Walters Ellen E, Luczak Susan E, Beam Christopher R, Ericsson Malin, Kremen William S, Krueger Robert F, Markon Kristian E, McGue Matt, Nygaard Marianne, Panizzon Matthew S, Plassman Brenda L, Reynolds Chandra A, Sachdev Perminder S, Thalamuthu Anbu, Whitfield Keith E, Pedersen Nancy L, Gatz Margaret
Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA, 90089-3332, USA.
Department of Psychology, University of Southern California, Los Angeles, CA, 90089, USA.
Eur J Epidemiol. 2025 Aug 12. doi: 10.1007/s10654-025-01286-x.
Low educational attainment is recognized as a modifiable risk factor for dementia. Despite the commonly accepted notion that greater educational attainment confers lower dementia risk, few family-based studies have investigated the causal bases for the association. Using data from seven twin samples from Sweden, Denmark, Australia, and the US participating in the IGEMS (Interplay of Genes and Environment in Multiple Studies) consortium (N = 60,027, 10.92% with dementia), we tested whether twins who achieve higher education than their co-twins have lower risk of dementia. The primary analysis applied a multilevel between-within regression framework, supported by descriptive statistics of within-pair differences. Results confirmed an overall association between educational attainment and dementia risk, such that individuals with higher educational attainment had less likelihood of developing dementia (phenotypic regression coefficient = -0.68, p <.0001). Within twin pairs, however, twins who achieved greater education than their co-twins did not uniformly show lower dementia risk (within-family regression coefficient = -0.07, p =.0983, while between-family regression coefficient = -0.98, p <.0001). Taken together, the pattern of results shows that the effect of educational attainment on dementia risk is largely attributable to genetic influences in common to educational attainment and dementia, although there are also contributions from environmental influences shared between members of the same family. Results were similar in men and women. These findings add to the literature by using a co-twin control design to address possible reasons that low educational attainment is associated with greater dementia risk.
低教育程度被认为是痴呆症的一个可改变的风险因素。尽管人们普遍认为教育程度越高，患痴呆症的风险越低，但很少有基于家庭的研究调查这种关联的因果基础。我们利用来自瑞典、丹麦、澳大利亚和美国的七个双胞胎样本的数据，这些样本参与了IGEMS（多研究中的基因与环境相互作用）联盟（N = 60,027，10.92%患有痴呆症），测试了接受高等教育的双胞胎是否比其同卵双胞胎患痴呆症的风险更低。主要分析采用了多层次组内组间回归框架，并辅以配对差异的描述性统计。结果证实了教育程度与痴呆症风险之间的总体关联，即教育程度较高的个体患痴呆症的可能性较小（表型回归系数 = -0.68，p <.0001）。然而，在双胞胎对中，接受教育程度高于其同卵双胞胎的双胞胎并不都表现出较低的痴呆症风险（家庭内回归系数 = -0.07，p =.0983，而家庭间回归系数 = -0.98，p <.0001）。综合来看，结果模式表明，教育程度对痴呆症风险的影响在很大程度上归因于教育程度和痴呆症共有的遗传影响，尽管同一家庭成员之间共享的环境影响也有作用。男性和女性的结果相似。这些发现通过使用同卵双胞胎对照设计来探讨低教育程度与较高痴呆症风险相关的可能原因，为文献增添了内容。
