Andrus Gerontology Center, University of Southern California, Los Angeles, California.
Population Research Institute, Nihon University, Tokyo, Japan.
J Gerontol B Psychol Sci Soc Sci. 2018 Apr 16;73(suppl_1):S20-S28. doi: 10.1093/geronb/gbx135.
This article provides the first estimates of educational differences in age-specific prevalence, and changes in prevalence over time, of dementia by education levels in the United States. It also provides information on life expectancy, and changes in life expectancy, with dementia and cognitively healthy life for educational groups.
Data on cognition from the 2000 and 2010 Health and Retirement Study are used to classify respondents as having dementia, cognitive impairment without dementia (CIND), or being cognitively intact. Vital statistics data are used to estimate life tables for education groups and the Sullivan method is used to estimate life expectancy by cognitive state.
People with more education have lower prevalence of dementia, more years of cognitively healthy life, and fewer years with dementia. Years spent in good cognition increased for most sex-education groups and, conversely, years spent with dementia decreased for some. Mortality reduction was the most important factor in increasing cognitively healthy life. Change in the distribution of educational attainment has played a major role in the reduction of life with dementia in the overall population.
Differences in the burden of cognitive loss by education point to the significant cost of low social status both to individuals and to society.
本文首次估计了美国不同教育程度人群在特定年龄的痴呆症患病率及其随时间的变化情况。同时，本文还提供了有关各教育群体的痴呆症和认知健康寿命的预期寿命及其变化情况的信息。
利用 2000 年和 2010 年健康与退休研究的数据，对认知功能进行分类，将受访者分为痴呆症、无痴呆认知障碍（CIND）或认知功能完整者。利用生命统计数据为教育群体估计生命表，利用沙利文法根据认知状态估计预期寿命。
受教育程度较高的人群痴呆症患病率较低、认知健康寿命较长、患痴呆症的时间较短。大多数男女教育群体的良好认知年限增加，而某些群体的痴呆年限减少。降低死亡率是增加认知健康寿命的最重要因素。受教育程度分布的变化在降低总体人群的痴呆症负担方面发挥了重要作用。
不同教育程度的认知损失负担存在差异，这表明社会地位低下对个人和社会都造成了巨大的代价。
