 6 case-control studies). RRs for low versus high education level were: Alzheimer's disease (AD) 1.80 (95% CI: 1.43-2.27); non-AD dementias, 1.32 (95% CI: 0.92-1.88), and all dementias 1.59 (95% CI: 1.26-2.01). For low and medium versus high education level, the RRs were: AD 1.44 (95% CI: 1.24-1.67); non-AD 1.23 (95% CI: 0.94-1.61), and all dementias 1.33 (95% CI: 1.15-1.54). These results confirm that low education may be a risk factor for dementia, especially for AD.
关于教育在痴呆症风险中所起的作用存在着相当大的争议。到目前为止，个别研究尚无定论。为了检验低教育水平与较高痴呆症风险相关这一假设，我们进行了一项荟萃分析。对截至2005年10月发表的关于教育与痴呆症风险关联的观察性研究进行了系统回顾。从队列研究和病例对照研究中提取相对风险（RRs）和比值比。我们首先比较了高教育水平人群与低教育水平人群的痴呆症风险。在随后的分析中，我们比较了高学历人群与非高学历（中等、低学历）人群的风险。我们根据队列研究的对数RRs或比值比的方差倒数进行加权。我们的荟萃分析纳入了19项研究（13项队列研究和6项病例对照研究）。低教育水平与高教育水平相比的RRs为：阿尔茨海默病（AD）1.80（95%可信区间：1.43 - 2.27）；非AD痴呆症，1.32（95%可信区间：0.92 - 1.88），以及所有痴呆症1.59（95%可信区间：1.26 - 2.01）。对于低和中等教育水平与高教育水平相比，RRs为：AD 1.44（95%可信区间：1.24 - 1.67）；非AD 1.23（95%可信区间：0.94 - 1.61），以及所有痴呆症1.33（95%可信区间：1.15 - 1.54）。这些结果证实，低教育水平可能是痴呆症的一个风险因素，尤其是对于AD。
